Dextromethorphan (DXM) is a common ingredient found in many cough and cold remedies. It helps stop a cough. Used as directed, DXM products are safe and effective. But DXM has become popular among teenagers who want a cheap, easy high.
DXM was approved by the FDA in 1958. You can find it in at least 70 over-the-counter (OTC) products. These include:
Alka-Seltzer Plus Cold & Cough Medicine
Coricidin Cough and Cold Tablets
Robitussin cough products
Triaminic cough syrups
Tylenol Cold products
Vicks NyQuil LiquiCaps
DXM has no serious side effects when used in small doses. When taken in larger amounts, it can distort awareness and alter time perception. It can also cause hallucinations.
Cold medicines with DXM also contain other ingredients that can be harmful in large amounts. These include acetaminophen or decongestants. Combining high doses of DXM with alcohol is very unsafe, too. It can lead to death.
Cough syrup abuse has been a problem for decades. But the concern in the past had been about the alcohol and codeine in cough and cold products. Because of that, the alcohol has been removed from most OTC cough and cold remedies. State laws also restrict the sale of products that contain codeine.
DXM seemed a good substitute to codeine and alcohol. It had few, if any, side effects, when used as directed. And a larger amount of DXM—drinking several bottles of cough syrup at 1 time, for instance—would cause vomiting.
Today, teens have alternatives to drinking the syrup, though. DXM is available in powder, capsule, and pill forms. You can find it on the Internet. These forms can be swallowed or snorted. Some websites even tell users how to extract DXM from cough syrup. They also advise users how much DXM to take to get high. Illicit users may take 240 mg to 1,500 mg of DXM at a time.
Slang terms for DXM include the following:
Poor Man's Ecstasy
The effects of DXM have been compared to PCP and the anesthetic ketamine. All 3 are called dissociative substances. At high doses, they give the abuser a feeling of not being in one's own body. DXM also causes hallucinations. The effects can last up to 6 hours. But that can vary. It depends on how much DXM is taken and what other drugs or chemicals are taken along with it.
Other effects of DXM include:
Nausea, vomiting, and dizziness
Lack of coordination
Panic attack or seizures
Lethargy or drowsiness—or hyperactivity
High blood pressure
Rapid eye movement
Racing or pounding heartbeat
Paranoia and hallucinations
Feeling of floating
Regular abuse of DXM at high doses can lead to a chemical psychosis. That’s when a person loses contact with reality. He or she may need to be hospitalized. The person may also need to take medicine.
As a parent, you should warn your children about the dangers of abusing OTC drugs. Some teens believe that OTC drugs are safer to abuse because they are legal.
Here are other suggestions:
Monitor the OTC drugs in your home. Keep track of how much medicine is in each bottle.
Don't buy extra OTC drugs to "stock up."
Don't allow your children to keep OTC drugs in their bedroom, backpack, or school locker.
Monitor your children's Internet use, keeping an eye out for websites visited that discuss OTC or other drug abuse.
Use OTC and prescription medicines responsibly yourself.