Dextromethorphan (DXM) is a cough suppressant found in more than 100 over-the-counter cold medications. DXM is either found alone or in combination with other drugs such as analgesics (e.g., acetaminophen), antihistamines (e.g., chlorpheniramine), decongestants (e.g., pseudoephedrine), and/or expectorants (e.g., guaifenesin). The typical adult dose for cough relief is 15 to 30 mg taken three to four times daily. The cough-suppressing effects of DXM persist for 5 to 6 hours after ingestion. When taken as directed, side-effects are rare. DXM comes in a few different forms: cough syrup, tablets, capsules or powder. Illicit use of DXM is referred to on the street as “Robotripping,” “skittling,” or “dexing.” The first two terms are derived from the products that are most commonly abused, Robitussin and Coricidin HBP.

DXM is abused by individuals of all ages, but its abuse by teenagers and young adults is of particular concern. This abuse is fueled by DXM’s OTC availability and extensive “how to” abuse information on various web sites. OTC products that contain DXM often contain other ingredients such as acetaminophen, chlorpheniramine, and guaifenesin that have their own effects, such as: liver damage, rapid heart rate, lack of coordination, vomiting, seizures and coma. To circumvent the many side effects associated with these other ingredients and to just consume pure DXM; a simple chemical extraction procedure has been developed and published on the Internet that removes most of these other ingredients in cough syrup.

DXM abuse has traditionally involved drinking large volumes of the OTC liquid cough preparations. However, abuse of the tablet, gel capsule and powder preparations have been on the rise recently. These new high-dose DXM products have a particular appeal for abusers. They are much easier to consume, eliminate the need to drink large volumes of unpleasant-tasting syrup and are easy to transport/conceal. These new products allow an abuser to continue use throughout the day with ease. The powdered form of DXM poses additional risks to the abuser due to the uncertainty of composition and dose. In addition to the OTC pills there are illicitly manufactured tablets containing pure DXM or mixed with other drugs such as pseudoephedrine and/ or methamphetamine.

People who abuse DXM take high doses to experience euphoria, visual and auditory hallucinations. Abusers take various amounts depending on their body weight and the effect they are attempting to achieve. Sometimes individuals ingest 250 to 1,500 milligrams in a single dosage, far more than the recommended therapeutic dosages described above. Abusers of DXM describe the following four dose-dependent “plateaus.” Behavioral effects for the dose-dependent plateaus: 100-200mg mild stimulation is experienced, 200-400mg euphoria and hallucinations appear, 300-600mg distorted visual perceptions and loss of motor coordination, 500-1500mg result in out-of-body sensations.

A few of the more prevalent physical side effects of DXM abuse are; over-excitability, lethargy, loss of coordination, slurred speech, sweating, hypertension and involuntary spasmodic movement of the eyeballs. Some of the many psychoactive effects associated with high-dose DXM use include confusion, inappropriate laughter, agitation, paranoia and hallucinations. Long-term abuse of DXM is associated with severe psychological dependence.

Approximately 5-10% of the Caucasian population are poor DXM metabolizers and are at increased risk for overdoses and deaths. Abusing high doses of DXM in combination with alcohol or other drugs is particularly dangerous and many deaths have been reported. When DXM is combined with antidepressants the combination is life threatening. DXM overdose can be treated in an emergency room setting and generally does not result in severe medical consequences or death. Most DXM-related deaths are caused by ingesting the drug in combination with other drugs. DXM-related deaths also occur from impairment of the senses which can lead to accidents. DXM is a legally marketed cough suppressant that is neither a controlled substance nor a regulated chemical under the Controlled Substances Act.

Street names of DXM include: CCC, Dex, DXM, Poor Man’s PCP, Robo, Rojo, Skittles, Triple C and Velvet. Drugs that cause similar effects include: Depending on the dose, DXM can have effects similar to marijuana or Ecstasy. In high doses its out-of-body effects are similar to those of Ketamine or PCP.

If you or someone you love has a problem with DXM, call our professionals at Sobriety Resources (855)289-2640 today to experience the freedom of sobriety.

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