Dextromethorphan (DXM) Addiction and Treatment Options

Dextromethorphan is an antitussive, or cough suppressant drug found in several over-the-counter (OTC) medications. It is an active component of several cough syrups and other cold and cough combination medications; however, it is also sometimes misused at high doses for its dissociative effects.1

This page will discuss in detail what dextromethorphan is, the side effects of using this substance, potential signs of a DXM-related substance use disorder, as well as various addiction treatment options.1

What is Dextromethorphan (DXM)?

Dextromethorphan, or DXM for short, is a cough suppressant widely available in various cold and cough medications. Its prevalent misuse among teens and young adults may be motivated, in part, due to its availability as an OTC medication.1

Common sources of misused DXM include “extra-strength” medications available as cough syrups, gel capsules, or tablet formulations:2

DXM Misuse

Illicit use of DXM may include taking the medication:2

  • For non-medical reasons (i.e., to get high).
  • In combination with other substances for combined intoxication.
  • Using DXM in ways other than instructed on the packaging. This might include taking higher than therapeutic doses, attempting to inject DXM, or mixing cough syrup with soda and drinking it—which is sometimes referred to as “robotripping” or “skittling.”

DXM is often misused by using it in conjunction with other substances, like alcohol and marijuana.2

Effects & Risks of DXM Misuse

DXM can have a variety of short-term effects. Some effects may be similar to alcohol intoxication, while others may seem more comparable to the effects of marijuana use.2

When DXM is taken in high doses, the drug has sedating and perception-distorting effects similar to the dissociative drugs phencyclidine (PCP) and ketamine.1

In high doses, DXM misuse may cause: 2,3

  • Excitability or loss of energy.
  • Anxiety and panic.
  • Hallucinations.
  • Paranoia.
  • Increased pulse and blood pressure.
  • Increased body temperature.
  • Sweating.
  • Altered mental status.
  • Slurred speech.

Can You Overdose on DXM?

Even though dextromethorphan can be purchased without a prescription, it is still possible to overdose on the drug. If you take enough DXM, you might experience life-threatening toxicity.2

The following signs may indicate DXM overdose toxicity:1,2,3

  • Muscular rigidity.
  • Respiratory depression or arrest.
  • Loss of motor coordination.
  • Seizures.
  • Coma.

DXM overdose toxicity is a medical emergency and may require immediate medical attention.

Dextromethorphan Addiction

DXM addiction—or a substance use disorder involving compulsive DXM misuse—is a medical condition characterized by the continued use of DXM despite clinically significant negative effects on someone’s life. Some of the criteria medical professionals might look for when assessing for compulsive or problematic DXM use include:4

  • DXM is taken in higher doses or for longer than intended.
  • A lot of time is spent trying to get DXM, use the drug, or recover from its effects.
  • DXM use leads to the inability to meet obligations at work, school, or home.
  • Continued DXM use despite having repeated social or interpersonal problems caused or worsened by the drug.
  • Skipping important work, social, or recreational activities to use DXM.
  • Misusing DXM in hazardous situations, such as driving.
  • DXM misuse is continued even after knowing a person has a persistent or recurring physical or psychological problem that is likely to have been caused or made worse by DXM misuse.

Dextromethorphan Withdrawal

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does not include the phenomenon of withdrawal as a diagnostic criterion for DXM or other dissociative or hallucinogen use disorders. However, a relatively mild withdrawal syndrome has been described in certain case reports.

One 2014 case study, published in Anesthesiology and Pain Medicine, included a description of self-reported depressed mood and fatigue in a patient shortly after ceasing DXM after prolonged use .5 Discussion

Another study published in 2010 reported on a case where one patient experienced sleep disturbances, nausea, and excessive perspiration when trying to wean himself off the drug. Later that same patient experienced cravings, nausea, high blood pressure, and rapid heart rate during a stay in an inpatient detoxification facility.6

Dextromethorphan Addiction Treatment

Research shows that evidence-based treatment approaches like behavioral therapy, peer support, psychoeducation, and treatment for co-occurring disorders can help someone achieve long-term recovery from DXM addiction.7

Sunrise House Treatment Center offers a few levels of addiction treatment, including:

Our helpful admissions navigators at make the treatment admissions process easy. Whether you are paying for addiction treatment out of pocket or using insurance coverage for rehab, our navigators will help you find the best way to cover your treatment.

Sunrise House’s inpatient rehab in New Jersey provides effective, evidence-based treatment approaches that can help you or your loved one get sober and remain in long-term recovery. Verify insurance coverage now using the confidential .

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