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Dextromethorphan is a cough suppressant commonly found in over-the-counter allergy, cold, and flu medications. At present, this medication can be found in over 120 OTC drugs. At the recommended doses on bottles or pill boxes, dextromethorphan – often abbreviated to DXM – is perfectly safe to use. The medication mildly suppresses areas of the brain that control coughing. The drug can also act as an expectorant, helping to break up congestion, and provide temporary relief for runny nose, watering eyes, and sinus congestion. Many medications with DXM also have acetaminophen, which is a common pain reliever.Because DXM is legal and not as tightly controlled as prescription medications or illegal drugs, many people abuse cough medications at very large doses in order to get high. At large doses, DXM can have hallucinatory and euphoric effects, but it can also be very dangerous.
What Are the Risks of Abusing DXM?
Risks associated with DXM abuse are outlined below.
First plateau (100-200 mg): mild intoxication and stimulation
Second plateau (200-400 mg): euphoria and hallucinations (auditory, visual, and tactile)
Third plateau (300-600 mg): loss of motor coordination, distortion of vision, or impaired vision
Fourth plateau (500-1500 mg): dissociative sedation
Fifth plateau or sigma (1500-3000 mg): longer-lasting dissociative sedation, greatly increased chance of overdose symptoms
Hallucinations begin early at the second plateau and continue through until the individual is too sedated to react. Paranoia and delusions can occur concurrently with hallucinations, leading the person to believe that they are being spied on, chased, surrounded by danger or evil, or able to perform actions that they cannot (like flying). Violent thoughts and tendencies can occur at this point, leading the person to harm themselves or those around them. These incidents will increase in severity if the person continues to consume DXM.
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Dextromethorphan continues to be an over-the-counter medication, although it has shown some potential for addiction and a high potential for abuse. It is important to get help as soon as possible for DXM addition or abuse problems. Medically monitored detox, individual and group therapy, and social support are extremely important elements of any rehabilitation program.