Dextromethorphan (DXM) is a drug found in dozens of over-the-counter medications to treat the common cold. It temporarily relieves cough caused by the common cold, flu, or other conditions, speeding up recovery.
Unfortunately, DXM can also be abused as a psychoactive drug if taken excessively or too frequently, increasing the risk of addiction to it. DXM abuse in teenagers has been rising in the U.S. Yet, unlike marijuana or ketamine, DXM is not a controlled substance.
In this article, we’ll explore the dangers of DXM when consumed recreationally or excessively.
3 Things To Know About Dextromethorphan (DXM) Withdrawal
When misused, DXM, also known as CCC, dex, rojo, Skittles, and velvet, can lead to dependence and addiction.
- Acute Symptoms Happen Fast
Acute withdrawal is the initial phase of withdrawal syndrome. It occurs immediately after the body stops receiving a drug it has become dependent on, causing painful and uncomfortable symptoms.
Because DXM addiction is relatively rare, there aren’t many studies to provide a timeline for withdrawal, but the acute period may last approximately 4 weeks.
The most common acute symptoms of the first two weeks may include the following:
- Major depression, anxiety, and irritability
- Strong cravings for DXM
- Sweating, tremors, chills, higher sensitivity to cold, and fatigue
- Insomnia
- Muscle pain and spasms
- Stomach cramps, vomiting, and diarrhea
- Increased heart rate and elevated blood pressure
During weeks 3 and 4, the most common symptoms are:
- Milder depression and anxiety
- Cravings for DXM
- Mild fatigue and insomnia
- Mild irritability
As withdrawal syndrome progresses and the patient receives appropriate medical attention, the symptoms will become progressively milder until the acute phase is over. Again, the timeline will be different for everyone, but this is the general outline of what most people experience.
- You Can Experience Post-Acute Symptoms
The post-acute phase is a longer-lasting but less intense addiction recovery stage. It may last weeks, months, or even years in some cases. Symptoms are primarily psychological, like depression, anxiety, and craving, but may also include fatigue and lethargy. Some patients may also suffer from suicidal ideation.
For long-term recovery, patients should seek psychiatric and therapeutic care.
- Genes Play A Large Role In DXM Withdrawal Syndrome
As mentioned before, individual differences play a significant role in the severity and length of DXM withdrawal syndrome. Many of these differences come down to genetic expression and can be observed in withdrawal syndromes for other drugs, not just DXM.
A drug’s half-life is the time it takes for the amount of a drug in your body to be reduced by half. DXM’s half-life lasts around 3 hours, but it may last as long as 6 hours in certain people.
Weight, gender, and other health-related factors might influence how long DXM remains in someone’s system.
For certain people, especially those of northern European heritage, DXM’s half-life may last up to 30 hours.
What Are The Dangers Of Dextromethorphan (DXM)?
DXM became popular after codeine became a prescription drug. Codeine is an opioid that can act as an antitussive, analgesic, and sedative.
DXM was seen as safer and, to this day, remains a non-controlled substance (you don’t need a prescription to get it), but it can still cause addiction if taken in ways other than recommended by medical professionals. It is recognized as a drug of abuse due to its effects at high doses.
In a high enough dose, DXM use acts similarly to marijuana, ketamine, or PCP intoxication. It may cause euphoria and visual and auditory hallucinations. When combined with other drugs or alcohol, DXM could potentially cause life-threatening overdoses.
How Much Dextromethorphan (DXM) is Safe?
The safe dose depends on several factors, such as age, the presentation of the medicine (pill, syrup, etc.), the time between doses, and others. Regardless of the form, DXM use is not recommended for children younger than four. Always consult a physician before you being using DXM or any other medications.
- For pills, the safe dose ranges between 5 and 15mg, taken every 2 to 6 hours, depending on the exact DXM concentration age.
- For the syrup, the safe dose ranges between 3.5 and 30mg, taken every 4 to 8 hours, depending on the exact DXM concentration and age.
- For oral suspension, the safe dose ranges between 15 and 60mg for extended-release oral suspension, taken every 12 hours. The dose depends on the age.
When used recreationally, doses may by far exceed the safe limits. Overdoses are more likely to occur when consuming 1500mg or more.
On rare occasions, people may have trouble processing DXM and suffer overdose symptoms when consuming doses that would be safer for most other people their age, gender, and size. These people should take smaller doses determined by their physicians.
Bottom Line
DXM is an effective antitussive present in dozens of medications. However, when taken in excessive doses, it may have psychoactive effects similar to marijuana or ketamine. It is habit-forming if taken outside medical parameters and may cause overdoses in doses higher than 1500mg, with potentially fatal consequences.
After DXM use is interrupted, people will suffer from acute withdrawal syndrome for several weeks or longer, followed by post-acute syndrome for weeks, months, or even years.
If you or someone you know is addicted to DXM, seek help by visiting a general practitioner and explaining your addiction symptoms. They will direct you to more specialized treatment to help you overcome withdrawal and form healthy habits for long-term sobriety.
Laurel McGinnis
Brie Rodriguez
CORI BAIZA
JOHN GAU
MARK GUDIM
Jeffrey M. Bishop, D.O.
AMANDA MARINELLI, DNP, BBA, AG NP-BC, PMHNP-BC, CARN-AP
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