Dextromethorphan (DXM) is a common ingredient found in many over-the-counter cough and cold medicines. While generally safe when taken as directed, DXM abuse can lead to serious health consequences, including addiction. Abusing substances like DXM can alter the brain’s pleasure response by temporarily boosting dopamine levels in the central nervous system. DXM can also elevate blood pressure and heart rate.
Young people are particularly vulnerable to the negative impacts of DXM abuse, as the brain regions responsible for reward processing, willpower, emotional regulation, and decision-making are still developing. The Substance Abuse and Mental Health Services Administration (SAMHSA) highlights the risks in their findings. The National Survey on Drug Use and Health (NSDUH) indicates that a significant percentage of adults aged 18 and older struggling with illicit drug or alcohol abuse started abusing substances, like alcohol or marijuana, before the age of 15. Even a single instance of DXM abuse can have adverse effects, and repeated abuse significantly increases the risk.
Risks and Dangers of DXM Misuse
Two of the most significant dangers of DXM abuse are the potential for a life-threatening overdose and the development of addiction. An overdose occurs when the drug reaches toxic levels in the bloodstream, overwhelming the body’s ability to metabolize it. This can lead to severe health problems or even death.
Symptoms of a DXM overdose may include:
- Nausea and vomiting
- Nystagmus (involuntary eye movement)
- Dizziness
- Dilated pupils
- Breathing difficulties
- Bluish tint to fingernails or lips
- Hallucinations
- Ataxia (loss of muscle control)
- Blurred vision
- Hypertension
- Rapid heart rate
- Fever
- Rash or itchy skin
- Drowsiness
- Hot and cold flashes
- Muscle spasms
- Headache
- Constipation or diarrhea
- Urinary retention
- Seizures
The National Capital Poison Center (NCPC) reports that DXM abuse results in approximately 6,000 emergency department visits annually, with half of these involving individuals between 12 and 25 years old.
DXM abuse is inherently risky, and the dangers are amplified when combined with other substances. Mixing DXM with other drugs or alcohol significantly increases the likelihood of adverse reactions and life-threatening overdoses. Furthermore, products containing DXM may also contain other ingredients, such as acetaminophen, a pain reliever that can cause liver damage with regular use. Individuals with pre-existing mental health conditions may also experience a worsening of their symptoms due to DXM abuse.
DXM Dependence and Addiction
Long-term DXM abuse can lead to dependence and addiction. Individuals who compulsively use large quantities of DXM cough syrup to achieve the desired effects may spend a considerable amount of time seeking, using, and recovering from the drug. They may lose control over the amount and duration of their drug use.
DXM use can replace other important activities. Common indicators of addiction include social withdrawal, erratic behavior, mood swings, increased secrecy, denial of a problem, lack of interest in previously enjoyed activities, declining grades or work performance, increased risk-taking behaviors, and unreliability in fulfilling obligations.
Changes in physical appearance, such as weight gain or loss, neglect of personal hygiene, and altered sleep and eating patterns, can also be signs of DXM addiction or addiction to other substances if the person is mixing DXM with other drugs.
DXM Addiction Recovery
Because addiction affects individuals differently, treatment approaches must be tailored to meet specific needs. As a dissociative drug, initial treatment for DXM addiction often involves medical detox. During detox, medications may be administered to alleviate withdrawal symptoms and address potential medical complications. Individuals with a history of heavy DXM use, a family history of substance abuse or addiction, co-occurring mental health disorders, or abuse of other substances may benefit significantly from medical detox due to a higher risk of severe dependence.
Once physical stabilization is achieved, the psychological aspects of addiction and substance abuse can be addressed. Treatment options for DXM abuse or addiction include both residential and outpatient programs.
Both outpatient and inpatient drug rehab programs offer individual and group therapy sessions, counseling, support group meetings, educational opportunities, life skills training, and alternative or holistic therapies. Behavioral therapies are used to understand the root causes of substance abuse and help individuals make positive changes to sustain recovery. Peer groups and 12-step programs provide a supportive network that extends throughout the recovery journey. Numerous options exist for treating DXM abuse and addiction, and trained professionals can assist families and loved ones in selecting the optimal level of care for a healthy and fulfilling future.
Recovery is attainable.
