Cough Medicine Abuse: Dextromethorphan

Dextromethorphan (DXM), a cough suppressant, is found in at least 70 over-the-counter (OTC) products, including Robitussin DM, Alka-Seltzer Plus Cold & Cough Medicine, Tylenol Cold products and Vicks NyQuil LiquiCaps.

While DXM products are effective at suppressing a cough and are safe to use, when taken in excessive amounts — or even at the prescribed amount in some individuals — they can produce feelings of drowsiness and relaxation. Many users have likened this feeling to the effects marijuana has on the body. An individual will feel their body begin to slow and feel more at ease while the brain acts at a reduced capacity. For example, when Robitussin is taken as more than the prescribed amount, it becomes the equivalent of a hallucinogenic drug such as LSD.

The combination of high doses of DXM with alcohol is especially dangerous and can even lead to death. In addition, cold medicines that contain DXM also contain acetaminophen or decongestants, which are also dangerous if taken in large quantities.

Individuals can abuse cough medicine or even form an addiction to it.

Abuses of DXM Cough Syrup

DXM cough syrup actually has a high potential for abuse simply due to the ease of acquisition (it is an over-the-counter medication) and its low cost.

In addition, the cough syrup is easy to administer, providing the desired effect very quickly. Teenagers and young adults present the greatest concern for abuse. The internet is increasingly home to extensive “how to” abuse information on a number of different websites.

Those individuals who are abusing cough syrup have reported a heightened sense of perceptual awareness, altered time perception and visual hallucinations. Those who are abusing it tend to display:

  • Hyper-excitability
  • Lethargy
  • Ataxia
  • Slurred speech
  • Sweating
  • Hypertension
  • Nystagmus

While abuse of cough syrup is not necessarily considered to be common, the dextromethorphan drug is increasingly being abused in tablets and gel capsules.

Side Effects

Side effects of this drug can occur as allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. More serious side effects include severe dizziness, anxiety, restless feeling, or nervousness; confusion, hallucinations; or slow, shallow breathing.


While it may be difficult to believe considering the taste, some individuals do take to consuming too much cough syrup and can develop and addiction. Much like that of narcotic drugs or prescription medications, if a person develops a dependence on DXM cough syrup, problems arise in cessation. If the individual stops taking the cough syrup abruptly, he or she can experience withdrawal symptoms.

Any and all of the following symptoms can occur in withdrawal:

  • Restlessness
  • Muscle aches
  • Bone aches
  • Insomnia
  • Diarrhea
  • Vomiting
  • Cold flashes

Treatment of Abuse and Addiction

No matter what the reasons for starting to take DXM cough syrup, an individual can develop a dependence and an addiction if the drug is taken too long or in too high of doses. The withdrawal process has the ability to be life-threatening if not properly monitored. As a result, it is important that those with an addiction seek the help they need to stop taking the drug and to learn how to function normally without it.

Detoxification is required to cleanse the body of this drug and must be done under the care of a board-certified physician and a board-certified psychiatrist. A quality treatment center will recommend a comfortable detox using withdrawal medications specific to the abuse of the dextromethorphan drug. A full physical on a person is required to determine the right medications for comfortable detox. This method helps to correct the chemical imbalances and should be combined with psychological evaluations and other medical care.

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One Response to Cough Medicine Abuse: Dextromethorphan

  1. Tisha Grau April 1, 2015 at 5:53 am #

    Tisha Grau My husband was addicted to DXM for 8 years. Is destroyed his last marriage, any relationship with his 8 children, it took his high paying career in graphic design, his hobby as a drummer in a well known band and position he played in his ice hockey team, his personal home/estate in michigan on 12 acres with stables, office, music recording studio, personal full size ice rink, crops, etc.. And most importantly IT FINALLY TOOK HIS LIFE.
    He started taking it because he thought it would make him more creative in his graphic design career because earning $350,000/year wasn’t enough for him. He drank 2 large bottles of the highest quantity dxm each day, some days more. He stopped sleeping, working, then stopped playing with his kids, sleeping with his beautiful wife, playing the drums, …He lost all motivation. It completely took away his ability to have an orgasm. It was good for me in one way. he’d get hard and I could ride him for hours taking my pleasure, but he could never cum. Also, He was always hallucinating. He would tell me the craziest things, and talk about being dead visiting the other side and coming back. He got in a rut and sank deeper and deeper and to be honest, he didn’t want to get out, to get clean, or get better.
    He would tell me of all the research he did on the internet re: DXM and how great it was. How it wasn’t bad for you. And how it wasn’t dangerous, not like heroin or coke, etc. He would be awake for days on cough syrup and then he’d completely crash and sleep like the dead for 3 days. I loved him but it was killing me to watch him do this to himself, and with all my problems and addiction to opiates,
    I had no business looking down on him or telling him what he should or should not do.
    One Sunday, he came out to the living room where I was watching a movie he didn’t like with a girlfriend. He had been in the bedroom on the computer “working” (what I called playing around). He said he was tired and going to take a short nap. I came into the bedroom 1 1/2 hours later to find him fully clothed wearing a heaving down coat and boots, laying 1/2 on the bed holding on to it in his tight fists face down with his waist legs on the floor- a huge feet considering how high off the ground the bed was. It looked like a terribly uncomfortable position so I tried to move him and couldn’t; then I tried to wake him and couldn’t. I got down closed to him and put my ear to his chest and confirmed a heartbeat and that he was breathing, though very slowly. I finally fell asleep next to him concerned. I woke up in the wee hrs. of the morning to find him still in the same position face down, ice cold, and stiff as a board- and I feared the worst.
    I got a neighbor awake to help me move him. I had the legs, she the shoulders. She angled him up about 6 inches and saw that his face was purple swollen, congealed with blood and a tiny blood stain on the bed where his mouth was. That’s when she dropped him and jumped back screaming HE’S DEAD!
    When the coroner got there I was told he’d been dead for hours. He must have died minutes after I had checked his pulse and breathing. I didn’t know. He regularly slept like the dead coming off DXM binges and couldn’t be woken. I was lying next to a dead man for hours!
    The official cause of death was a DXM overdose. Other than his cough syrup habit, he was one of the healthiest people I knew, in great shape, perfect weight, no heart problems or high blood pressure, an iron stomach that never got sick and could eat anything, he never got sick or caught a cold. He was totally healthy. He knew his limit with cough syrup as he’d been using it daily for 8 years, and did nothing different that day. But just like that, all of a sudden he was dead. He left behind 8 children, the oldest 19 then 17 and the youngest was 5 or 6.
    How do explain to them that their father left them intentionally choosing cough syrup over them when given a choice. Then the cough syrup killed him, and he will never be coming back?

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