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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