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Home Drugs Dextromethorphan (DXM) – Side Effects – Risks – Abuse & Addiction

Dextromethorphan (DXM) – Side Effects – Risks – Abuse & Addiction


Dextromethorphan (DXM) is the active ingredient in many cough suppressants. It comes in a variety of over-the-counter,  nonprescription cough remedies such as Vicks, Robitussin and TheraFlu.

It was originally created as a non-addictive alternative to codeine by the CIA and Navy in the 50s. It received FDA approval for use in over-the-counter medications in 1958. Today it continues to be sold in liquid, capsule, spray and tablet form.


This drug is a morphinan class drug with stimulant, sedative and dissociative properties when it is abused,. Dextromethorphan is now considered to be a recreational drug. This is due to its ability to induce perceptual distortions, hallucinations and hyperactivity when taken at higher doses.

Side Effects

In addition to suppressing activity in the brain area controlling cough reflexes. It may cause the following side effects when taken in recommended doses:

  • Nausea
  • vomiting
  • Dizziness
  • Drowsiness/sedation
  • Constipation
  • Diarrhea
  • Nervousness
  • Anxiety


When this drug is consumed at three to nine times the recommended dose, abusers can experience some or all of the following side effects:

  • Euphoria
  • Increased self-confidence/motivation/energy
  • Restlessness
  • anxiety
  • mild agitation
  • Insomnia
  • Problems with short-term memory
  • Rapid speech/irrational flow of ideas
  • Glassy eyes/dilated pupils
  • Reduced appetite
  • Sweating

Higher Dosages

People who take 15 times or more the recommended dosage will experience some or all of the following serious side effects:

  • Hallucinate both visually and auditorily
  • Vomit repeatedly
  • Have double and blurry vision, extremely bloodshot eyes – some abusers may even lose vision temporarily
  • Experience depersonalization or dissociation (psychotic break from reality)
  • Perspire profusely
  • Grind their teeth
  • Suffer tachycardia, chest pains, hypertension
  • Black out or lose consciousness


  • Overdosing on dextromethorphan leads to a dangerous, altered state of consciousness similar to the state experienced by people on PCP or ketamine.

People who have taken 750 to 1500 milligrams of cough medicine (normal dose is 10 to 25 milligrams) may imagine they are invincible or possess superhuman powers. This state can cause people to do things that could harm them like jumping off buildings or driving too fast on curvy roads.


Many cough suppressants also contain acetaminophen, guaifenesin or chlorpheniramine for reducing fever and relieving muscle and joint aches related to colds and flu. Abusers could suffer permanent liver damage, seizures or even coma due to overdosing on these other ingredients.

  • Combining additional substances such as alcohol, marijuana or other drugs may cause signs of impending overdose such as reduced heart rate, slowed breathing and dangerously low blood pressure.


Although research is scant, people abusing it can become physically and psychologically addicted. These products can cause opioid-like effects. It over excites dopamine receptors in the brain.

  • Abuser may suffer intense withdrawal symptoms such as anxiety, nausea, fever, chills and strong cravings


Most stores in all 50 states will not sell OTC medications containing this drug to teens under 18. Larger chain department stores like Walmart will always ask for identification when a young adult tries to purchase cough suppressants. However, smaller pharmacies and grocery stores are less inclined to ID teens.

  • Recent studies show 10 percent of adolescents in the U.S. have abused cough syrup for the purpose of getting high.
  • This means cough syrup is abused by teens more than ecstasy, cocaine or crystal methamphetamine.

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