Dextromethorphan, commonly known as DXM, is a cough suppressant found in more than 120 over-the-counter cold and cough medicines. When used as directed, DXM is a safe and effective way to relieve cough. However, DXM is frequently abused in high doses to produce dissociative and hallucinogenic effects, which can be extremely dangerous and potentially fatal.

If you or a loved one is battling DXM abuse, seeking professional help is essential. At JourneyPure, our knowledgeable team of addiction experts delivers personalized, evidence-based treatment to help you break free from DXM addiction and build a strong foundation for lasting recovery. Call us at 888-985-2207 to learn more about our nationally-accredited drug and alcohol rehab programs in Kentucky, Tennessee and Florida.

DXM is often marketed by the substance name in other countries

DXM is often marketed by the substance name in other countries

What is DXM?

DXM is the active ingredient in many nonprescription cough and cold products, such as:

  • NyQuil, Robitussin, Delsym, Mucinex DM
  • Coricidin Cough & Cold, Vicks DayQuil Cough
  • Alka-Seltzer Plus Cold & Cough
  • Tylenol Cold & Cough
  • Dimetapp DM
  • Various store-brand/generic products

At recommended doses of 10-20 mg every 4-6 hours, DXM works on the cough center of the brain to suppress cough. However, at high doses of 250-1500 mg, DXM acts as a dissociative drug, producing effects similar to PCP and ketamine like:

  • Euphoria and mood changes
  • Altered perceptions of time, space, sight and sound
  • Visual and auditory hallucinations
  • Feelings of detachment from one’s body and environment
  • Impulsivity and poor decision making
  • Increased sociability and feelings of empathy

DXM is also an NMDA receptor antagonist and a sigma-1 receptor agonist. It interacts with serotonin receptors as well. The combined impact on these neurotransmitter systems is responsible for the dissociative, mind-altering and mood-elevating effects of DXM that abusers seek.

History of DXM Abuse

DXM abuse dates back to the 1960s when teenagers began abusing Romilar, an OTC medication containing DXM and an antihistamine. This formula intensified DXM’s effects. Romilar’s maker removed it from the market in 1973 due to widespread abuse. However, pure DXM remained legal in OTC medicines.

In the 1990s-2000s, recreational DXM use saw a major revival, especially among youth. This was largely due to the easy accessibility of DXM products, their low cost, and the perception that they were less risky than illegal drugs. The internet also played a role by spreading information on how to abuse DXM and connecting potential users.

Common slang terms for DXM abuse include:

  • Robotripping, skittling, dexing
  • Triple Cs (Coricidin HBP Cough & Cold)
  • Red Devils (Robitussin pills)
  • Tussin, orange crush, purple drank (cough syrups)
DXM tablets are one form the drug can be found in

DXM tablets are one form the drug can be found in

The Dangers of DXM Abuse

While DXM itself is not illegal, taking it in high doses is very risky. Potential dangers include:

  • Impaired vision, slurred speech, poor coordination
  • Nausea, vomiting, diarrhea, abdominal pain
  • Elevated blood pressure, fast heartbeat, chest pain
  • Numbness, tremors, seizures
  • Confusion, disorientation, memory loss
  • Anxiety, panic attacks, paranoia, aggression
  • Liver damage from large doses of acetaminophen in some DXM products
  • Serotonin syndrome from mixing DXM with antidepressants
  • Overdose, coma or death, especially when combined with alcohol, opioids or other CNS depressants

Over time, chronic DXM abuse often leads to tolerance, meaning that higher doses are needed to feel the same effects. This increases all the risks. Heavy users may also develop physical and psychological dependence, feeling unable to function without DXM. If use is reduced or stopped abruptly, unpleasant withdrawal symptoms can emerge, such as anxiety, depression, insomnia, fatigue, and intense cravings.

Addiction to DXM is characterized by compulsive use despite mounting negative consequences in one’s health, relationships, work/school performance, and overall wellbeing. Professional help is usually needed to break the cycle of DXM addiction.

How Long Does DXM Stay in Your System?

The noticeable effects of DXM begin within 30-60 minutes of ingestion and last up to 6 hours. Residual “afterglow” effects like lightheadedness and altered mood can linger for a day or more after heavy use.

In terms of drug tests, DXM can be detected for the following windows of time:

  • Blood: 1-2 days
  • Saliva: 2-3 days
  • Urine: 3-7 days or longer for heavy/long-term use
  • Hair follicle: Up to 90 days

However, standard drug tests do not usually screen for DXM. It can only be detected by specialized tests. Still, if abuse is suspected, any unexplained positive result for PCP or opiates should raise concerns, as false positives for these substances have been known to happen with high-dose DXM use.


The psychological impact and health consequences of DXM addiction frequently persist long after detox. Post-acute withdrawal symptoms like mood swings, sleep disturbances, and drug cravings can come and go for several months. The flood of serotonin from frequent high doses may lead to lasting deficits in the brain’s serotonin system, causing depression, cognitive impairment, and emotional instability. The dissociative effects of chronic use may also lead to persistent problems with memory, concentration, and decision making.

Quality addiction treatment delivered by experienced professionals is critical for DXM abusers to stop using, stay stopped, and regain their mental and physical health. Attempting to quit alone can be very difficult and increases the risk of relapse.

Find Freedom from Addiction at JourneyPure

If you’re ready to overcome DXM addiction, JourneyPure is here to help you every step of the way. Our comprehensive addiction treatment programs are tailored to your unique needs and address both DXM abuse and any co-occurring mental health concerns driving it. Our services include:

  • Medically-supervised detox for a safe, complete withdrawal
  • Behavioral therapies to help you understand your addiction and build recovery skills
  • Integrated treatment for dual diagnosis, including depression, anxiety, bipolar, ADHD and more
  • Medication-assisted treatment options to ease cravings and support recovery
  • Family counseling to restore trust and communication
  • Holistic therapies like yoga, mindfulness, art and nature activities to promote overall wellness
  • Detailed aftercare planning and active alumni community to help you stay on track

Don’t let DXM addiction rob you of the happy, healthy life you deserve. Call JourneyPure today at 888-985-2207 or contact us online to start your path to lasting freedom. Our compassionate admissions navigators are available 24/7 to answer your questions, verify your insurance coverage, and guide you in taking the first crucial steps in your recovery journey.

Staff Spotlight

Will Long

  • Middle Tennessee State University
  • years in the field

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