What is DXM?

Dextromethorphan or DXM

Dextromethorphan or also known as “DXM” is an ingredient that is used in many cough suppressants and cold medications. If it is taken at the right dose, it is safe and effective to use; when it is taken at high doses it can cause a “high” and psychedelic effects that mimic the same feelings as ecstasy.

The term for being high on DXM is called “robotripping” and can cause many physical and psychological symptoms and effects that are sometimes life-threatening that include:

  • Dizziness
  • Muscle twitches
  • Hallucinations

DXM can be found in many cold or flu medications and is used to treat mild coughing. It can come in many different forms including:

  • Lozenges
  • Chewable tablets
  • Syrups
  • Capsules
  • Dissolvable strips

From American Addiction Centers, “Medications that contain DXM include a number of familiar medications, such as Robitussin, NyQuil, Vicks Formula 44, etc. Street names for the drug include DXM, skittles, red devil, Robo, cousin, triple C, and a number of others. Some users commonly refer to abuse of this drug as Robo- tripping in reference to its being consumed in cough syrups (the term Robo being taken from the cough medicine Robitussin).”

Health Effects of Using DXM

There can be short or long-term health problems associated with DXM use which can include:

  • Liver damage or failure
  • Increased heart rate
  • Vomiting
  • Loss of coordination
  • Seizures
  • Coma

Symptoms of Robotripping

DXM is considered a hallucinogen, meaning it can cause hallucinations or other symptoms of euphoria. People who are high on Dextromethorphan will experience a mild euphoria, but when taken in large doses it can cause extreme illusions and paranoia. Sometimes, symptoms are bad enough to cause aggressive or violent behavior.

The major symptoms of robotripping include:

  • Agitation
  • Violent behaviors
  • Impaired cognitive and perceptual functioning
  • Vivid nightmares
  • Dissociation
  • Hallucinations
  • Delusions
  • Double vision
  • Sleepiness
  • Trouble speaking
  • Numbness in the fingers or toes
  • Involuntary movement (ataxia)
  • Blotchy skin

Social Symptoms of DXM use

  • Changes in appearance.
  • Uncooperative nature.
  • Sudden drop in academic performance.
  • Poor hygiene.
  • Financial troubles
  • Changes in eating patterns.
  • Loss of interest in hobbies, family, or social activities.
  • Gradual or sudden change in friends.
  • Changes in sleeping patterns.

Addiction to DXM

What is DXM?

DXM is available in over 100 different over-the-counter cough medications and is intended to be used to treat mild coughing that is associated with a cold, allergies, flu, bronchitis, or other respiratory problems.

How DXM is Derived

DXM is produced from a derivative of morphine but is not considered an opiate due to the difference in how it reacts in the body. It has an affinity for the receptors in the brain that cause neurotransmitters (NDMA) to have excitement and euphoria. Although, it is an antagonist for NDMA which means it inhibits the actions and the release of NDMA, which accounts for its efficacy to suppress someone’s cough.

When taken as directed, DXM has very little side effects that may include nausea, stomach pains, constipation, dizziness or a mild headache. A typical and safe dose of DXM is around 15-30mg over the course of 24 hours. When taken at high doses (more than 10 times the recommended amount) or at frequent intervals that are fewer than 4 hours apart the substance can have different side effects depending on the dosage.

Signs of Addiction to DXM

People who continually use DXM may build a tolerance to the drug within one to two weeks of using and will require more of it to achieve the same effects. Some of the signs someone may be misusing DXM may consist of:

  • Loss of interest in hobbies, sports or other activities that the person once enjoyed
  • Continually buying the drug despite financial troubles
  • Hanging around a new group of friends or people or dropped other friends that you used to spend time with
  • Feeling paranoid, confused or hostile
  • Acting “drunk” or impaired despite having an alcoholic breath
  • Unpredictable mood swings o other aggressive behaviors
  • A feeling of depression, anxiety, or hopelessness
  • Difficulty cutting back on the drug
  • Failed attempts at stopping the use of the drug
  • You feel anxious or worried when you do not have access to the drug
  • A feeling of guilt or shame around using the drug
  • Using the drug in larger amounts than prescribed
  • Withdrawal symptoms upon discontinuing the drug

Withdrawal Symptoms

Often, with any drug comes withdrawal symptoms when the person stops using it. The symptoms can range from mild to severe and may be uncomfortable to the person going through it. The symptoms for DXM withdrawal below can happen anytime from 1-72 hours after the last dosage.

Withdrawal symptoms can consist of:

  • Sweating
  • Hallucinations
  • Depression
  • Shakiness
  • Anxiety
  • Restlessness
  • Insomnia
  • Bone or muscle pains
  • Cold flashes
  • Diarrhea
  • vomiting

Treatment for DXM

Treatment for DXM can range from an intensive outpatient program to a full-time residential treatment facility. The severity, frequency of use and dosage will determine the best type of care needed to treat your DXM addiction and recover successfully.

Types of Treatment

There are many options available to someone seeking recovery from DXM addiction. The following are treatment strategies including:

Supervised Detox

Detoxification or “detox” is when you clear a drug or substance out of your body, often causing uncomfortable withdrawal symptoms.

Inpatient rehabilitation Facility

When attending a residential treatment facility, the patient will receive 24-7 care from a professional medical staff. Services included may be counseling including one-on-one or group therapy, yoga, meditation, mindfulness activities, physical activities or exercise and other therapies proven to treat addiction for DXM.

Outpatient Care

A treatment option for those who would like to remain living at home, but still need help for their addiction. There are often barriers that may require a person to continue working, taking care of their children or other things that make it a challenge for them to go to a residential facility. There also may be circumstances where someone has a mild addiction and can remain living in their home environment and still receive the care necessary to get sober.

Additional Resources

  • Ongoing counseling after treatment
  • 12-step programs
  • Sober living facilities or transitional facilities
  • Sponsors to help with transitions out of treatment

If you or someone you know is suffering from an addiction, please reach out to someone right away. There is help available to treat your addiction to DXM.


Table of Contents