Dextromethorphan Abuse

Table of Contents

DXM (dextromethorphan) is a cough suppressant ingredient found in many different over-the-counter medicines. It is found in extra-strength cough syrups, as well as in tablets and gel capsules. DXM may be a standalone ingredient, or it can be combined with other drugs – antihistamines, pain relievers, expectorants, and decongestants, for instance. When taken in excessive amounts, DXM can lead to feelings of euphoria and trigger both auditory and visual hallucinations.

This guide to DXM examines issues that include:

  • What are dextromethorphan abuse long term effects?
  • What are the symptoms of dextromethorphan abuse?
  • How to engage with evidence-based addiction treatment.

Can Dextromethorphan Be Abused

Dextromethorphan abuse commonly occurs. While it is a legitimate and effective cough suppressant when used as directed, when someone consumes the drug in large quantities, far exceeding the recommended dosage, this is considered DXM abuse. Most people abuse this substance to for its  psychoactive effects, including euphoria and hallucinations.

Dextromethorphan Abuse Potential

The potential for DXM abuse is particularly high because it is easily accessible as an over-the-counter medication in many cold and cough products. This accessibility can lead to its misuse, especially among teenagers and young adults who might seek it out for its mind-altering effects.

When taken in high doses, DXM acts on the same brain cell receptors as dissociative hallucinogenic drugs like ketamine and PCP. The effects can range from mild stimulation to complete dissociation from the environment. High doses can lead to distorted visual and auditory perceptions, a skewed sense of reality, and other distressing psychological effects.

Abusing DXM can lead to dangerous side effects, especially when combined with other substances or medications. Potential risks include impaired judgment and motor coordination, nausea, dizziness, rapid heart rate. In severe cases, DXM abuse may lead to brain damage, seizures, or death. Chronic abuse can also lead to addiction and withdrawal symptoms upon discontinuation.

Parents, educators, and healthcare providers play a significant role in education about the dangers of DXM abuse, especially in communicating with young people about the risks of abusing OTC medications. Monitoring and regulating the purchase of products containing DXM can also help in preventing its widespread abuse.

Dextromethorphan Abuse Symptoms

Developing an awareness of the signs and symptoms of dextromethorphan abuse can help in identifying individuals who may be misusing this substance. While the symptoms can vary from person to person, common dextromethorphan abuse effects include:

Behavioral changes

  • Sudden mood swings: People abusing DXM may exhibit extreme changes in mood, ranging from euphoria to agitation.
  • Social withdrawal: They might isolate themselves from friends and family to conceal their substance misuse.
  • Changes in daily routines: Disruption in normal daily activities, such as school or work, may be noticeable.

Physical symptoms

  • Robotic movements: DXM can cause unsteady and robotic-like movements, leading to impaired coordination.
  • Dilated pupils: Those who misuse this OTC medication may have enlarged pupils, even in well-lit environments.
  • Sweating and flushed skin: Elevated body temperature can result in excessive sweating and flushed skin.

Cognitive and psychological effects

  • Confusion: DXM abuse can lead to confusion, disorientation, and difficulty concentrating.
  • Hallucinations: Some people may experience vivid visual or auditory hallucinations.
  • Impaired judgment: Decision-making abilities may be severely compromised, leading to risky behaviors.

Frequent and excessive use

  • Increasing tolerance: Individuals who abuse DXM may need higher doses to achieve the desired effects.
  • Compulsive use: Some people may repeatedly consume DXM, even in situations where it is unsafe or inappropriate.
  • Craving: A strong desire or craving for DXM can be a prominent sign of abuse.

Dextromethorphan Abuse Side Effects

The abuse of dextromethorphan is associated with an array of side effects, some of which can be harmful or even life-threatening. These side effects can vary in severity depending on the dosage and frequency of abuse. Here’s what you should know:

  • Physical side effects: High doses of DXM are known to cause severe nausea and vomiting. DXM abuse can result in tachycardia (rapid heart rate) and high blood pressure. In extreme cases, DXM can suppress the respiratory system, leading to breathing difficulties.
  • Cognitive impairment: DXM abuse can cause unsteady movements and poor coordination, increasing the risk of accidents. Those who misuse this substance may experience difficulty with memory and maintaining attention on tasks. DXM can lead to disorientation and confusion.
  • Psychological effects: People may experience heightened anxiety and paranoia during and after DXM use. DXM abuse can cause emotional instability and mood swings. Vivid auditory and visual hallucinations can manifest, contributing to a sense of detachment from reality.
  • Long-term health consequences: Prolonged DXM abuse may lead to liver damage, kidney problems, and cardiovascular issues. There is an increased risk of developing mental health disorders like depression and anxiety with long-term DXM abuse. Chronic abuse can result in physical and psychological dependence, making it difficult to quit without experiencing withdrawal symptoms.

Those displaying DXM abuse symptoms or experiencing its side effects should seek professional help. Prompt intervention and treatment can help in preventing further harm and streamlining sustained recovery.

Dextromethorphan Abuse Withdrawal

Long-term dextromethorphan abuse followed by abrupt discontinuation can lead to the emergence of withdrawal symptoms, which may include any or all of the following:

  • Fatigue: Individuals may feel extreme tiredness and lack of energy.
  • Gastrointestinal distress: GI distress can present as vomiting and diarrhea, contributing to discomfort.
  • Insomnia: Sleep disturbances often occur during withdrawal, making it challenging to achieve restful sleep.
  • Nightmares: Vivid and distressing dreams may manifest during the withdrawal phase.
  • Memory problems: Cognitive difficulties, including impaired memory, might become apparent.
  • Panic attacks: Sudden and intense episodes of anxiety and panic may be experienced.
  • Intense cravings: There can be strong desires to resume DXM use, which may be difficult to resist.
  • Flashbacks: Some people might encounter flashbacks or recurrent hallucinogenic experiences.

Beyond this, those who have engaged in prolonged, high-dose DXM abuse over an extended period may be at risk of developing toxic psychosis and enduring lasting psychological issues. These long-lasting effects can be severe and require professional intervention and support for recovery.

Dextromethorphan Addiction Treatment

Treating dextromethorphan addiction requires a comprehensive approach that addresses both the physical and psychological aspects of dependence. The treatment process usually begins with a thorough assessment to determine the extent of DXM abuse and any co-occurring mental health conditions. A medical and psychiatric evaluation is the cornerstone of developing a tailored treatment plan.

Many people struggling with DXM addiction also have co-occurring mental health disorders, such as depression or anxiety. Dual diagnosis treatment addresses both addiction and underlying psychiatric conditions concurrently.

For individuals with severe DXM addiction, supervised medical detoxification is generally the optimum route to recovery. During this phase, medical professionals monitor and manage withdrawal symptoms to ensure safety and comfort.

Behavioral therapy is a fundamental component of addiction treatment. Therapists work with individuals to identify the underlying causes of their addiction, develop coping strategies, and modify problematic behaviors. CBT (cognitive behavioral therapy) is one of the most commonly used approaches for DXM addiction.

Individual and group counseling sessions provide a platform for people to discuss their challenges, share experiences, and receive emotional support from peers and therapists. These sessions can help individuals develop crucial life skills and build a support network.

In some cases, medication-assisted treatment may be beneficial, especially for those with a history of chronic DXM abuse. Medications can help reduce cravings and manage withdrawal symptoms. However, the use of medications for DXM addiction is less common compared to opioid or alcohol addiction.

Involving family members in treatment can promote a more supportive environment for recovery. Family therapy sessions can help repair relationships damaged by addiction and educate loved ones about addiction and recovery.

Recovery is an ongoing process, and aftercare is essential to maintain sobriety. Learning strategies to prevent relapse is a core component of addiction treatment. Individuals develop relapse prevention plans, identify triggers, and acquire tools to manage cravings and high-risk situations. Continuing support may include outpatient counseling, 12-step programs, or participation in support groups like NA (Narcotics Anonymous). Many rehabs also offer alumni programs to promote sober connections.

Many people also benefit from holistic approaches like mindfulness meditation, yoga, art therapy, or exercise, which can promote overall well-being and stress management.

Seeking professional help from addiction specialists and treatment centers is the best way to begin the journey to recovery from DXM addiction. With the right support and resources, it’s possible to achieve lasting sobriety and improve your overall quality of life, even if you have been abusing DXM long-term.


Is dextromethorphan addictive?

Dextromethorphan, commonly found in cough suppressants, is not considered addictive in the traditional sense, as it does not trigger the development of physical dependence. That said, DMX may be abused for its dissociative effects.

Is dextromethorphan a narcotic?

No, dextromethorphan is not considered a narcotic (opioid). It is a cough suppressant that is used in many over-the-counter cold and cough medications, and it works by suppressing the cough reflex in the brain.

Get Treatment for Dextromethorphan Addiction at Ohio Recovery Centers

At Ohio Recovery Centers, we focus on outpatient treatment of drug addiction. This means that you can access the help you need while still keeping up with your daily life. For those who need more structured support, we also have a more intensive outpatient program to help you achieve lasting sobriety.

Our treatment programs in Cincinnati, OH, are designed to meet the specific needs of each person dealing with DXM addiction. We use proven methods like MAT (medication-assisted treatment), different types of psychotherapy, and counseling. Plus, we offer a range of holistic therapies at Ohio Recovery Centers.

If you’re ready to tackle DXM addiction, you can call us at 877-679-2132 and begin your recovery right away.

Table of Contents

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Joseph Gilmore

Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.
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Christopher Glover CDCA

My name is Christopher Glover, and I am from Cincinnati, Ohio. I am currently in school and working to grow in competence to better support our community. As a recovering individual I know the struggles that you or a loved one can go through and that there is help for anything you may be struggling with.

The hardest part is asking for help and we are here as a team to best support you and your decision to start your journey towards a better future. Connect with Chris on LinkedIn

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Amanda Kuchenberg PRS CDCA

I recently joined Ohio Community Health Recovery Centers as a Clinical Case Manager. I am originally from Wisconsin but settled in the Cincinnati area in my early 20s.  My career started in the fashion industry but quickly changed as I searched to find my drive and passion through helping others who struggle with addiction. 

As someone who is also in recovery, I wanted to provide hope, share lived experience, and support others on their journey.  I currently have my Peer Recovery Support Supervision Certification along with my CDCA and plan to continue my education with University of Cincinnati so I can continue to aid in the battle against substance addiction. Connect with Amanda on LinkedIn.

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Patrick McCamley LCDC III

 Patrick McCamley (Clinical Therapist) is a Cincinnati native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2019. Patrick received his bachelors degree in psychology from University of Cincinnati in 2021 and received his LCDC III (Licensed Chemical Dependency Counselor) license from the Ohio Chemical Dependency Professionals Board in 2022. Patrick has worked in Clinical Operations, Clinical Case Management, and Clinical Therapy throughout his career.

Patrick has tremendous empathy and compassion for the recovery community, being in recovery himself since 2018. Patrick is uniquely qualified to be helpful because of the specific combination of his academic background and his own experience in recovery.

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Bill Zimmerman CDCA

Bill Zimmerman is a Greater Cincinnati Area native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2018. Bill received his (Chemical Dependency Counselor Assistant) license from the Ohio Chemical Dependency Professionals Board in 2020.

Bill has worked in Clinical Operations in both support and supervision, and Program facilitating and 12 step recovery support during his career. Bill has a passion for the recovery community, having been in recovery himself since 1982. Connect with Bill on LinkedIn

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Taylor Lilley CDCA, PRS

Growing up in Louisiana with addiction running rampant on both sides of my family. A life away from drugs and alcohol seemed impossible for someone like me. I remember what it was like sitting across from someone thinking there is no way they could ever understand what I was going through.

Sharing my experience offers a credibility and a certain type of trust with clients that only someone who has walked down this road can illustrate. To immerse myself further into the field of addiction, I am currently studying at Cincinnati State for Human and Social Services.  I hope I never forget where I came from, if I can do it, so can you!

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Thomas Hunter LSW

Hello my name is Thomas Hunter. I was born and raised in Cincinnati, Ohio. I am a licensed social worker.In my scope of practice I have worked in the areas of mental health and recovery for thirty years. The clients I have worked with in my career have ranged in age from seven to seventy.

I strive each day to serve my purpose of helping those in need and I believe I do so by utilizing all of my experiences to accomplish my goal of supporting those who desire to establish their sobriety and maintain it in their recovery. Connect with Thomas on LinkedIn.

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Mary D.Porter,LICDC

 My name is Mary D. Porter. I received my Masters of Social Work in 2008 from The University of Cincinnati. I received My Licensed Independent Chemical Dependency Counselor Licensure in 2001. I retired from The Department of Veteran Affairs Medical Center on April 14, 2014. Currently, I am the Associate Clinical Director for The Ohio Community Health Recovery Centers in Cincinnati.. Due to the fourth wave of the Opioid Epidemic in 2019,  I decided to enter back into the workforce to assist the addicted population.

The overdoses were astounding and I wanted to help.  I consider myself  to be an advocate for the addicted population. My compassion, resilience, empathy, wisdom, knowledge, experience and  love I have for this forgotten population goes beyond words. I consider what I do for the addicted population as a calling versus a “career,” because I too was once an “addict and alcoholic.” Today I am 45.5 years alcohol and substance free.

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Ben Lemmon LCDC III

Hello, my name is Ben Lemmon, and I’m the Vice President and Clinical Director at Ohio Community Health Recovery Centers. I’ve been working in the addiction and mental health field since 2013 and decided to enter the field after overcoming my own challenges with addiction.

When I first meet a client, I always explain to them that the reason we are meeting is because they are not capable of obtaining or maintaining sobriety, and my goal is to create a person that can maintain sobriety. I believe a person’s personality is made up of their thoughts, feelings and actions and my job is to help clients identify the thoughts, feelings and actions that have them disconnected from recovery and provide them with the tools to live a healthy and happy life. Connect with Ben on LinkedIn