DXM is legal and available Over-The-Counter in the United States.
Addictive Potential: Low
Emergency Room Visits Yearly: Unknown
Mandatory Minimum Sentence: None
Mechanism of Action: NMDA receptor antagonist
Overview:
Dextromethorphan hydrobromide monohydrate (DM or DXM) is an antitussive drug that is found in many over-the-counter cold and cough preparations. The FDA approved dextromethorphan for over-the-counter sale as a cough suppressant in 1958. This filled the need for a cough suppressant lacking the sedative side-effects, stronger potential for abuse, and physically addictive properties of codeine phosphate, the most widely-used cough medication at the time (now prescription-only in the United States).
During the 1960s and 1970s, DXM became available in an over-the-counter tablet form by the brand name Romilar. It was put on the shelves in hopes of cutting down on codeine cough remedies. In 1973, Romilar was taken off the shelves after a burst in sales due to common recreational use. It was then replaced by cough syrup, in an attempt to cut down on recreational usage. More recently, gel capsule forms began reappearing in the form of Robitussin CoughGels as well as several generic forms of that preparation.
Dextromethorphan is classified as a dissociative hallucinogenic drug when taken at doses higher than medically recommended (usually in the 200mg-1000mg range). DXM has effects that are similar to those of ketamine and phencyclidine (PCP). It can produce distortions of the visual field, feelings of dissociation, distortions of bodily perception, excitement, as well as a loss of comprehension of time. Biochemically, DXM's effects can be attributed largely to dextrorphan (DXO), a chemical by-product (or metabolite) that is produced when DXM metabolizes within the body. Both DXO and DXM are NMDA receptor antagonists.
Slang terms for DXM often correlate to the brands of cough medicine used, such as "tussin," "robo," "dex," "triple C's," and "skittles." Recreational use of DXM is frequently referred to in verb form as "dexing," "tussing," "roboing," and "robotripping".
DXM Side Effects and Adverse Reactions:
body rash/itching
nausea
drowsiness
dizziness
fever
gastrointestinal disturbances
vomiting
blurred vision
dilated pupils
sweating
hypertension
shallow respiration
diarrhea
urinary retention
In some rare documented cases, dextromethorphan has produced psychological dependence in people that abused it. However, it does not produce physical addiction, according to the WHO Committee on Drug Dependence.
Dextromethorphan should not be taken with either of the following:
monoamine oxidase inhibitors (MAOIs)
selective serotonin reuptake inhibitors (SSRIs)
CNS depressant drugs and substances, including some psychotropics such as alcohol, will have a cumulative CNS depressant effect if taken with dextromethorphan.
