DXM Addiction and Misuse

DXM is a common ingredient found in many over-the-counter medicines. Read on for more information about DXM, its potential for misuse, symptoms of withdrawal, and how to get help if you or someone you love has lost control of their DXM use.

What Is DXM?

Cough syrup with DXM being poured into a spoonDXM, or dextromethorphan, is a cough suppressant found in over-the-counter (OTC) cough, cold, and flu medicines. It is often used in both gel capsules and cough syrups.

At low OTC doses, DXM suppresses cough and creates some sedation, which helps people who are sick relax, get rest, and experience fewer coughing fits. But at very high doses, it is a dissociative anesthetic, producing psychedelic effects.

The chemical is found in over 120 OTC drugs.

The antitussive was developed as a replacement for codeine, which is an addictive opioid drug; however, DXM itself has now become a drug of abuse.

Although it is still available over the counter, many states have enacted legislation to limit how much DXM-based product a person can buy at one time and/or require that sellers check the buyer’s ID to make sure they are a legal adult.

How Is DXM Abused?

People who abuse or DXM for nonmedical reasons may take more than the recommended OTC dose.

Recommended dosages for DXM, as stated on the medicine’s label, range between 10 mg and 20 mg every 4–6 hours, or 30 mg every 6–8 hours. Servings are measured differently depending on whether the product is a liquid cough syrup or capsule.

According to the Drug Enforcement Administration, people who misuse DXM will take much more than that, ranging between 240 mg and 1,500 mg per recreational dose.

Some reports suggest people who misuse DXM consume 3 or 4 bottles of cough medicine per day to maintain a high. While this may induce euphoria and psychotropic effects, there are many other harmful ingredients in cough and cold medicines.

Consuming large quantities of any substance, including OTC medications, is extremely dangerous.

Prevalence of DXM Misuse

Although some states prevent adolescents and teens from purchasing cough or cold medicines, this age group is the most likely to misuse this substance.

Here are some quick stats about DXM use in the U.S. from 2006:

  • 3.1 million Americans between the ages of 12 and 25 reported recreational abuse of DXM at least once in their lives.
  • 1 million reported abuse in the past year.
  • Adolescents ages 12–20 make up 51% of hospitalizations from DXM overdose.

And in 2011, the Monitoring the Future Survey reported high percentages of adolescent DXM misuse:

  • 2.9 percent of 8th graders
  • 4.3 percent of 10th  graders
  • 5 percent of 12th graders

Note: Any illicit forms of DXM sold online—powders, pills, or tablets specifically created for recreational use—are very dangerous, and can lead to dependence, addiction, withdrawal, overdose, and death.

Side Effects from DXM Abuse

Taking DXM for nonmedical reasons for a long time or in large amounts can cause various side effects, such as:

  • Dizziness.
  • Nausea and vomiting.
  • Slurred speech.
  • Hypertension, or increased blood pressure.
  • Tachycardia, or increased heart rate.
  • Breathing problems.
  • Hallucinations, typically visual or auditory but sometimes tactile.
  • Seizures.

Effects from DXM typically begin within 15–30 minutes after the substance is ingested, and can last for several hours.

People who misuse DXM regularly may develop a physical tolerance to and/or dependence on the drug. They may also develop an addiction, or substance use disorder, leading to compulsive consumption of DXM products.

Physical dependence can lead to withdrawal symptoms when person attempts to stop or reduce DXM use, making it more likely that they will continue use to avoid these sensations. Chronic abuse of DXM can even induce psychosis.

Withdrawal from DXM

Symptoms of DXM withdrawal include:

  • Anxiety.
  • Insomnia.
  • Restlessness.
  • Diarrhea.
  • Nausea or vomiting.
  • Upset stomach.
  • Weight loss.
  • Cravings.

While these symptoms are not physically dangerous, they may be uncomfortable. People who try to stop taking DXM without medical supervision to ease withdrawal symptoms are more likely to relapse, which can lead to overdose.


ambulance driving toward an emergencyAlthough DXM is easy to find and legal to purchase for adults, high doses of the drug can cause an overdose. In 2014, the American Association of Poison Control Centers reported that there were:

  • 45,748 cases of DXM poisoning (some of which were accidental).
  • 33,811 single exposures to the drug.
  • 6 deaths from DXM misuse.

Symptoms of DXM overdose include:

  • Breathing problems, usually irregular, shallow, or depressed breathing.
  • Bluish tint under the fingernails, on the tip of nose, or on the lips.
  • Blurred vision.
  • Drowsiness and dizziness.
  • Hallucinations.
  • Changes in blood pressure, either high or low.
  • Involuntary muscle twitches and twinges.
  • Nausea, vomiting, and stomach or intestinal spasms.
  • High body temperature, or hyperthermia.
  • Seizures.
  • Coma.

Treatment for DXM Misuse

Group of young adults in therapy supporting a young woman who is upsetDXM addiction is treatable. Medical professionals can monitor the detox process, ensuring patients are as safe and comfortable as possible.

There are no FDA-approved treatment medications for DXM addiction. The standard of care generally involves a combination of evidence-based therapies and counseling.

Therapy may take place in a group or individual setting, and is designed to help patients better understand their addiction, address addiction-related behaviors, and build a social support network and relapse prevention skills.

At Recovery First Treatment Center in Hollywood, Florida, we offer different types of addiction treatment.

Our inpatient rehab facility near Miami offers an intimate, personalized approach to addiction care, and tailors treatment plans to meet each patient’s individual needs.

To learn more about our programs, using insurance to pay for rehab, or start the admissions process, contact us at today.

You aren't alone. You deserve to get help.
Recovery First is located in Hollywood, Florida, which is easily accessible from Miami or Ft. Lauderdale. Our small groups means you get more one-on-one support and make stronger connections with the community. Take the next step toward recovery: learn more about our addiction treatment programs near Florida's Atlantic coast or learn about how rehab is affordable for everyone.