A law enforcement investigation determined that the boys also repackaged DXM powder into gelatin capsules purchased at a health food store in order to sell it to others in their high school. At least three nonfatal overdoses resulted from the repackaged DXM, two of which required ER treatment. Older adults may develop DXM addiction due to chronic pain management and the use of multiple medications. As highlighted by the National Institute on Drug Abuse (NIDA), this population is at risk of polypharmacy, where multiple prescriptions can lead to unintentional misuse of DXM. Treatment for dextromethorphan (DXM) addiction involves a combination of behavioral therapies, support groups, and emerging therapies. However, at higher doses, DXM acts as a dissociative anesthetic, similar to ketamine and phencyclidine (PCP).
What Are The Uses Of Dextromethorphan?
It is best known by its trade name, Robitussin, but is commonly found in other cough medicines such as Nyquil, Benylin DM, Coricidin Cough and Cold, and many more. Among other mechanisms of action, DXM and its major metabolite dextrorphan produce its dissociative effects by antagonizing the glutamatergic NMDA receptor. Below is a list of medications, supplements, and foods that can interact with dextromethorphan.
What Happens If I Miss A Dose Of Dextromethorphan?
In higher doses, the effects of DXM become more psychedelic in nature. The effects of high-dose DXM feel a lot like ketamine or other dissociatives. They disconnect the mind from the body which can be both freeing and terrifying at the same time. At the recommended dose, DXM has little, if any psychoactive side effects. In higher doses, DXM can induce states of inebriation similar to alcohol, dissociative states similar to ketamine, or full-blown psychotic episodes like PCP. Long-term misuse of dextromethorphan may lead to psychological dependence.
Best Cough Suppressor
- This pushes people to experiment with the amount of the drug and very often leads to DXM abuse and addiction.
- That’s particularly true for substances like DXM that encourage a powerful psychological dependency and alter perception while driving a constant cycle of escalating doses to get high.
- Screening tools for DXM addiction include the DSM-5 criteria, CAGE-AID, DAST-10, and ASSIS.
- The daily limit of DXM, according to most medication packaging, is 120 mg within 24 hours.
- If you’d like to explore an alternative to dextromethorphan, talk with your doctor or pharmacist.
- Addiction Resource does not favor or support any specific recovery center, nor do we claim to ensure the quality, validity, or effectiveness of any particular treatment center.
Poor judgment, visual distortions, and irrational behavior may also occur, putting the individual at high risk for causing or being involved in an accident. This may lead to a DXM HBr hangover, and this soon becomes a vicious cycle. Death is rare, but the most significant risk which may appear because of abusing Dextromethorphan. It is important for parents to care for their teens by never assuming that they are too innocent to abuse this drug.
What Happens If I Overdose On Dextromethorphan?
Ask the child’s doctor if you don’t know how much medication to give the child. Dextromethorphan is the only cough suppressant available as an over-the-counter drug without a prescription. If you have questions about how to pay for dextromethorphan, talk with your doctor or pharmacist. Whether or not you have health insurance, cost may be a factor when you’re considering dextromethorphan. Most insurance plans do not cover over-the-counter medications like dextromethorphan.
- In 2012 the CHPA launched a propaganda campaign on the Internet that distributed video materials explaining the negative effects and the possible adverse consequences of the abuse of this drug.
- The strength of the dose is given in milligrams (mg) and mg per milliliter (mg/mL).
- Dextromethorphan is an over-the-counter cough suppressant found in more than 120 cough and cold products.
- Dextromethorphan (DXM) addiction is a type of substance use disorder characterized by the compulsive misuse of DXM, a common ingredient in over-the-counter cough medications.
How Does DXM Addiction Develop?
While all of these over-the-counter medications contain DXM, certain varieties of cold medications are specifically targeted for misuse and abuse. Laboratory tests involve analyzing biological samples to diagnose conditions or measure substance levels in the body. Laboratory tests may be ordered to detect the presence of DXM or other substances in the body.
Brand Names Of Combination Products
One example is Auvelity, which contains dextromethorphan and bupropion. Also tell them about any herbs, vitamins, and supplements you use. Dextromethorphan is a generic drug, which means it’s an exact copy of the active ingredient in a brand-name medication. The brand-name medications that dextromethorphan is based on are Delsym and Robitussin Long-Acting CoughGels.
Addiction is when people continue to use their substance of choice despite mounting consequences. People who abuse drugs or alcohol may go to great lengths to hide the extent of their substance use. They may rationalize or explain their behaviors in ways that they hope will vindicate them. Typical recreational doses of DXM range from 250 mg to 1,500 mg, according to the Drug Enforcement Administration — which could amount to an entire bottle of extra-strength cough syrup.
Other Types Of Dissociatives
In response to the rising non-medical use, the DEA convened two advisory committee meetings in the early 1990s, but came to no consensus on what actions to take. In 2010, an FDA panel voted against making DXM a scheduled substance, believing that the public health and economic benefits outweighed the abuse potential of the drug. If you’re interested in taking Delsym instead of dextromethorphan, talk with your doctor or pharmacist. To learn more about how generics compare with brand-name drugs, see this article.
Some types of medications known to inhibit CYP2D6 include certain SSRIs and tricyclic antidepressants, some antipsychotics, and the commonly available antihistamine diphenhydramine. Therefore, the potential for interactions exists between dextromethorphan and medications that inhibit this enzyme, particularly in slow metabolizers. The drug interactions listed above are not all of the possible interactions or adverse effects.
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Interactions
In 2006, 143.8 calls per million people were made to poison control reporting a DXM overdose. A recent analysis reported that DXM abuse peaked around 2006 and has generally been in decline since. This data specifically reported on calls to poison control centers, which are generally only called in the case of overdose. Trends in over-the-counter substance misuse are often less well-studied than prescription or illicit drug use. However, some data can shed light on the prevalence of DXM abuse. When people misuse DXM in order to get high, they take massive doses well above the recommended daily limit.
