Dextromethorphan (DXM) Addiction: Side Effects, Detox, Withdrawal, and Treatment

Last Updated on August 11, 2023

Dextromethorphan syrup

What is Dextromethorphan (DXM)?

DXM, or dextromethorphan, is a dissociative anesthetic and a commonly-used synthetic substance found in over-the-counter cough and cold medicines.1 DXM has a long history of efficacy and safety in suppressing cough when used in therapeutic doses but it is also misused for recreational purposes, as it can cause a high.

The effects of dextromethorphan vary depending on the dose. When taken appropriately as directed on the box, DXM provides temporary relief from sinus congestion, cough, runny nose, itchiness in the nose and throat, and watery eyes. However, when used in high doses, dextromethorphan can have powerful psychedelic effects. These effects are often compared to those caused by drugs like PCP or ketamine.

Dextromethorphan is sold in tablets, gel capsules, and liquid. Traditionally, the misuse of DXM involved the liquid form of the drug, but today, people may abuse all three forms for recreational purposes. Misusing dextromethorphan with other drugs or alcohol can cause serious side effects, health problems, or death.

Although not all people who misuse DXM will become addicted, if it is misused regularly, it can be addictive and may cause dependence and withdrawal symptoms. The risks of abusing this drug have prompted state lawmakers country-wide to prohibit minors from buying over-the-counter medicines that contain dextromethorphan.

As of September 2019, Texas has joined 18 other U.S. states that have restricted access to OTC DXM products like NyQuil and Robitussin.2

Dextromethorphan (DXM) Brand Names

There are more than 120 different products that contain dextromethorphan. Here are a few examples of medications that contain DXM:

  • Balminil DM
  • Benylin DM
  • Bronchopan
  • Buckleys D
  • Calylin #1
  • Delsym
  • Koffex DM
  • Novahistex DM
  • Nyquil
  • Robitussin Lingering Cold Long-Acting Cough
  • Robitussin lingering Cold Long-Acting CoughGels
  • Children’s Robitussin Cough Long-Acting
  • Sucrets 8 Hour Cough Relief DM Cough Formula3

Slang for Dextromethorphan

The following terms are street names or slang for dextromethorphan:

  • Dex
  • Dextro
  • Drix
  • Gel
  • Groove
  • Mega-perls
  • Poor Man’s Ecstasy
  • Red Devils
  • Robo
  • Rojo
  • Rome
  • Sky
  • Syrup
  • Tussin
  • Velvet
  • X1

About Dextromethorphan (DXM) Abuse and Addiction

Because it has been used over-the-counter for decades, dextromethorphan is generally considered safe. Most people don’t have a second thought about keeping it in their medicine cabinet. However, the Drug Enforcement Agency reports DXM abuse to be on the rise.4

When used in amounts that are more than the recommended dose, DXM can be a powerful drug with effects like heightened perceptual awareness, altered perception of time, and even visual hallucinations. This is referred to as “robotripping.” Also, when used in conjunction with other drugs, DXM has an additive effect.

Because DXM is easy to acquire, curious teens can experiment with the drug. Some people can even become addicted to DXM, drinking bottles of cough syrup or taking whole boxes of DXM pills at a time. Just like any other drug addiction, the effect produced by DXM becomes an obsession, and it becomes more and more difficult to reach the desired “high” while being forced to increase the dosage.

Although DXM is safe when used as directed, recreational misuse and experimentation can have dire consequences and even withdrawal symptoms. What started as an experiment can turn into a difficult period of sickness and intense mental craving. Not everyone who tries drugs gets addicted, but DXM CAN become addictive over time.

Teens are naturally curious, and some are drawn to risky behaviors. A 2017 study by the National Institute on Drug Abuse (NIDA) found that 3 percent of twelfth graders reported taking large doses of cough medicine to get high.5

Open dialogue and taking steps to protect the family are great ways to reduce the probability of future problems. The truth is some people will experiment and some people will face addiction no matter how many precautions you take.

Side Effects of Dextromethorphan (DXM) Abuse

Side effects of dextromethorphan abuse include:

  • Nausea
  • Panic attacks
  • Sweating
  • Loss of motor coordination
  • Sedation
  • Slurred speech
  • Racing heart rate
  • Disassociation
  • Intense confusion
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Signs and Symptoms of Dextromethorphan (DXM) Abuse and Addiction

Teens may be more at risk for developing dextromethorphan addiction, as they are most likely to experiment with drugs like DXM. However, no one is immune to the risk. Some common signs and symptoms of DXM abuse or addiction may include:

  • Disconnecting from family and friends
  • Sudden changes in eating and sleeping habits
  • Needing larger doses of DXM to achieve the same effects (developing a tolerance)
  • Experiencing withdrawal symptoms when reducing DXM use or when trying to quit
  • Wanting to stop abusing DXM but being unable
  • Having cravings for DXM
  • Buying large amounts of over-the-counter products that contain DXM

Dextromethorphan (DXM) Detox and Withdrawal

Chronic abuse of dextromethorphan can cause withdrawal symptoms, such as:

  • Anxiety
  • Weight loss
  • Diarrhea
  • Insomnia
  • Upset stomach
  • Shakiness
  • Excessive sweating
  • Hallucinations
  • Depression6

Dextromethorphan withdrawal symptoms can be difficult to manage on your own without professional medical assistance and the discomfort can make it very hard to quit. Medical detox programs can make DXM detox and withdrawal much easier to manage and can also improve your odds of staying sober long-term.

Medical detox provides round-the-clock monitoring as well as medication-assisted treatment to reduce the severity of withdrawal symptoms. Clinical therapy is also provided to help clients address the psychological side effects of withdrawal and prepare for entry into rehab.

Treatment for Dextromethorphan (DXM) Addiction

After completing a medical detox program for DXM addiction, enrolling in a drug rehab program can be a helpful way to address the contributing causes of addictive behavior. It can also provide critical life skills, education, and behavioral therapy to curb the addiction and pave the way for a lifestyle of sobriety.

According to the National Institute on Drug Abuse (NIDA), individuals in recovery benefit most from long-term addiction treatment that lasts 90 days or longer. Like any other chronic, relapsing disease, ongoing treatment can help people maintain their sobriety and learn how to manage their disease so they can successfully live a drug-free life.

During a drug rehab program for DXM addiction, clients will participate in various treatment methods that are designed to help them overcome negative mindsets, beliefs, and attitudes that contribute to addiction. These evidence-based treatment methods also provide opportunities for personal growth that will enhance a sober lifestyle.

  • Educational lectures about addiction and recovery
  • 12-Step Program work (or a similar recovery program curriculum)
  • Training on how to cope with high-risk situations, triggers, and drug cravings
  • Life skills development

Clients achieve these objectives by working closely with addiction treatment professionals and their peers in recovery. Many rehab centers use a mixture of medical and clinical treatment methods to provide a well-balanced evidence-based treatment process that addresses the whole person, not just the addiction.

Inpatient Drug Rehab vs. Outpatient Drug Rehab for Dextromethorphan (DXM) Addiction

Two of the most common types of drug rehab programs for DXM addiction are inpatient rehab programs and outpatient rehab programs. While there are some differences between the two, they are both recovery-focused. Here is a side-by-side comparison.

In residential rehab, clients:


  • Maintain residence at the rehab center
  • Adhere to a structured, daily schedule set by staff
  • Attend daily group and individual counseling sessions
  • Participate in various types of therapeutic activities and group activities daily
In outpatient rehab, clients:


  • Attend a series of structured outpatient group sessions
  • Live at home or in a sober living home
  • Complete homework assignments independently
  • Maintain other personal obligations like a job or school while in rehab

In most cases, residential drug rehab is ideal for people who have severe addictions and complex medical and clinical treatment needs. However, anyone can attend residential treatment if they want to.

The cost of drug rehab will vary depending on the type of treatment services that are provided, the location, the rehab center’s amenities, and many other factors. Fortunately, many payment options can reduce the costs associated with rehab, including:

Continued Care Options for Dextromethorphan (DXM) Addiction Treatment

People who are recovering from substance use disorders need ongoing treatment to prevent relapse and to maintain a healthy and happy sober lifestyle. There are several different types of continuing care options for people in recovery, with sober living programs and aftercare being two common ones.

Sober Living Programs

Sober living programs are designed to bridge the gap between rehab and an independent lifestyle of sobriety. They are particularly helpful if a person does not have a safe and sober environment to return to after rehab is over.

Sober living homes, also sometimes called ¾ houses, transitional living homes, or halfway houses, are gender-specific living environments that provide recovery support services for men and women in all stages of sobriety. Common recovery support services offered at sober living homes include:

  • Drug and alcohol testing
  • Personal monitoring
  • Tiered recovery programs
  • Education assistance
  • Employment assistance
  • Volunteer assistance

The cost of a sober living program varies greatly depending on its location, amenities, and recovery support services offered. Payment is often collected monthly.

Aftercare Programs

Aftercare is another form of continuing care for people in recovery. This type of program provides regular outpatient group meetings that clients attend regularly. Group meetings are designed to be a safe, supportive, and open environment where people can share their struggles and successes in a life of recovery.

Aftercare is also a great opportunity for people in recovery to continue developing their communication skills, meet other like-minded sober people, work through personal issues related to recovery, and provide support to others.

If you or a loved one is struggling with dextromethorphan (DXM) abuse, there is help available. Call (512) 605-2955 to learn more today.


  1. http://www.cesar.umd.edu/cesar/drugs/dxm.asp
  2. https://www.texastribune.org/2019/05/29/texas-passes-law-cough-medicine-dextromethorphan/
  3. https://www.rxlist.com/consumer_dextromethorphan/drugs-condition.htm
  4. https://www.deadiversion.usdoj.gov/drug_chem_info/dextro_m.pdf
  5. http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2017.pdf
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925345/
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