Dextromethorphan (DXM) Misuse, Overdose, and Treatment

Dextromethorphan (DXM) is a common ingredient in many over-the-counter cough and cold medicines. When used as directed, it’s a safe and effective cough suppressant. But when taken in large doses or for non-medical reasons, DXM can cause hallucinations, euphoria, and serious health risks—including addiction and overdose.

If you or someone you love is misusing DXM, help is available. Understanding how the drug works, the dangers of misuse, and the treatment options available can make recovery possible.

What Is Dextromethorphan (DXM)?

Dextromethorphan is a cough suppressant in over-the-counter cough syrup. This drug works by signaling the part of the brain that triggers the cough reflex. When dextromethorphan is taken in excess, people feel euphoric or “high.”

According to the Journal of the American Board of Family Medicine, the effects of dextromethorphan misuse can range from a mild stimulant effect with distorted visual perceptions to a sense of complete dissociation from one’s body. The severity of the effect depends on how much dextromethorphan is consumed. These effects typically last for six hours.

Additional symptoms of dextromethorphan drug abuse include:

• Bizarre and hyperactive behavior.
• Fast, uncontrollable movements of the eyes.
• Lack of muscle coordination.
• Hallucinations.
• Depression.
• A false-positive urine test for PCP.

Signs and Risks of DXM Misuse

Because DXM is legally available and inexpensive, misuse is especially common among teens and young adults. Many take cough syrup in high doses or combine it with soda or candy, a practice often referred to as “robotripping.”

Chronic DXM misuse can lead to:

• Psychological dependence
• Insomnia
• Dysphoria (feelings of unhappiness or dissatisfaction)
• Toxic psychosis (loss of contact with reality)
• Memory and concentration problems
• Over time, misuse can also strain relationships, interfere with school or work performance, and increase the risk of overdose.

Can You Overdose on Dextromethorphan?

Yes. A DXM overdose can occur when someone intentionally or accidentally takes too much of the drug. Overdose risk increases when DXM is combined with alcohol, opioids, or other medications.¹

Signs and Symptoms of DXM Overdose

Common signs of DXM overdose include:²

• Bluish fingernails or lips.
• Breathing problems.
• Blurred vision.
• Drowsiness or loss of consciousness.
• Elevated heart rate.
• Muscle twitching.
• Nausea or vomiting.
• Hallucinations or confusion.

If you suspect someone has overdosed on DXM, call 911 immediately. While waiting for help, stay with the person and provide emergency responders with as much information as possible, including the product name, the amount taken, and the time of ingestion. Prompt medical attention can mean the difference between life and death.

DXM Overdose Treatment

At the hospital, healthcare professionals will assess the person’s vital signs, including heart rate, blood pressure, breathing rate, and temperature, and may perform blood and urine tests.

Treatment for DXM overdose can include:^2,3

• Gastric lavage (stomach pumping) to remove remaining drug from the stomach.Activated charcoal to prevent further absorption.
• Breathing support, such as a ventilator, if respiratory distress is present.
• Intravenous fluids to stabilize hydration and blood pressure.
• Naloxone, in some cases, to reverse the effects of the drug.
• Benzodiazepines to prevent seizures.
• Cooling measures to manage high body temperature.

Most people who receive timely medical treatment recover fully. However, an overdose is often a sign of a deeper problem )such as substance misuse or a co-occurring mental health issue) that requires longer-term treatment.

Can You Die From a DXM Overdose?

Overdosing on DXM can be, but usually isn’t, fatal. Most deaths from overdose occur because people take dextromethorphan with other drugs or are involved in an accident.⁴

However, a 2009 research study investigated the deaths of five adolescents who had purchased dextromethorphan from the Internet. Despite the presence of other substances in their bloodstream, autopsies found that the primary cause of death was toxic levels of dextromethorphan.⁵

Recovering From a DXM Overdose

Many people survive a DXM overdose and go on to recover fully with proper care. According to the Drug Enforcement Administration (DEA), overdose on DXM does not typically result in severe medical consequences or death when treated promptly. Still, any overdose should be viewed as a critical warning sign.

Recovery often requires addressing the reasons behind misuse. Treatment programs that combine medical detoxification with therapy and relapse prevention can help prevent another overdose and promote long-term healing.

How to Treat Dextromethorphan Addiction

If you or a loved one is struggling with DXM misuse or dependence, professional treatment can make a life-changing difference.

Checking into a residential dextromethorphan recovery center provides 24-hour care, structure, and therapeutic support to help individuals:

• Manage withdrawal symptoms safely.
• Understand why they turned to DXM or other drug.
• Develop healthy coping skills.
• Recognize and manage triggers.
• Build relapse prevention strategies for lasting recovery

Common approaches to DXM addiction treatment include:

• Medical detox and intervention.
• 12-step programs.
• Community-based and holistic healing.
• Spiritual or faith-based approaches.
• Behavioral therapies such as CBT or motivational interviewing.

Inpatient and Outpatient Treatment Options

Inpatient treatment involves living at a recovery center for several weeks or months. This environment provides structure, medical supervision, and access to therapies such as:

• Individual and group counseling.
• Recreational or art therapy.
• 12-step support groups.
• Vocational and life-skills training.

Outpatient treatment offers similar therapies but allows participants to live at home and attend sessions several times per week. This option may be suitable for those with milder substance use disorders or strong support systems.

Dual diagnosis programs treat both substance use and co-occurring mental health conditions, such as depression or anxiety. Treating both together greatly reduces the risk of relapse.

Finding the Right Dextromethorphan Recovery Center

Choosing the right recovery center can feel overwhelming, but asking the right questions helps narrow your options:

• Location: Would you prefer treatment close to home or in a new environment away from triggers?
• Cost: Inpatient programs tend to cost more than outpatient ones, but insurance may cover part or all of the expenses.
• Staff qualifications: Look for licensed addiction professionals and accredited facilities.
• Program length: Inpatient programs typically last 30, 60, or 90 days, though some offer longer stays.
• Aftercare: The best programs include ongoing support, relapse prevention planning, and check-ins after discharge.

Paying for Treatment

The cost of DXM rehab varies depending on location, duration, and amenities. Fortunately, several options can help make treatment affordable:

• Insurance: Many health insurance plans cover all or part of addiction treatment.
• Sliding-scale programs: Some centers adjust fees based on income.
• Medicare or Medicaid: Public insurance programs may cover certain treatment costs.
• Payment plans or financing: Some facilities allow monthly payments or offer financing options.

Before enrolling, contact your insurance provider or the rehab center directly to verify coverage and costs.

Take a Step Toward Recovery Today

Chronic DXM misuse and addiction can be difficult to diagnose and are often overlooked by medical professionals. But recovery is always possible with the right help, support, and treatment.

If you or a loved one is ready to seek help for dextromethorphan misuse, you don’t have to face it alone. Explore your options and reach out to a rehab center today using Recovery.com. Taking the first step toward help could be the beginning of lasting recovery.