What is DXM?
DXM is short for Dextromethorphan. In small amounts its a very effective cough suppressant, but in large amounts it is a very powerful dissociative drug. This can be found in many over-the-counter cough medicines.
This drug has been used for recreational purposes for around 30 years. During the sixties and seventies, DXM was available over the counter in tablet form. It was introduced as a replacement for codeine-containing cough remedies in an effort to cut down on abuse.
DXM has notably different effects at different dosage levels. There are 4 distinctive levels, and we call these levels "plateaus". Most recreational use happens during the first and second plateau. Doses are measured in mg/kg or milligrams per kilogram. So to find your dosage take your weight in kg (pounds divided by 2.2), and then divide it by how many total milligrams your taking. It is hard to describe how any of these plateaus feel, because DXM is one of those things you have to experience to know.
• 1st Plateau: 1.5-2.5 mg/kg This is the weakest level. This feels slightly intoxicating, a little light headed. Some music euphoria is noticeable.
• 2nd Plateau: 2.5-7.5 mg/kg This level is often compared to being stoned and drunk at the same time. When this might seem true, there is also a noticeably strong "mental" high also. You can have trouble talking with slurring and can have a hard time carrying on an in-depth conversation because your short-term memory can be temporarily impaired. And occasionally you can have mild hallucinations.
• 3rd Plateau: 7.5-15 mg/kg This level has strong intoxications and hallucinations. Things can become very confusing as your thinking processes are disturbed. You can sometimes daze-off into your own world, and get lost in your own mind. Trips in this plateau can sometimes be unpleasant.
• 4th Plateau: +15 mg/kg This is the strongest level. This is a sub-anesthetic dose, and can be compared to a high dose of Ketamine. Your mind and body become separated at this level and it can become dangerous psychologically, and physically. Personally I say that you should never have to go this high, it can be very dangerous. But whatever you do, NEVER go past 20 mg/kg (about 2000mg for a 220lb person), this can become very toxic and kill you.
DXM doesn't appeal to everyone; in fact, it seems to follow a "rule of thirds". One-third of people who try DXM like it, one third hate it, and one third could care less. Especially if you take too much, DXM. Some of the more important dangers you might want to know about are:
Nausea, diarrhoea, vomiting, and allergic reactions (often from the cough syrup itself)
Hot flashes, dizziness, and bad trips
Psychotic breaks (generally from high dose use)
Psychological addiction and depression (generally from regular use)
Irreversible brain damage (from chronic use at high doses)
This drug is mildly addictive, but usually only mentally.
DXM is found in over the counter cough medicines or syrups.
Most DXM-containing cough syrups also contain one or more of the following other active ingredients: nasal decongestants, antihistamines, acetaminophen, or guaifenesin. These substances can be dangerous or fatal in high doses (which you automatically consume when using DXM as a recreational drug).
Most people who have used DXM cough syrups recreationally seem to prefer to take it on a mostly empty stomach, possibly with crackers or some other source of carbohydrates. You might want to avoid slamming your kidneys and pancreas with a lot of glucose at once, therefore eating some crackers or so is advisable.
When taken recreationally the "trip" usually lasts around 5-6 hours. That's including the come-up, peak and come-down.
One more time: most DXM-containing cough syrups also contain one or more of the following other active ingredients: nasal decongestants, antihistamines, acetaminophen, or guaifenesin. These substances can be dangerous or fatal in high doses (which you automatically consume when using DXM as a recreational drug).
Don't take DXM if you are taking any of the following other drugs:
Antidepressants of any kind. MAOIs (monoamine oxidase inhibitors) are the worst; DXM + an MAOI will kill you. DXM with other antidepressants can cause serotonin syndrome, an unpleasant and occasionally fatal condition.
Diet drugs like phentermine, fenfluramine (Redux), or phen-fen. Again, a risk of serotonin syndrome.
Non-drowsy antihistamines (allergy medicines) like Allegra, Seldane, or Hisminal.
Links / Further reading
This article is based on the following pages: