Dextromethorphan is a cough suppressant found in many over-the-counter cold and flu medications, including cough syrups. When codeine, a mild opioid narcotic, was moved to Schedule III and required a prescription for purchase, drugs containing dextromethorphan were popularized since the active ingredient was believed to be safer.
Unfortunately, dextromethorphan has been shown to be habit-forming and intoxicating. It is now a drug of abuse that can even cause a life-threatening overdose when a person consumes too much. Nonmedical abuse of DXM can lead to experiences that are reportedly similar to those caused by PCP or ketamine. It is legal for purchase, although many states may require a driver’s license or other identification to prove purchasers are of age.
Symptoms of dextromethorphan intoxication include:
Although dextromethorphan alone can cause intoxication, other drugs often found in cold or flu medicines can enhance the ingredient’s effects. These include analgesics like acetaminophen, antihistamines, and decongestants like pseudoephedrine.
Long-term abuse of dextromethorphan-based drugs often leads to dependence, tolerance, and addiction.
The Drug Enforcement Administration (DEA) lists different dose-dependent plateaus, as experienced by people who abuse DXM. The maximum recommended daily dose of DXM is 120 mg; beyond that, intoxication and dangerous side effects begin to appear.
Intoxication from a nonmedical dose begins between 15 and 30 minutes after ingestion, as the stomach digests the drug, and the effects typically last for 3-6 hours. At 1500 mg or more, a person is likely to overdose on dextromethorphan. This is 5-10 times the recommended dose of any over-the-counter medicine containing DXM.
Common behavioral symptoms from DXM overdose include hyperexcitability and somnolence. If a person displays either, or both, of these symptoms, they may be experiencing an overdose. Also, if a person appears to experience hallucinations or psychosis, they may be overdosing on DXM.
Dangerous physical symptoms of dextromethorphan overdose include tachycardia, slow breathing, changes in blood pressure and body temperature, and seizures. It is important to get help for a person suffering from a DXM overdose before these symptoms begin because they are more likely to lead to coma or death.
If a person is overdosing on DXM, they require emergency medical attention. Call 911 immediately. There are no drugs that counteract a DXM overdose; the only way they can survive the condition is to get help in a hospital immediately.
In the hospital, a dextromethorphan overdose will be treated with several emergency procedures to stabilize the individual. Some of these may include:
However, some people are simply poor metabolizers. People who fall into this category do not metabolize medications as efficiently as the average person. Typically, these people should take smaller doses than recommended for over-the-counter or prescription medicines to avoid intoxication, addiction, and overdose. However, a person may not know that they fall into this category until it is too late. It is important to know the symptoms of overdose, and if they are experienced, call 911 or go to the nearest emergency room.
Combining DXM and antidepressants can cause serotonin syndrome. This occurs when the brain is flooded with too much serotonin. Symptoms of serotonin syndrome include:
This is not an overdose of DXM, but it is a very dangerous condition that requires emergency medical attention. People experiencing serotonin syndrome or those witnessing someone who is, should call 911 immediately.
It is important to get help to end substance abuse problems before side effects become life-threatening. Detox with the help of a medical professional, a complete rehabilitation program, and social support are the components of a successful rehab program. Professional programs offer various kinds of therapy and supportive treatments to help clients end substance abuse issues related to specific drugs, including DXM.