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medication capsules on wooden surface and spoon

DXM, which is the shortened version of dextromethorphan, is a drug that has been used as a cough suppressant across the world for decades. When DXM came out in the 1950s, it was immediately abused by people looking to get a quick and easy high. Because the drug was so widely used, it was pulled from shelves. And years later, drug companies were able to infuse it into other bitter or bad taste medications so that they could limit the potential that people would abuse it, but still take full advantage of its cough suppressant qualities. Over the years, the bad-tasting drug didn’t sell well, so drug companies slowly started to improve the taste. As the taste improved, so did the number of people abusing it, and today, it remains a drug that is widely abused—especially because it is easily accessible.

DXM is easily accessible because it is a popular over-the-counter medication to help people with coughs. There are more than 100 different brands that use DXM in their cough medications, and people take it not only when they have purely respiratory issues, but also the flu, allergies, common cold, chest infections, and more.

DXM as a Medication: the Basics

DXM is a medicinal product that is derived from morphine. Despite its relationship to morphine, however, it is not a controlled substance, and it is also not an opiate. Instead, DXM is considered an NDMA antagonist. NDMA antagonists inhibit the release of a particular neurotransmitter called N-methyl-D-aspartate (NDMA), and this allows people to better control their coughing. Opiate drugs also help suppress coughing in people, but they work in an entirely different way than DXM does.

DXM Abuse: the Basics

DXM is one of the best medications that scientists have come up with to control coughing. But because it’s so effective and helpful to people who need it, it is also very readily available. This means that it’s attractive to people who want to find an easy way to get high. People looking for a quick high may use medicines with DXM in ways that are not medically appropriate. DXM has its own street names, including robo, triple C, red devil, and skittles. Some people even refer to abusing DXM in Robitussin as “Robo-tripping” since people will drink the cough syrup in order to experience a high. Robitussin is not the only drug that people misuse regularly, but other extremely popular drugs like Vicks Formula 44 and Nyquil are also medications that people will drink in order to feel intoxicated.

DXM abuse occurs in a wide variety of populations, including all age groups. However, the majority of DXM addicts are people in younger age groups, most likely since they do not have the ability to access other intoxicants legally or easily, like alcohol. Studies have shown that males are far more likely to abuse DXM than females.

DXM Abuse: How to Gauge the Severity of Someone’s DXM Usage

Because DXM has because so commonplace, the DEA has laid out some guidelines by which to measure the severity and risk that comes with someone’s DXM usage. There are four levels of plateaus of DXM abuse, and each describes how much DXM a person is taking, what they’re experiencing, and if they are at risk for much greater and riskier health repercussions. If you want to gauge your own DXM abuse, or you want to try to see if someone you know is at risk of severe addiction, learn more about each of the four plateaus described by the DEA described below:

  • Plateau One: This plateau represents the least severe stage of DXM abuse. This is usually the plateau people are on when they are just beginning their journey with abusing the dug. People in Plateau one take between 100 and 200mg of DXM per day. When they take the drug, they usually feel euphoric and energized—these people are taking DXM for the stimulant effect.
  • Plateau Two: When people up their regular DXM dosage from 200mg when abusing the drug, they’ve reached plateau two. People in plateau two take between 200 and 400 mg of the drug when they use it. Besides feeling the same feelings of stimulation and euphoria that people in plateau one get, these people tend to also start hallucinating. Most hallucinations that people have in plateau two are visual hallucinations. This is the plateau that where people start to describe DMX abuse as “tripping,” since it has psychoactive effects causing changes in people’s perceptions.
  • Plateau three: When people are taking between 300 and 600 of DXM, they have hit plateau 3 of DXM abuse. When someone reaches Plateau 3 of DXM abuse, they have all the experiences of the previous two plateaus, but more severe—and new symptoms, as well. Besides having feelings of euphoria, feeling stimulated, and hallucinating, people in this phase are now significantly impaired physically. They are unable to operate motor vehicles/machinery. They may also have trouble walking and their vision may be distorted, making it impossible for them to move around a space safely.
  • Plateau four: This is the plateau level that people reach whenever they use more than 600mg of DXM. Anyone who reaches level four of DXM usage experiences the same symptoms as above including euphoria, stimulation, and hallucinations. They also become physically impaired and have a hard time with coordination. Depending on how much DXM a person has consumed, they may also become extremely sedated or lethargic. Alternatively, they may lose consciousness or feel dissociated—as if they are not real or the world around them is not real. This is an incredibly dangerous phase to reach because individuals who are intoxicated may put themselves in physically dangerous situations or take so much DXM that they end up overdosing and having difficulty waking up.

DXM Abuse: the Dangers

Taking DXM as directed controls cough. It can produce a few mild side effects, including nausea, stomach cramping, constipation, and mild drowsiness. Some people who take DXM appropriately may feel dizzy or get a headache, but these side effects are generally tolerable and short-lived, if uncomfortable.

People who abuse DXM, however, experience a wide range of dangerous side effects, and these side effects can not only make someone feel incredibly sick, but they can also become serious and deadly, especially if people abuse the drug over a long period.

The risks associated with DXM abuse include:

  • Liver damage (especially when a person is taking other medications that are processed through the liver)
  • Hypoxia, which can cause organ damage to the brain, lungs, or heart
  • Respiratory issues, especially if they have experienced long-term suppressed respiration thanks to DXM
  • A buildup of excess acids in one’s bodily fluids, which can do damage to the entire body
  • Severe substance use disorder that requires treatment

DXM Abuse: Signs to Watch Out For

DXM abuse can be hard to spot since it is an ingredient in so many over-the-counter medications, and it rarely causes physical dependence, so you won’t notice anything like a physical withdrawal from the drug. However, there are several signs to watch out for if you suspect someone is abusing DXM. Here are some of the most common and prominent signs that you or someone you love may be at risk of having or developing a substance use disorder related to DXM:

  • Frequent consumption of medications with DXM in them, even when you don’t need them for a medical purpose
  • Cravings to use the drug, which arise regularly
  • Using the drug when it is not appropriate or dangerous — e.g. when you have to drive a car or supervise children.
  • Taking DXM with other drugs, which might cause a more intense feeling of intoxication
  • Showing signs that their use is out of control, like continuously buying and finishing bottles of medicines with DXM in them, admitting that they take too much but still using it, worrying that DXM is going to run out, allowing DXM usage to interfere with important daily activities and responsibilities
  • Describing out of body or dissociative experiences when taking DXM
  • Having vision issues after taking the drug
  • Displaying flawed or confused judgment after consuming DXM
  • Appearing intoxicated, but not smelling at all of alcohol
  • Having a high tolerance for DXM, and needing to take more both whether you want to feel intoxicated or whether you actually need it for its medicinal cough suppressant effects

DXM Use Disorder: What to Know if You Suspect You or a Loved are Addicted to DXM

While using DXM is possible without becoming dependent on it, many people don’t realize that people who abuse DXM regularly are at risk of severe health consequences or psychological feelings of dependence. If you or someone you know are using DXM recreationally or in a way not directed by a doctor, you may be at risk of addiction—or feeling like it’s difficult to stop the drug without help. Studies have shown that chronic use of the drug often leads to a significant tolerance to it. This means that people need to take a higher dose or more of the drug to feel the same effect, and it puts people at risk because they may take high enough doses that can end up having extremely negative effects on their physical health and safety.

The greatest risk to anyone chronically using DXM is a feeling of psychological dependence. When people stop the drug, they often experience very unpleasant psychological symptoms or issues, like depression, apathy, feelings of anxiety, cravings that are hard to stave off, and more. You don’t have to be physically addicted to a substance to be diagnosed with substances use disorder—anyone who struggles with their usage, and wants to stop but can’t, deserves to be offered help to reach recovery.

To figure out if you or a loved one have a problem with DXM, consult with a mental health professional. Only trained mental health professionals can assess whether someone’s misuse of the medicine has risen to the level of a substance use disorder, and they can also recommend the level of treatment that seems appropriate for the problem.

What to Do if a Professional Confirms You or Your Loved One is Suffering from DXM Abuse

When you have spoken to a mental health professional and they have determined that someone’s usage of DXM is problematic, it is time to seek treatment. While they might not be in incredible physical danger from stopping usage of the drug cold turkey, the psychological effects of stopping may be intolerable to many people who abuse the drug.

For this reason, treatment can be one of the best options for someone who feels psychologically dependent on DXM. Not only can treatment help someone feel more comfortable while they are quitting usage of a substance they’re used to consuming, but it can also help someone learn how to ride out cravings for the drug without giving into them. Treatment can also be a good option because it can help someone understand why they are using the drug, and it can help them learn better ways to cope or deal with whatever they are medicating with DXM.

If you want to encourage someone in your life to get treatment for DXM abuse, here are some helpful tips. Treatment must be sought by someone who is willing and ready to go, and who wants to be there, in order for it to stick. So, you’ll want to ensure that you approach your loved one with the understanding that they might not feel ready themselves, or might need some time to talk or think about the decision if they have not come up with the idea on their own.

  • Encourage therapy: A therapist might be better support for a loved one suffering from addiction, and their encouragement may feel more relevant or reliable than that of a loved one. If you know someone who is suffering from DXM abuse, consider them to speak to an outpatient psychotherapist. The therapist can gauge the problem and recommend treatment if they believe it is necessary.
  • Have an intervention: Hire a professional interventionist to hold an intervention with the loved one who is suffering. At an intervention, participants tell their loved one they must seek treatment, and they explain the consequences if treatment is not sought. The entire event is orchestrated and controlled by an interventionist who knows how to handle delicate and emotional situations. Participants let the addict know how their DXM usage has affected their life, then offer consequences, should the user choose not to seek treatment. Interventions are often successful when handled properly because they are a great display of love and a tremendous offer of help when a person often feels too lost or resource-less to get help themselves.
  • Contact a treatment center: If you or a loved one are ready to seek treatment for DXM abuse but are just not sure where to get started, contact a treatment center that can handle DXM abuse. Treatment centers will speak to potential addicts (or their family members, if appropriate), and explain how treatment for DXM works. They’ll talk about what it takes to enroll in the program, as well as what to expect while you’re completing it. If you’re ready to get over your DXM abuse, treatment centers can often help you arrange every step of the process—from getting to the treatment center, to getting matched up to your practitioner, to letting you know what to pack and bring, to helping you get home when you’re finished, to following up once you have been home for a certain amount of time. Treatment centers are an excellent resource for substance use disorder sufferers who also feel ready to seek help.

How to Recover from DXM Abuse (and Stay Recovered)

Whether you end up in a treatment program for DXM abuse or you are able to stop using the drug with the help of physicians and mental health professionals, staying in recovery is not as simple as it seems. While the basic definition of recovery is not abusing DXM anymore, people who have recovered from DXM abuse must take many extra steps to help ensure that they stay healthy and well long after their actual usage has stopped. Here are some tips for remaining in recovery from DXM abuse, even long after you no longer consume the drug recreationally.

Get and Stay in a Support Group

There are many free support groups across the world for people who are recovering from substance use disorders. Some rely on 12-step programs, while others are structured practices like regular meditation. Find the support group that fits you and stay in it. In a support group, you may find a mentor or “sponsor” who understands what you need to do to stay sober and who can guide you through the process. Also, finding yourself a healthy community of peers can help ensure that your life is filled with people who make you feel loved and cared for, without including drugs or alcohol in that mix.

Care For Your Body

One thing that happens when someone is actively misusing substances is that they often neglect their own self-care. Start treating your body right and taking good care of it, and you’ll start feeling better and better. Focus on nutrition and ensuring you get enough nutrients to give yourself energy. Hydrate so your organs function properly and you are as awake and alert as possible. Sleep, because it allows both your body and brain to recover. By focusing on taking care of your body instead of abusing it you can remind yourself of how valuable you are and prioritize your health, which you may have compromised while you were using.

Avoid Other Intoxicants

While DXM is its own kind of drug, avoid other intoxicants to avoid slipping back into a pattern of substance misuse. People usually use substances to numb out or seek pleasurable emotions when they are dealing with hard, stressful, or unhappy issues in their lives. If you find yourself drawn to trying another intoxicant, seek a mental health professional or trusted loved one to talk to instead. Turning to different drugs to deal with a problem or to have fun may simply result in addiction again, instead of allowing you to get in touch with your body, understanding your experience, and learning how to cope with healthy options, not just the numbness or oblivion that a chemical can bring.

Getting Treatment for DXM Abuse at Windward Way Recovery

Now that you understand the signs and symptoms of DXM abuse, you may be worried about yourself or a loved one. If someone you know might be suffering from DXM addiction or misusing the drug, one good first step to take is reaching out to the team at Windward Way Recovery. At Windward Way Recovery, we treat patients that suffer from a wide variety of drug and alcohol addictions—including DXM abuse.

For a better understanding of whether you or a loved one qualify for treatment for DXM abuse, reach out to one of our intake specialists. Our team can help you understand the signs and symptoms to worry about, as well as what you can expect from going through treatment at Windward Way Recovery.

Our team is focused on offering comprehensive and compassionate care to a wide range of patients, and we offer a variety of treatment programs, including full-time inpatient rehab, partial hospitalization, and intensive outpatient treatment. When you talk to our team of specialists, you can figure out which treatment program is right for you—then how to get you started in the best program that fits, so you can get started on your way to a happy, healthy, and DXM-free life.

Reach out to us today to learn more about the evidence-based and holistic care that Windward Way Recovery offers.

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