Dextromethorphan is an antitussive cough suppressant that was officially put on shelves in 1958 to be sold over the counter to cut down on/replace codeine as a cough syrup, which is a potentially addictive narcotic. Common brands names with dextromethorphan (DXM, DM) as the main ingredient include Robitussin Cough, Delsym, Benylin Adult Formula Cough Suppressant, and Vicks 44 Cough Relief. Numerous combination formulas containing DM exist, as well. While DM is tremendously useful in relieving cough by acting on the portion of the brain that controls coughing, dextromethorphan has unfortunately also been found to produce psychedelic effects when used recreationally in a manner inconsistent with its labeling.
Dubbed “robo tripping”, recreational users generally experience an altered consciousness at dosages 7 to 50 times the remedial dosage and find themselves in a dissociative state with speeding up or slowing down of sensory input. Users report experiencing stages of highs called plateaus in which they report several feelings and sensations from an intoxicated feeling all the way to out of body and hallucinatory occurrences. While these “trips” may be fun and exciting to those who are looking for a “legal” (easy to purchase) way to get high, little do most people know that DXM can be lethal and can kill you from just one “robo trip.”
Interestingly, not everyone can take dextromethorphan, even at the therapeutic (regular) dosage. When DM is ingested, it is rapidly absorbed by your digestive system just to be processed by a variety of enzymes and metabolic catalysts, one of which is CYP2D6, which a number of the population is deficient in. If you are one who lacks CYP2D6 (you wouldn’t know beforehand), the intensity of what you will feel from DXM and the duration of the high increases, and consequently, the potential for toxicity is a genuine threat. Studies have demonstrated that a large majority of deaths from dextromethorphan occur when one is insufficient in the CYP2D6 enzyme, and to add to that, other very common drugs suppress this enzyme even further. Dextromethorphan cannot be taken with antidepressants of anykind, diet drugs, or non-drowsy antihistamines such as Allegra. In today’s society, it seems that who hasn’t taken any medications from those categories?
While a CYP2D6 deficit can greatly increase your risk of death if you take dextromethorphan, some recreational “robo” users overdose or die simply because not only are they taking excess doses of DXM, but a number of other drugs, as well. Many cold formulas contain not only dextromethorphan (often as dextromethorphan HBr), but also guaifenesin, Tylenol or Advil, and antihistamines, too. A deadly dosage of Tylenol for an adult is just 7.5 grams, which can easily be ingested if one were to take half of a package of cold medication to get high on dex.
While death and coma are the worst-case scenarios that can exist, recreational dextromethorphan users may experience moderate to severe side effects such as psychosis, severe agitation and anxiety, vomiting, itching, sweating, increased urination and frequency of urination, serious diarrhea, rapid heart rate, loss of appetite, seizures, and insomnia. Long-term psychosis, mental disturbance, and brain damage have been reported, as well.
To those out there who are thinking about using dextromethorphan to get high – think twice, because if it doesn’t make you gravely ill, it can promise to destroy your future, and there is a good chance it could kill you, too. Save the dex for that nasty cough you always end up with during the winter, and closely regard the indications and recommendations on the label.