DXM, or dextromethorphan, is a common ingredients in many over-the-counter cough medicines. It is often abused in high doses because it has dissociative, sedative, and stimulant properties. Due to its availability, one in ten teenagers reported abusing DXM in 2008. When taken as directed, DXM-containing medications are effective cough suppressants, but when abused, they can produce effects similar to illicit dissociative drugs like PCP and ketamine. Abusing DXM can lead to all sorts of severe physical health problems, including increased heart rate and low blood pressure. However, the most frightening effects of dextromethorphan abuse may be its ability to produce psychosis and extreme detachment from reality. DXM is a dissociative drug like PCP and ketamine. According to the National Institute on Drug Abuse, at high doses, dissociative drugs can cause “Marked psychological distress, including feelings of extreme panic, fear, anxiety, paranoia, invulnerability, exaggerated strength, and aggression.” For this reason, DXM has been referred to as the “poor man’s PCP”. When taken as directed, dextromethorphan can be an effective cough suppressant. However, at higher doses, the effects can be severe. According to a 2017 Psychopharmacology Bulletin entitled Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis, “When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia.” Other research shows that DXM use can cause violent behaviors, elevated temperatures, and death from cardiac arrest or respiratory failure. DXM acts on similar brain areas as PCP and ketamine, and can even cause false positives for PCP on drug tests. According to the U.S. Department of Health and Human Services’ publication Facts on Dextromethorphan (DXM), “Other effects of DXM abuse can include impaired motor function, numbness, nausea and vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage can occur. That means little or no oxygen can get to the brain.” Also, many medications containing DXM also contain aspirin, which can cause severe liver damage when taken in high quantities. DXM can be psychologically addictive. According to the National Institute on Drug Abuse, “Repeatedly seeking to experience that feeling can lead to addiction-a chronic relapsing brain condition characterized by inability to stop using a drug despite damaging consequences to a person’s life and health.” The more frequently a person abuses DXM, the more likely they are to experience negative health effects, including severe psychosis, from the drug.
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