Dextromethorphan (DXM) is a substance present in dozens of over-the-counter (OTC) medications, often under brand names, such as Robitussin, Vicks, and Theraflu. It can also be found in a variety of forms, including liquid, gelcaps, and tablets. Reports of abuse of DXM reach back several decades.
Despite this, many loved ones of potential abusers remain relatively unaware of how problematic DXM misuse can become. In fact, according to the National Capital Poison Center, approximately 6,000 young people visit an emergency department each year concerning DXM abuse. While suicide or self-harm is not common, excessive DXM doses can induce hallucinations and psychotic symptoms that could result in adverse consequences.
The Problem’s Scope
According to NIDA (National Institute on Drug Abuse), just over three percent of American adolescents report having abused cough and cold medications. DXM abusers report experiencing a broad range of effects. Doses three or four times the label’s recommended allowance can produce effects comparable to those of alcohol.
DXM can induce highs similar to PCP (phencyclidine) or Angel Dust when taken in extremely high doses, which include hallucinations, euphoria, dissociative feelings, and out-of-body experiences.
Many OTC medications containing DXM also include other substances such as pain relievers, decongestants, and antihistamines. Very high doses of any of these elements come with their own set of risks. For instance, acetaminophen is detrimental to the liver in extreme amounts, and antihistamines can also produce hallucinations. Moreover, the combination of these ingredients can compound the overall risk of dangerous effects.
One of the main reasons young people misuse these drugs is that they may be more easily accessible than alcohol and illicit drugs. For many people seeking to get high, DXM suffices when they cannot obtain more preferable substances. Furthermore, social media has brought a whole new element to the DXM community, where abusers can share experiences and recipes and encourage others to do the same. For susceptible persons, the Internet is remarkably influential, especially if it is their primary method of socialization.
Stages of Robotripping
Effects of robotripping can vary significantly depending on how much is consumed. DXM causes different levels of intoxication that vary with dosage.
A 100-200-milligram (mg) dose of DXM induces effects comparable to ecstasy. Individuals describe feeling more energetic, sociable, and talkative.
A 200-400 mg of DXM may induce effects similar to alcohol intoxication, such as euphoria, except with a more significant decrease in motor skills and cognitive functioning.
A dose of 400-600 mg of DXM can induce effects similar to ketamine (Special K) include dissociation, hallucinations, and complete loss of motor coordination.
The 4th stage involves an extremely high DXM dose anywhere from 500-1,500 mg, and the effects may be comparable to taking a hallucinogen like PCP.
Ingesting this amount of DXM can cause a trance-like state and potentially out-of-body experiences. Delirium and hallucinations can result in hostile, aggressive or violent behavior and reduced pain perception.
Physical Side Effects
DXM can induce several physical effects that vary between individuals and by dose. Also, DXM products often contain other active ingredients that cause unique complications. Potential side effects include the following:
High body temperature
Hot flashes and sweating
Itching and rashes
Involuntary eye movements
Onset of Effects
Effects of using excessive doses of DXM tend to begin around 30-60 minutes after ingestion and peak between 2-4 hours. However, the amount, other ingredients, body mass index, and individual factors can influence the onset and duration of effects.
What’s Being Done
In 2008, makers of OTC cough and cold medications voluntarily placed a warning on product packing that urged people to learn more about medicine abuse at www.stopmedicineabuse.org. In 2010, the pharmaceutical industry laid out a plan to reduce abuse through education, outreach to at-risk youths, and support of restricting access. For example, the Consumer Health Product Association (CHPA) now monitors Internet searches related to DXM abuse and directs young people to information about its potential risks.
Also, since 2012, fourteen states have enacted laws to restrict the sale of cold and flu medications that contain DXM to individuals under age 18. In these states, pharmacies and retailers require proof of age before selling any product that includes DXM and may be subjected to fines if they allow minors to buy these medicines. Still, DXM can be readily abused by adults.
According to Consumer Reports, in the U.S., several drugstore chains such as Rite-Aid and Walgreens state they have voluntarily employed these regulations for all of their stores. Even with these measures firmly in place, however, access by young persons is not impossible—they can be purchased by any individual 18 years or older who is willing to do so for others. And while some pharmacies keep these medicines behind the counter, many do not, leaving them on the shelf within easy reach of potential shoplifters.
What Loved Ones Should Do
Even with strict limitations in place, there is always room for mistakes. Loved ones of potential abusers unaware of the risks of medications containing DXM may have them accessible in their family’s medicine cabinet. Experts urge people to monitor all medications in the home and never leave prescription or over-the-counter drugs with abuse potential available to others.
Getting Help for Drug Abuse
If a loved one has anxiety, depression, or any other mental health disorder(s), don’t assume that they haven’t secretly been considering or engaging in self-medication through drug abuse. Like other potential signs and symptoms of drug or alcohol abuse, it is essential not to ignore changes in mood, behavior, mood, or social group.
Ultimately, robotripping is risky behavior and may need to be subject to professional help, especially if the individual affected by it has been abusing other substances. Just Believe Detox and Believe Recovery centers are specialized addiction treatment centers that offer multifaceted programs that include behavioral therapy, counseling, group support, relapse prevention, aftercare planning, and more.