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from the DXM FAQ

3   DXM QuickFAQ

used at Erowid with the permission of author William White

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This is a quick question-and-answer section about DXM which avoids most of the technical detail of the full FAQ sections. However, since DXM is a complex drug, you are advised to read the appropriate sections in the full FAQ.


3.1   What is DXM?




DXM, or dextromethorphan, is a cough suppressant drug found in cough syrups and cough medicines. It can be used recreationally, but there are risks.















3.2   You Mean I Can Get High Off Cough Syrup?




Yes, if you choose the right kind; if you pick the wrong kind, you can end up dead. And you may not like the "high" you get; some people love it, others hate it.















3.3   What Kinds of Cough Medicine are Safe?




Basically, anything containing ONLY dextromethorphan hydrobromide (DXM HBr). Popular US brands include Robitussin Maximum Strength Cough (and generic equivalents), Drixoral Cough Liquid Caps (the red kind), and generic equivalents.















3.4   What Happens if I Drink the Wrong Cough Syrup?




If it has gauifenesin (Robitussin DM and generic "DM" syrups have this drug), you'll probably puke your guts up. If it has acetaminophen (paracetamol), you stand a good chance of a painful, prolonged death. Anything else, you're likely to ruin the trip and may end up in the hospital.















3.5   I'm Taking Other Drugs -- Can I Take DXM?




Quick answer: it depends. Don't take DXM if you are taking any of the following other drugs:
  • Antidepressants of any kind. MAOIs (monoamine oxidase inhibitors) are the worst; DXM + a MAOI will kill you. DXM with other antidepressants can cause serotonin syndrome, an unpleasant and occasionally fatal condition.
  • Diet drugs like phentermine, fenfluramine (Redux), or phen-fen. Again, a risk of serotonin syndrome.
  • Non-drowsy antihistamines (allergy medicines) like Allegra, Seldane, or Hisminal.
















3.6   What's the DXM Trip Like?




Well, that depends on how much you take. There are four different kinds of experiences, based on the dosage; these are called plateaus. The first plateau is a mild stimulant effect with a little bit of a buzz, and has been compared to MDA. The second plateau is more intoxicating and has been compared to being drunk and stoned at the same time. The third plateau is dissociative, like a lower dose of ketamine. The fourth plateau is fully dissociative like a higher dose of ketamine.

You should not attempt higher plateau doses unless you have someone with you who can take care of you in case you get sick or freak out. It happens on DXM. Many things can happen unexpectedly on upper plateaus, such as spontaneous memory recall, complex delusions, hallucinations, out-of-body experiences, near-death experiences, and perceived contact with spiritual or alien entities. You need to be pretty stable and grounded before you can handle these things.















3.7   How Much DXM Do I Take?




See the full FAQ; it's complicated and depends on your body weight; furthermore, some people can't handle DXM due to a genetic mutation in an important enzyme. So you always want to do a low dose on your first trip, and then increase gradually with each new trip.















3.8   Is DXM Like Acid?




No. It's more like ketamine or PCP, but not much like them either.















3.9   Is DXM Fun?




Some people think so; others point out that while the lower two dosage plateaus are more recreational or fun, the upper two seem to be more suited for self-exploration and shamanic work.















3.10   Is DXM Dangerous?




Yes, especially if you take too much. Some of the more important dangers you might want to know about are:
  • Nausea, diarrhea, vomiting, and allergic reactions (often from the cough syrup itself)
  • Hot flashes, dizziness, and bad trips
  • Psychotic breaks (generally from high dose use)
  • Psychological addiction and depression (generally from regular use)
  • Irreversible brain damage (from chronic use at high doses)
The last -- brain damage -- is fairly rare, occurring in less than 1% of the regular users I've interviewed. They all used DXM very frequently. If you do DXM twice a month or less, you'll probably be OK. But remember there's always the risk of something going wrong.















3.11   If DXM is Dangerous, Why Do It?




That's up to you. Most people in our culture seem to shun the idea of taking real risks, whether it be through drugs or high-risk sports such as mountain climbing and hang gliding. On the other hand, when someone goes and climbs a mountain without adequate equipment and training, and then falls to her death, nobody goes and blames the mountain.

There are many people who believe that the risks of DXM (or other drugs) are worth the rewards. If you are a legal adult and are willing to take responsibility for your actions, in my opinion you should be permitted to experiment with psychedelics to your heart's content.