DXM IMAGES

Dose
As with many psychoactive substances, dosages of DXM vary greatly, depending on the individual and the desired level of effects. Recreational doses range from 100 mg to 1200 mg or more.

Law
DXM is legal to buy, sell, or possess in the United States although it is increasingly common for stores to require that buyers be over 18 years old. If sold for human consumption, it is regulated by the FDA.

Chemistry
Dextromethorphan hydrobromide (C₁₈H₂₅NO) is a semisynthetic derivative of morphine, a chemical found in the opium produced by opium poppies.

Pharmacology
DXM is partially converted by first-pass metabolism into the active compound dextrorphan, which exerts cough-suppressing and dissociative effects through non-competitive antagonism of NMDA receptors. It is non-analgesic and does not cause sedation or respiratory depression. It is readily absorbed and has a half life is around four hours.

History
DXM was approved for use as a cough suppressant in 1958 and soon became widely available in pill form as a non-narcotic alternative to opiate-based cough suppressants. Cough syrups replaced the pill form in the late 1970s to discourage recreational use.

Slang
The Substance: DXM, Robo, Tussin
The Experience: Robo-tripping, Tussing

Onset
DXM takes 20 minutes to 1 hour to take effect, with higher doses generally taking longer. Peak effects of recreational doses begin 1 1/2 to 3 hours after onset.

Duration
Effects of low doses generally last 4-6 hours, with large doses lasting 6 hours or more.

The Experience
The DXM experience varies by dose. Different recreational dose ranges are sometimes described in terms of plateaus of effects. Low doses produce a mild stimulant effect. Moderate doses generally produce intoxicating effects that are sometimes compared to alcohol or cannabis use. High doses are dissociative in the sense of causing a feeling of separation from one's body, and are sometimes compared to the effects of other dissociatives such as PCP or ketamine.

Addiction Potential
Dextromethorphan is believed to be physically non-addictive, but some heavy users report an uncommon psychological addiction. Regular use produces tolerance.

Olney's Lesions?
There has been concern that DXM, like some other dissociatives, causes vacuoles (small holes) in the brain - a syndrome called Olney's Lesions. However, there is some evidence that these concerns are unfounded.

Contraindications

• Do not operate heavy machinery. Do Not Drive.
  
  
• Do not take while pregnant. Dissociatives can seriously affect fetal brain development.
  
  
• Many DXM-containing products (such as Coricidin Cough and Cold) also contain other active ingredients which can be dangerous or fatal in high doses. See Guide to DXM in Nonpresescription Drugs for more information.
  
  
• Avoid using DXM in combination with alcohol.
  
  
• Do not take DXM if you have recently taken an MAOI. MAOIs are most commonly found in the prescription anti-depressants Nardil (phenelzine), Parnate (tranylcypromine), Marplan (isocarboxazid), Eldepryl (l-deprenyl), and Aurorex or Manerix (moclobemide). Ayahuasca also contains MAOIs (harmine and harmaline). DXM and MAOIs are a potentially dangerous combination. Check with your doctor if you are not sure whether your prescription medication is an MAOI.
  
  
• Do not take DXM if you have recently taken an SSRI such as fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft).
  
  
• DXM use in combination with other OTC cold remedies can increase risk of adverse reaction.