Recreational use of dextromethorphan
Dextromethorphan, or DXM, a common active ingredient found in many over-the-counter cough suppressant cold medicines, is used as a recreational drug and entheogen for its dissociative effects.
[6] Owing to its recreational use,[7] many retailers in the US have moved dextromethorphan-containing products behind the counter so that one must ask a pharmacist to receive them or be 18 years (19 in New York and Alabama, 21 in Mississippi) or older to purchase them.
At high doses, dextromethorphan is classified as a dissociative general anesthetic and hallucinogen, similar to the controlled substances ketamine and phencyclidine (PCP).
[17] In addition to producing PCP-like mental effects, high doses may cause a false-positive result for PCP and opiates in some drug tests.
William E. White, author of the "DXM FAQ", has compiled informal research from correspondence with dextromethorphan users suggesting that heavy abuse may result in various deficits corresponding to the brain areas affected by Olney's lesions; these include loss of episodic memory, decline in ability to learn, abnormalities in some aspects of visual processing, and deficits of abstract language comprehension.
[1] Misuse of multisymptom cold medications, rather than use of a cough suppressant whose sole active ingredient is dextromethorphan, carries significant risk of fatality or serious illness.
Multisymptom cold medicines contain other active ingredients, such as paracetamol (acetaminophen), which can cause permanent bodily damage such as kidney failure or death if taken in quantities exceeding the recommended dose.
[26][27][28] Guaifenesin, an expectorant commonly accompanying dextromethorphan in cough preparations, can cause unpleasant symptoms including vomiting, nausea, kidney stones,[29] and headache.
Central nervous system (CNS) stimulants such as amphetamine and/or cocaine can cause a dangerous rise in blood pressure and heart rate.
[citation needed] In Russia, dextromethorphan (commonly sold under the brand names Tussin+ and Glycodin) is a Schedule III controlled substance and is placed in the same list as benzodiazepines and the majority of barbiturates.
[37] In December 2021, the National Medical Products Administration reclassified all oral single-component dextromethorphan to prescription drugs due to potential abuse.
[39] In April 2024, the National Medical Products Administration announced that dextromethorphan, compound diphenoxylate tablets, nalfurafine, and lorcaserin are included in the second-class psychotropic drug catalog.
Indonesian National Narcotic Bureau has even threatened to revoke pharmacies' and drug stores' licenses if they still stock dextromethorphan, and will notify the police for criminal prosecution.
[47] In its official press release, the bureau also stated that dextromethorphan is often used as a substitute for marijuana, amphetamine, and heroin by drug abusers, and its use as an antitussive is less beneficial nowadays.
MEpid., states that dextromethorphan, being chemically similar to morphine, has a much more dangerous and direct effect to the central nervous system, thus causing mental breakdown in the user.
[50] This claim is contradicted by numerous scientific studies which show that naloxone alone offers effective treatment and promising therapy results in treating dextromethorphan addiction and poisoning.
Cases of individuals being sentenced to time in prison and other penalties for selling pure dextromethorphan in this form have been reported, because of the incidental violation of more general laws for the sale of legitimate drugs – such as resale of a medication without proper warning labels.
