Psychedelics have a long history of use and abuse by cultures all around the world. Their otherworldly effects have been used to achieve deep introspection and religious experiences. In the 20th century, the US government and countercultural psychonauts sought to unlock the secrets of drugs like LSD and MDMA. But today, they remain outlawed for their various unpredictable effects. However, in some cases, psychedelic drugs make it into your medicine cabinet while you are none the wiser.
In fact, there is a good chance that you have the psychedelic dissociative drug dextromethorphan (DXM), in your stockpile of cold medicine right now. But is this ubiquitous chemical substance harmful to your brain?
What Is DXM?
DXM is a chemical drug that’s found in a variety of over-the-counter cough suppressants like Robitussin and NyQuil. It can also be found in pain relievers and is even being used as a treatment for addiction. After preceding chemical compounds were synthesized and tested in the 1940s, scientists successfully tested DXM in a study of drugs that could be a non-addictive replacement for codeine in 1952. By 1958, it was available over the counter.
In recommended doses, DXM has a low risk of adverse effects, and side effects are mild. However, it is sometimes used in high amounts as a recreational drug. It first saw a trend of abuse in the 60s and 70s when the tablet form became available. It was taken off the shelves and replaced by cough syrup.
Now, in the Internet age, DXM information is readily available, and it can easily be bought in enough quantity to abuse. Today, legislators are working on making it harder to buy in bulk. For instance, in California, it is illegal to sell to minors without a prescription.
When abused in high doses, DXM can have hallucinogenic and dissociative effects. It can also have several other adverse side effects, eventually leading to overdose.
Physical Effects of a DXM Trip
As a cough suppressant and expectorant (a substance that removes mucus from your respiratory tract), the recommended dose is between 10 and 50 mg. However, people that abuse DXM for its psychedelic effects take more than 100 mg. Some users take up to 1,500 mg in a single dose, which can have extreme effects and pose a serious health risk.
Users will often drink syrup in large quantities as fast as possible to absorb as much as possible before vomiting. Otherwise, the user’s body may reject the liquid before intoxication is achieved. Some use DXM in tablet form by grinding it and insufflating the powder. This is a more potent method of administration and allows users to achieve a high without injecting large quantities of liquid.
Besides nausea and vomiting, abuse of DXM is associated with several other physical symptoms, including:
- Hot flashes
- Lethargy or hyperactivity
At extremely high doses, some of the more serious effects like hypertension or seizures can cause dangerous.
Cognitive Effects of a DXM Trip
As a psychedelic dissociative, DXM trips can involve hallucinations that dull the senses and make the user feel as if they are cut off from the world around them. The effects can be similar to other abused psychedelics like ketamine and phencyclidine. Experiencing a feeling of dysphoria is also possible, which is the perceived loss of sense of self, like an extreme out-of-body experience.
Other psychological effects of a DXM trip include:
- Visual and auditory hallucinations
- Slurred speech
- Panic attacks
- Floating feeling
- Altered perception of time
An extreme sense of fear and paranoia can lead to a feeling of impending doom. Disturbing psychological effects of psychedelic drugs can sometimes lead to lasting results on mental health.
Are there Neurotoxic Effects of DXM?
In pharmaceutical drugs, toxicity levels are a major part of safety testing. Certain substances can cause damage to the heart, brain, liver, or other parts of the body. With a recommended dose, DXM has a very low toxicity and poses a limited risk. However, some researchers have studied the potential for DXM to act as a neurotoxin in high doses.
Similar drugs like PCP cause Olney’s lesions, which is a form of brain damage caused by NMDA receptors. Since DXM belongs to this group, it was studied extensively in rats to determine its neurotoxicity risk. However, researchers found that DXM does not cause brain damage in rats and there is no evidence that it would be neurotoxic to humans.
Despite the fact that other drugs in its chemical family can harm the structure of the brain, DXM is safe to use without risk of brain damage. However, at high doses, it can still be dangerous in other ways.
Overdose Potential During a DXM Trip
Since an overdose occurs from a high dosage of a drug that causes adverse effects beyond its intended use, most effects resulting from an extreme dosage of DXM are technically a sign of overdose. However, in some cases, seizures, tachycardia, and hypotension require medical intervention. Most overdoses of DXM can be treated in an emergency room and don’t result in serious medical complications or death.
Still, deaths linked to DXM occur in certain circumstances. Most fatal overdoses of DXM happen when high doses of the drug are mixed with other substances like alcohol. And, like some other drugs, DXM can interact with chemicals found in grapefruit that increase liver toxicity. Like other psychedelic drugs, DXM impairs the senses to the point where getting up and moving around, especially in public, can be dangerous. Unlike some other psychedelics, DXM may cause hyperactivity which encourages movement which can lead to accidents.
DXM Dependence and Withdrawal
Though there is very little risk for physical addiction in DXM, the drug has shown potential for psychological addiction. After long periods of abuse, psychological addictions have been reported. When a user quits after a long period of abuse, they may experience withdrawal symptoms that are similar to antidepressant withdrawal.