Dextromethorphan hydrobromide (‘DXM’ or ‘DM’) is a drug of the morphinan class with sedative, dissociative, and stimulant properties (at higher doses). It is a cough suppressant in many over-the-counter (‘OTC’) cold and cough medicines especially in those with ‘DM’ or ‘Tuss’ in their names. Dextromethorphan has found numerous other uses in medicine, ranging from pain relief (as either the primary analgesic, or an opioid potentiator) and psychological applications to the treatment of addiction. Not to be confused with Dextrorphan or Dexamethasone. It is sold in syrup, tablet, spray, and lozenge forms. In its pure form, dextromethorphan occurs as a white powder. Examples include Benylin DM, Mucinex DM, Camydex-20 tablets, Robitussin, NyQuil, Dimetapp, Vicks, Coricidin, Delsym, TheraFlu, and Cheracol D.
Know Your Body & Mind — ‘Set’
Know Your Environment — ‘Setting’
Know Your Drug — Practice Harm Reduction
Almost always used orally, although pure DXM powder is occasionally snorted.
DURATION OF EFFECTS
Total duration: 4-6 hours
Onset: 20-60 minutes
Peak: 1.5 – 3 hours
Coming down: 1-2 hours
Hangover/after effects: 1-12 hours
Half life: Even though the apparent effects of the drug wear off after 4-6 hours, the drug is still active in your system for up to 24 hours after you have taken it. Remember this if using other substances or redosing.
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 feel unwell or panic. 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 a strong foundation of support and experience to navigate this space
*Effects vary from person to person. Check out our table below that has listed the potential physical, psychological and emotional effects.
- Taking drugs is never without risk. In an unregulated market it’s impossible to know the purity or dose of any drug. ‘Dose’ depends on the form a drug is in (liquid, powder, pill, crystal) and how you have it (snort, eat, inject).
- Recreational doses range from 100 mg to 1200 mg or more. Use in a comfortable environment with people you trust. It is a good idea to start with a small amount.
Medical Oral Dose
- For coughs, DXM is given at 20-30 mg up to four times per day.
- Some people can’t use DXM due to a genetic mutation in an important enzyme. You always want to do a low dose on your first trip, and then increase gradually with each new trip.
- Carefully consider before taking more, always start with a very small amount to assess your sensitivity and the strength.
Recreational Oral Dose
- Light: 100 – 250 mg
Common: 250 – 600 mg
Strong: 600+ mg
- Higher amounts can come with a higher rate of spiritual or interesting experiences, but the largest doses are riskier due to a higher rate of mania, confusion, and delusions. Although it’s a fairly safe substance in terms of physical effects even at ~1,000 mg, it’s best to remain in the common dose range for psychological safety.
Carrying DXM and paraphernalia (e.g.snorting equipment) puts you at risk of criminal charges including trafficking, even if you don’t deal. Know your local laws Know your local laws e.g. the Drugs Misuse Act 1986 (Qld), the Drugs Poisons and Controlled Substance Act 1981 (Vic).
- Urinary retention
- Increased heart rate
- Increased blood pressure
- Slurred speech
- Red/blotchy skin rashes
- Nystagmus (rapid eye movement)
- Difficulty communicating
- Allergic-like responses
- Mood Lift
- Visual / Auditory hallucinations
- Reduced or increased anxiety
- Music enhancement
- Short term memory loss or confusion
- Altered time perception
‘Set’ is the mindset a person brings with them and includes the physical, emotional and spiritual condition of the person, their expectations about the drug’s effects and how they will react to it. ‘Setting’ is the environment that a person is in, including the social environment, who you are with and the physical surroundings, e.g. at home, at a festival or an unfamiliar location. For psychedelic drugs, more so than other psychoactive substances, set and setting are very important in determining the nature of the experience.
- Try to use in a safe environment with friends and people you trust – somewhere you feel comfortable.
- Always dose yourself and measure your dose to the mL. This way you know how much you are taking
- Take your time and be mindful of how you are feeling as the drug is coming on, before you consider increasing your dose; more is not necessarily better.
- Psychedelics affect all the senses, especially auditory and visual senses, leading to hallucinations.
- Psychedelics alter the way we think, our sense of time, and our emotions. Reactions and experiences can vary dramatically from person to person.
- Research ‘Integration’, which is an ongoing process afterward to translate your psychedelic experience to have a positive impact in your life.
LONG TERM EFFECTS
- Psychological dependence
- Liver damage
It is not recommended to use DXM if you have or are at risk of:
- Respiratory issues (breathing)
- Liver issues
- Heart issues
Roadside Police: Although DXM is not tested for or detectable through saliva tests, there are reports from individuals that the presence of high levels of DXM may cause false positives for PCP and Opiates (illicit and tested for) in standard urine tests. It is illegal to drive under the influence of any illicit drugs, including DXM and any driver may be subject to a roadside behavioural impairment test. Wait at least 24 hours before driving. Taking multiple doses over a period of several hours can lengthen this time period.
Workplace: Urine: 1 hr – 3+ days after; Hair: Up to 90 days; Blood:15min – 2 days after
Drug Checking: Lab-quality testing has been trialled in Australia and is not available as a health service yet but DIY reagent testing is an option. Marquis gives a reaction. [See photos of testing results here > verbinding.110110]
Possible outcomes. What works for one person may not work for another. We recommend you proceed with caution.
- MAOIs – Extreme risk of death
- Anti depressants – Risk of serotonin syndrome possibly fatal
- Diet Drugs (ie.fenfluramine, phentermine or phen-fen) – Risk of serotonin syndrome
- Non-drowsy antihistamines (i.e.. allergy medicines like Allegra, Seldane, or Hisminal) – Avoid. It is safest to take products that only contain DXM. A large portion of over-the-counter products contain an analgesic (e.g. paracetamol, aspirin), a decongestant (e.g. phenylephrine, pseudoephedrine), an antihistamine (e.g. chlorpheniramine, brompheniramine, pheniramine), and/or an expectorant (eg.guaifenesin.) Some of the combinations, such as products containing guaifenesin, typically just lead to gastrointestinal problems. Whereas combining it with paracetamol/ acetaminophen can be very dangerous at recreational doses. Even guaifenesin can occasionally cause significant health problems, such as renal failure.
Low risk effects
– Low Risk
Check out the TripSit drug combinations chart here for info on other combinations.
Call 000 if experiencing adverse effects, feel unwell or concerned in any way
This educational resource has been developed collaboratively by healthcare workers and people who use drugs for their peers and the wider community. The role of Hi-Ground is to provide practical, evidence-based, unbiased information to assist you to make educated choices and to promote harm reduction, community care, and wellbeing.
In an unregulated market it’s impossible to know the purity or dose of any substance. Taking drugs from an unregulated market carries its own risk, and you can educate yourself and practice harm reduction to reduce this risk.
Knowledge is power.
This resource is produced by DanceWize & Hi-Ground