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Overview of Dextromethorphan detox

Some drugs have a much higher rate of abuse among adolescents and young adults. These are usually substances that are legal and are easy to obtain. These substances often have other genuines purposes, but when misused can cause intoxication. Some examples are glue, markers, paint, whipped cream cans, air rifle propellant, and sleeping pills. Another one of these common over-the-counter drugs is Dextromethorphan. It is found in cough suppressant medicine and one of the most abused, and potent, of these lightly regulated substances. Dextromethorphan, or DXM, is a dissociative drug than can be both psychologically and physically addicting. Because of its potent nature there is sometimes a need for specialized Dextromethorphan detox programs.

DXM was developed in the 1950s as an alternative to the addictive drug codeine. It proved to be far less addictive. At prescribed amounts it works on the part of the brain that induces coughing, rather than reducing pain like codeine. This makes it an effective non-narcotic cough medication. At the time, the effects of high doses were not known. It became popular among teens in the 1980s when it became more widely known that amounts far higher than the recommended dose could cause an intense intoxication. At 10+ times the recommended dose it cause euphoria, slurred speech, increased appreciation of music, and mild stimulant effects. It is considered similar to the effects of smoking marijuana or being drunk and has coined the term "Robo-tripping" because the drug is found in Robitussin. It is also found in many other over-the-counter medicines like NyQuil, Coricidin, and Delsym. Many of these medicines are very cheap, making it desirable for adolescents or people with little to no income. The drug is a dissociative so it is also similar to Ketamine. The more DXM that is ingested the more intense the effect become. At higher doses it becomes far more dissociative and psychedelic.

Because DXM has varying effects at different doses there is a term called "plateaus". The plateaus range from 1-4. The first plateau induces breakthrough effects, these include euphoria and stimulation and noticeable intoxication. As the plateaus increase the experience becomes much more psychedelic and dissociating. At the 4th plateau a user may lose sense of time, have intense visuals, altered thinking, loss of motor skills, slurred or non-sensical speech, and out of body experiences. Often users describe higher plateaus to not be pleasant and are often more intended to induce a spiritual experience. Some user describe seeing or talking to aliens or non worldly beings while on a very high doses of DXM.

Often DXM acts as a "gateway drug" because it is common among youth. When a teen tries one drug they are more likely to try another. After this they may find drugs that they find more pleasant than DXM and switch to that. For some, the unique intense effects of DXM can be addicting and the type of high they prefer. It can cause a user to forget everything else in their life and allows for a type of escape. Long term DXM abuse can have severe effects on the brain as well as the body. Regular intake can cause a rise in tolerance meaning that more of the drug is needed to produce the same effects. This also makes it harder and harder to stop taking the drug. When one quits DXM they will feel physically symptoms and be in a mental fog. Though less common than other drugs, DXM can cause physical addiction and be very difficult to get off of. There is no taper, so in medical detox they will use a certain combination of drugs to assist with withdrawal. Also, one will have to learn positive coping skills when faced with anxiety and depression. DXM effects the flow of serotonin in the brain so it will likely cause depression after long term use.

Click below for detailed Stimulant detox guides

How Detoxing From Dextromethorphan works

The objective in medical detox is to remove a substance from one's body safely and comfortably. For some drugs (like opioids, benzos, and alcohol) tapers are used. This prevents serious symptoms like seizures and can help reduce withdrawal symptoms. With DXM, there is no taper. This makes the detox process slightly more complex. A patient will be evaluated to determine the best course of action. It will need to be known exactly how much and how often the patient was ingesting DXM. After this doctors can determine what kind of medications will need to be used. As the detox process goes on medical staff can monitor symptoms and make sure the right amount of medications are being used to a insure safe and comfortable detox. Day by day medications will be decreased and adjusted depending on the patient. The main goal is to have no other medications harmful or addictive substances in the body by the end of detox.

Often for anxiety and sleep benzodiazepines or barbiturates are used. Because these are powerful and addicting drugs they are usually only used in the first few critical days of detox. These drugs prevent seizures and tremors as well as reduce anxiety and restlessness. Non-narcotic drug may also be used for sleep and anxiety like clonidine and Trazadone. These drugs can be prescribed more long term to assist with early recovery. They are non-addictive and can make the first few months without DXM much more comfortable without creating another problem. Antidepressants are also common in detox. Because of the effect DXM has on the brain depression is common. Antidepressants can be prescribed during and for after the initial detox process. The body needs to time heal, and often psychological effects can last much longer than physical ones. This is why continuing care is recommended after the initial detox process.

WHAT DOES THE Dextromethorphan DETOX PROCESS LOOK LIKE?

The dextromethorphan detox process will take 3-10 days. The patient is admitted into a detox facility and is given a room. The patient will be monitored 24/7 by medical staff to insure safety. Vital signs are constantly checked to make sure a person is not having abnormal or adverse effects. Detox is similar to being admitted to a hospital Intensive Care Unit, because doctors, nurses, and other staff are constantly available and making sure each patient is safe and comfortable. A patient is also closely monitored for risk of falling, because DXM detox can make a person very weak.

The initial few days will be the most severe. It will leave a person with severe depression, anxiety, restlessness, diarrhea, and confusion. Many different types of "comfort medications" will be prescribed to assist with these symptoms so that detox can be more bearable. Toward the end of detox the symptoms will naturally dissipate and less medication will be needed. At this point only psychological symptoms will persist. Depression is the most common, but non-narcotic drugs can be prescribed to assist with this long term. Sometimes difficulty sleeping persists longer than other symptoms as well. There are many different natural and non-narcotic sleep aides to help with this at the end of, and after, the detox process.

Though after the detox process DXM will no longer be in the body, the body and brain still need time to recover. The brain will need to re-learn how to naturally respond to pleasure and anxiety, which can be difficult at first. In detox there are often therapists on site that can help a person come up with a plan on how to have healthy and effective coping skills to assist in long-term recovery. There are also often visitors at the detox who once struggles with substance abuse. They can share their experience and hope to others still in the detox process. They can often give suggestions on what to do after the detox process.

Dextromethorphan is not typically considered a very addictive substance, but it can be and has shown evidence of withdrawal. Physical addiction is more rare, but psychological addiction can still causes some amount of withdrawal. Without a detox program a person would feel the full effects of withdrawal, and it will likely be very difficult to remain sober. With more physical symptoms a user will have diarrhea, nausea, and cramps. The psychological symptoms felt are restlessness, irritability, anxiety, depression, and difficulty sleeping. These symptoms will dissipate as time goes on, but without medical assistance will be very severe and are likely lead to relapse.

Dextromethorphan Detox Withdrawals

Pill Bottle Icon Can be bought at convenience stores
Syringe Icon Popular among teens and people who need to pass drug tests
Pill Icon Roughly 3 million Americans aged 12-25 have used DXM to get high

Dextromethorphan is not typically considered a very addictive substance, but it can be and has shown evidence of withdrawal. Physical addiction is more rare, but psychological addiction can still causes some amount of withdrawal. Without a detox program a person would feel the full effects of withdrawal, and it will likely be very difficult to remain sober. With more physical symptoms a user will have diarrhea, nausea, and cramps. The psychological symptoms felt are restlessness, irritability, anxiety, depression, and difficulty sleeping. These symptoms will dissipate as time goes on, but without medical assistance will be very severe and are likely lead to relapse.

List of Dextromethorphan Withdrawal Symptoms

  • Depression
  • Anxiety
  • Unexplained nervousness
  • Nausea
  • Diarrhea
  • Vomiting
  • Restlessness
  • Confusion
  • Hallucinations
  • Psychosis

Can you detox from Dextromethorphan at home?

It all depends on the amount of use, but typically detoxing from any substance is never recommended to be done at home. If the amount of use is not serious or daily it may be possible to detox from home, but it will be much more difficult. Withdrawal is a medical condition and therefore medical assistance is always advised. It is always best to have a doctor determine what is best in a drug detox scenario.

At home one cannot have any sort of medication to assist with their symptoms, and they may also find it is very difficult to remain clean due to the anxiety and depression. One may feel so depressed they are unable to see the benefit of staying sober. Also, in a medical detox facility therapists are on site. Therapists can help diagnose underlying mental health conditions or help with making an effective plan for health coping skills. With severe DXM abuse psychosis is also a possibility. Dissociatives like DXM can also trigger mental health conditions or severe paranoia. This can make the process more dangerous without medical supervision.

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How long does it take to detox from Dextromethorphan

DXM takes about 24-72 hours to completely leave the body, but inpatient detox is typically 3-10 days. This is because even when the drug is out of the body symptoms are still felt. A person can be very lethargic, depressed, and anxious for a week. After this time a person will begin to feel better and less serious symptoms will persist.

After detox most off the symptoms will fade, but there is also a risk for post acute withdrawal syndrome, or PAWS. This can caue symptoms of insomnia, depression, anxiety, and trouble concentrating for weeks, months, or even years in rare cases. PAWS can be treated with medical assistance, and that is another reason why it is so important to get medical help if you are attempting to detox from dextromethorphan.

  • In 2006 3.1 million Americans aged 12-25 had used over-the-counter cough suppressants to get high
  • In 2004 about 1% of all drug related ER visits involved DXM
  • Medications with DXM often have acetaminophen, which in doses needed to cause intoxication can cause severe liver damage
  • Vick’s NyQuil is the most abused medicine containing DXM