Dextromethorphan - Effects on the Body

Effects on the Body

Taken in its recommended doses, dextromethorphan sends a chemical signal to the brain to quiet a persistent cough. The medicine's effects begin about fifteen to thirty minutes after taking it, and they last between three and six hours. Most doctors do not recommend using over-the-counter cold medications for more than a week. Cold symptoms that last longer than a week might be the first signs of a more serious illness and a doctor should be consulted. At its normal dosage level, dextromethorphan does not cause any side effects, and it is not habit-forming.

Signs of DXM Abuse

To help people know if someone they care about is abusing DXM, health professionals note the following warning signs:

  • Stockpiles of cold and cough medications, more than anyone would need for a bout of the flu.
  • Empty pill packets or bottles of cough syrup found in odd places, such as under beds, in dresser drawers, or in wooded areas near homes or schools.
  • The presence of strange-looking tablets in various shapes and colors, evidence of purchase from the Internet.
  • Bookmarked Web sites or emails that encourage DXM use.

Various Web sites, such as Kids Health for Parents (http://kidshealth.org/parent/), provide information on DXM and other drug abuse warning signs.

What Are the Plateaus for Dextromethorphan Overdose?

As an abused drug, dextromethorphan has been compared to hallucinogensA substance that brings on hallucinations, which alter the user's perception of reality. such as ketamine and PCP. Four "plateaus" have been identified for dextromethorphan overdose. Each plateau carries a different set of symptoms and behaviors. The higher the plateau of abuse, the greater the chances of permanent brain damage, psychological addictionThe belief that a person needs to take a certain substance in order to function, whether that person really does or not., or lasting behavioral problems in the user.

At the first plateau, users report mild sensations of dizziness or euphoriaPronounced yu-FOR-ee-yuh; a state of extreme happiness and enhanced well-being; the opposite of dysphoria..They might perceive music as either more pleasant or as strangely distorted. A first-plateau dextromethorphan abuser can still move and carry on conversations, but perceptions are altered to the point where driving a car or making other value judgments might be very difficult.

At the second plateau, users begin to experience visual hallucinations—colors swirling through the vision field with eyes closed. At this level, users also experience nausea, often with vomiting, and they have more trouble walking and communicating. To an outside observer, second plateau dextromethorphan abusers are clearly "on something." They behave as if drunk or stoned. Double vision can also occur.

Upon reaching the third plateau, users experience a wider variety of hallucinations. All sensory input is altered to some degree. An abuser might see visions that are not there or misunderstand what he or she is actually seeing. Walking and talking become very difficult, and the user becomes disoriented and out of touch with reality. This can lead to bouts of paranoia (a feeling of great personal danger) or to the recall of forgotten memories, both pleasant and unpleasant. Because motor skills become seriously impaired at this level, abusers can be a danger to themselves just from tripping and falling. Judgment is altered, leading to the possibility of self-destructive behavior.

DXM Plateaus

The symptoms of dextromethorphan abuse are categorized according to the strength of the dosage taken by the user. These categories are called plateaus. According to the article "What Every Parent Needs to Know about Cough Medicine Abuse," available on the Drug Free AZ Web site, common symptoms of abuse at the various plateaus include:

  • First plateau: mild euphoria, mild dizziness, mild distortions of color or sound.
  • Second plateau: visual hallucinations, blurred vision, slurred speech, drowsiness, nausea, and vomiting.
  • Third plateau: double vision, disorientation, hallucinations, rapid movements of the eyes, paranoia, difficulty speaking and walking.
  • Fourth plateau: "out of body" experiences, complete loss of motor control, altered sense of time and altered sense of reality, hallucinations involving vision, hearing, and touch.

Users undergoing withdrawal from dextromethorphan may have difficulty sleeping and suffer from depression or feelings of hopelessness.

The fourth plateau experience is extremely dangerous and sometimes deadly. At this level, the dissociation, or split between mind and body, occurs. Bizarre thoughts and hallucinations abound. Meanwhile, the abuser has little or no motor control and simply cannot move. An immobilized user may choke on his or her vomit and suffocate, or suffer seizures and brain damage. Those who abuse dextromethorphan at these highest dosages are at the greatest risk of sudden death. Survivors of fourth plateau use may become psychologically addicted to dextromethorphan and continue abusing it in search of more hallucinations and that "out of body" feeling.