Health - The REAL Truth About the Dangers of DXM

Discussion in 'DXM' started by Richard_smoker, Apr 22, 2006.

  1. Richard_smoker

    Richard_smoker Gold Member

    Reputation Points:
    Sep 19, 2005
    from U.S.A.
    This post is a compilation of everything I have found in both the scientific literature as well as from the experiences of this board. Where it has been possible, I have broken down each problem, restated every 'long word', and tried to be as objective as possible. There were many times that my sources began to overlap, and for this and other issues, there may be some grammatical and organizational issues with the post itself. With the help of member-input, mods, etc., I will work on cleaning up this post until it is 'perfect.' PLEASE feel free to criticize the SHIT out of this; including my logic, my sources, etc. BTW, I have yet to complete the references to many of these quotes, so be gentle.

    also, please note that much of this subject is still in the investigational realm. Very little information is known for certain about toxic effects from recreational-doses of DXM... I will attempt to bring together the current theories and facts and each person can decide for him/herself. Suffice it to say that prior to investigating this issue, I personally had no idea how dangerous that DXM actually can be and how dangerous that it "is" even when taken in 'acceptable' trip doses without any other medications thrown into the mix.

    Part of my decision to NEVER do recreational DXM after compiling this research is this: There have been several deaths from DXM overdose. The signs and symptoms of those patients who died were IDENTICAL to the presenting signs and symptoms that a "regular" person would experience while taking this drug. In other words, the psycho-active effects of DXM are almost entirely based upon DXM's toxic effects... So, if I were asked the question, "How dangerous is DXM?"; this is very similar to asking "How many times can I take Cyanide until I eventually die?" or "How much arsenic can I swallow but still live to talk about it!?"

    But still, it's YOUR BRAIN, it's YOUR BODY. and your life... Choose wisely. Here are my findings. -Dick

    Is DXM Dangerous?

    YES, DXM use can be dangerous especially if take too high of a dose. take DXM too often.
    3.take high-doses of DXM AND take it too frequently, aka “Chronic, High Dose Usage”

    Important Short-Term Dangers:
    • Nausea, diarrhea, vomiting, and allergic reactions (often from the cough syrup itself)
    • Hot flashes, dizziness, and bad trips
    • Psychotic breaks (generally from high dose use)
    • Poisoning from Bromide Ions (Bromism)
    Important Long-Term Dangers:
    • Psychological addiction and depression (from regular use)
    • Poisoning from Bromide Ions.
    • Irreversible brain damage (from chronic use at high doses)
    Brain damage is fairly rare, occurring in less than 1% of the regular users that William White interviewed. He says, “They all used DXM very frequently. If you do DXM twice a month or less, you'll probably be OK. But remember there's always the risk of something going wrong.” FYI: William White is the ‘famous’ author of the DXM FAQ.


    DXM was first patented with U.S, Patent 2,676,177.

    In 1958 the FDA approved DXM as an anti-tussive (cough medicine), in response to the recreational use of codeine cough medicine at that time. There were several advantages of DXM over codeine. DXM was not physically addictive, and a normal dose did not cause any pleasant, "sedative-like" effects.

    In 1960, DXM was marketed in the US as a DXM-only pill called Romilar. It was considered "safe cough medicine" compared to codeine. But soon, Romilar users discovered the abuse potential of DXM.

    13 years later, Romilar was withdrawn from the shelves.

    After Romilar's removal in 1973, it was assumed that DXM would be phased-out in favor of some newer compound less susceptible to abuse. As it turns out, this hypothetically 'newer and better' drug was never discovered. And so DXM and codeine remained the only cough-relievers available.

    So, manufacturers re-released DXM in syrup which tasted disgusting. William White, (DXM FAQ) suggests that the reason people "forgot" about DXM's abuse potential was mainly due to the emergence of hallucinogenic studies, and the abundance of better drugs such as LSD and Magic Mushrooms (White, 1997).

    The 1980s and early '90's saw very little DXM abuse as the War on Drugs was waged in the U.S. There was very little information around about abusing DXM until the internet took shape in the mid-90's, allowing people to dissiminate information together on various subjects. First, DXM information was spread on Usenet. As internet access increased, DXM became a star, and now there dedicated websites with compiled information that is more accurate, and includes scientific information about DXM. But, even after the dissemination of DXM 'knowledge', the medical community remained relatively unaware of the drug, until several deaths were attributed to DXM.

    William White's comprehensive DXM FAQ details DXM's effects, chemistry and dangers as a how-to guide for the interested psychonaut. While he originally presented DXM as benign, White soon began receiving various reports from users who claimed long-term effects like changes in moods, personalities, and memory. After these disturbing reports, and after Dr. Olsney's discovery of DXM-induced brain lesions in rats, he changed his stance on DXM being 'harmless.'

    The purpose of THIS compilation is to bring together the presently known and understood information from several fields of science and medicine into the layman arena where the DXM 'epidemic' first began--the internet. Now, DXM users, and potential users of DXM can become better educated on possible side effects, toxicity, issues of concern, potentially deadly combinations, and the internet community can hopefully learn more respect and shed the frivolous stance on DXM's availability as a recreational drug. If this does not occur, then DXM will certainly go the route of all other "famous" psychoactive plants and drugs--into the realm illegality. Remember that as every teenager presents to his/her local ER with advanced DXM toxicity, that more pressure will be placed on the already-advancing search for a newer, kinder, non-psychoactive anti-tussive medication. The search that originally began in 1973.



    DXM is metabolized by the liver (liver secretes bile and functions in metabolism of protein and carbohydrate and fat; synthesizes substances involved in the clotting of the blood; breaks down toxins by the cytochrome P450 oxidase enzyme). Specifically, DXM is broken down by a P450 enzyme called: CYP2D6.

    Concerns about Liver Enzyme CYP2D6:
    1. Poor Metabolizers.
    A significant portion of the population have a functional deficiency in this enzyme called "CYP2D6 Poor Metabolizers". Since CYP2D6 is the primary metabolic pathway in the inactivation of DXM, the duration of action and effects of DXM are significantly increased in "CYP2D6 Poor Metabolizers." Also, Deaths & Hospitalizations have been reported in poor metabolizer recreational users.

    2. Inhibitors of CYP2D6.
    A large number of medications, including antidepressants (SSRI's), are potent inhibitors of CYP2D6. So, there is a HIGH potential for drug interactions between DXM and other medications. There have been reports of fatal consequences arising from such interactions.


    Obviously (due to the plateau-type effects), DXM intoxication varies depending on the dose. Many of the expected effects of recreational DXM use are actually signs of DXM toxicity in various organs.


    List of Known Acute Toxic Effects

    Plateau 1 & 2: In addition to Euphoria & laughing, people on 1st or 2nd plateau often develop Tachycardia (FAST Heart Rates), Blood Pressure spikes, Vomiting, Mydriasis (pupil dilation), Nystagmus (eyeballs shaking), Sweating, Loss of Motor Coordination (cerebellar intoxication / cerebellar shutdown).

    Plateau 2&3:
    In addition to the above findings, persons with moderate intoxication (Plateau 2 & 3) may demonstrate hallucinations and a distinctive, plodding ataxic gait that has been compared with "zombie-like" walking.23

    Plateau 2,3, or 4:
    Severely intoxicated individuals in a dissociated state may be agitated or somnolent.5,6,8,21

    Plateau 3&4:
    Extremely agitated patients may develop hyperthermia and metabolic acidosis. The presence of these signs are largely ominous. They represent a severe shift in the body's natural ion balance: causing or resulting from kidney failure, inadequate oxygenation, and/or a diseased, allergic-type reaction within the neuro-muscular junctions.


    Probably the most important effects to consider from long-term abuse is liver or brain damage.

    Bromide Ions.
    DXM is usually found as a salt of DXM and hydrobromide ions.

    Large amounts of bromide ions can cause sedation and eventually lead to bromism (bromide poisoning), which affects (among other things) the skin andnervous system.It is one more VERY important reason to avoid prolonged high-dose use.

    ***The Cerebellum is a very important part of the brain! It is the Sensory/Motor Processing and Integration Center of the brain. It is necessary for nearly every coordinated motor activity (using muscles), balancing, touch, feeling, applying your hands and fingers to perform fine motor tasks, and MUCH more!!***

    Many Doctors believe that prolonged heavy use of DXM may lead to bromism. There is a case presented in the American Journal of Nephrology that demonstrated “Spurious Hyperchloremia and Decreased Anion Gap” in a DXM user. 1992;12:268-70. Translation: the human body is an aqueous environment—just like the ocean. Like the oceans, our body water is NOT just plain, pure H2O. Instead, it is “salty”—meaning that there are dissolved ions. The most common, and most commonly known are Sodium, Chloride (i.e. NaCl). Also very important to the functioning of our internal environment are other ions: Potassium, Magnesium, Calcium, etc. Bromide is very low on the list of ‘normal’ ions in terms of concentrations.

    This brings us nicely into the discussion about our renal system.


    You might recall an ongoing argument about GHB. Should you make it with KOH (potassium) or NaOH (sodium)? If you make it w/potassium, then you can actually ‘overdose’ on the potassium and… well, look it up yourself if you’re interested.

    If you make it w/sodium, then you can ‘overdose’ on sodium, causing a serious depletion in the essential—and short-supplied potassium. This is because the body’s watery environment exists in homeostasis—in other words, your body uses MANY mechanisms to keep its pH normal (~7.2), in other words, your organs make sure that there aren’t too many negative charges (“basic” or “alkaline”) and to make sure there aren’t too many positive charges (“acidic” or “acidosis”). Some positive ions: H+, Na+, Ca++, Mg+. Some negative ions: OH-, Cl-, K-, and more.

    “Anion Gap” is simply a measure of your blood pH minus the concentration of “normal” ions—mostly sodium and chloride.

    Equation for A.G. = Serum Sodium - Chloride - Bicarbonate

    HIGH ANION GAP: Most types of acidosis that are UNNATURAL are a result of strange positive ions (or “acids”) not normally found in the blood.
    Causes include: Metabolic acidosis (lactic acid), Methanol poisoning, Uremia (uric acid from kidney failure), Diabetes (ketones), paraldehyde poisoning, Iron, INH (a medicine), Ethylene Glycol, Salicilates (aspirin=”salicylic acid”).

    LOW ANION GAP**:**THIS is what you get from DXM!!!
    Causes include: Paraproteinemia (too many weird, charged un-natural proteins, e.g. Multiple Myeloma), Hyponatremia (low sodium), Hypermagnesemia (high Mag level), Hypoalbuminemia (too LITTLE albumin—a fancy word for normal blood protein), and…. Lastly: Spurious Hyperchloremia (from Bromide toxicity)

    So, essentially, DXM toxicity seems to exhibit TWO contradictory adverse effects upon the body's normal serum pH:
    1. Low anion Gap, caused by spurious Hyperchloremia from Bromide toxicity and
    2. Metabolic acidosis
    (higher anion gap)
    What do these conflicting messages mean?
    Well, for starters, they both practically PROVE that DXM is toxic to your body's aqueous serum environment. At the very minimum, DXM causes heavy glucose and abnormal ion loads on fluid homeostatic mechanisms, meaning stress and damage to the kidneys and pancreas.

    In addition to these findings, there has been reported several cases of DXM effecting serum protein levels (increased protein from MUSCULAR CELL DEATH AND BREAKDOWN, aka Rhabdomyolysis). From an unknown mechanism, probably not unlike Dantrolene Poisoning, DXM can apparently cause rhabdomyolysis--a condition that causes permanent, irreversible kidney failure.

    Remember, these effects are in addition to the liver issues.

    Just to repeat myself ONE more time, it certainly seems that the effect of DXM poisoning is to shift your body's plasma ion balance in both directions, skewing the normal balancing act we measure by serum pH. DXM causes increased anion gap and metabolic acidosis, and hyperchloremia (low Cl-) and low anion gap.

    The biggest danger from this is when your kidneys cannot handle the continuous assault--trying to detoxify the blood and return proper balance to pH and ion concentrations.

    Experienced DXM users describe a rapidly developing and persistent tolerance to the drug.6 Dependence is rarely described.24-26
    By literature reported in 1994, there were only 2 reported fatalities from DXM overdoses. At this time, the Medical Community was almost completely OBLIVIOUS to the underground abuse of DXM.

    Even though there were 2 KNOWN CASES of Death from DXM, there were NO reports and NO RESEARCH describing the effects of chronic abuse. The first report of long-term usage was described in 1994. It demonstrated significant cognitive deterioration that was associated with prolonged use of DM.

    Since 1994, other effects have been described, and most are likely linked to DXM abuse. Toxic psychosis and cognitive deteriorationcan arise from chronic use of the drug.24,28,29

    Long Term Use Could Very Likely Cause:
    1. Toxic Psychosis: this would be akin to "Tripping All the Time." Paranoia, Fear, Helplessness, Detachment, Dissociation, etc. It is known that psychotic breaks are more common in the upper two plateaus (3&4). (*reference*)

    2. Cognitive Degeneration: Put simply, this is when someone becomes "dumb." There are indications from patient cases of declining intelligence, with repeated, toxic exposure to dissociatives such as DXM, PCP, & K. Since this effect is difficult to directly measure, the effects have been demonstrated through indirect measurement and observation. I have a few reports with detailed methodology with possible logical flaws if anyone is interested. One would be foolish not to heed this warning, because no one knows for certain if a 'small' case of psychosis or cognitive decline will be able to 'recover.' In cases of high-dose, repeated assault, damage to cognition from DXM use appears permanent.

    3. Liver Failure--to some degree. Liver disease is not always cut-and-dry, nor is it always characterized by a single, definitive STRIKE to the liver, (followed by hepatic shut-down and death). Instead, & more frequently, liver failure is a progressive disease that begins with a series of permanent toxic events... and it is often slow and insidious in progression.

    4. Kidney Failure--again, like the liver, the kidneys will sustain a heavy amount of abuse (including interruption of blood-supply for several minutes) before they begin to lose their normal functioning ability. Essentially, what we're creating--with chronic recreational DXM--are significantly WEAKENED hepatic and renal systems. More here.

    Perhaps this can be thought of in terms of 'aging.'
    Take for example, a 21 year-old Chronic, High-Dose DXM User. This individual's kidneys and liver could very likely be compared to those of someone MUCH OLDER than those of your peers. (e.g. a 50 year-old's liver &/or kidneys).

    This analogy comes from deductive reasoning, based SOLEY on the nature of the drug's pharmacological profile at so-called 'recreational' doses. I do not have actual proof that a 21 year-old has a 50 year-old man's kidneys &/or liver, but one does not necessarily need proof to support a claim that hepatotoxic substances cause aging of the liver; nor that kidney-toxins will induce renal changes.These are typical sequelae of people who suffer the type of insults which occur in the setting of recreational-dose DXM. Cause and Effect Pattern. Just like breathing in flu-virus vapors will OFTEN lead to you catching the flu... or like when you inject your muscle with sulfuric acid, it will hurt like shit.

    Long Term Use May Also Cause:

    5. True Liver Failure--without a transplant, you will die from this. Remember: slow, agonizing death. Usually takes 2-3 days to die, sometimes weeks.

    6. Complete Kidney Failure--these people have arterio-venous shunts surgically placed under the skin, connecting artery-to-vein. They must be dialyzed twice a week. They do not make urine. They will die without constant dialysis or a kidney transplant.

    7. Pancreatic Failure--a distant possibility. would be horrible. very painful. causes Type I Diabetes (no more insulin production). Permanent loss of control over blood sugar levels. these people have no more insulin to lower blood sugar, no more glucagon to raise blood sugar.

    8. ?Permanent Brain Damage?--Olsney's Lesions? maybe this should be #1 on the list?? who knows...? scientists certainly do not know. Sure, Dr. Olsney's claim from his original research does NOT support the existence of Olsney's Lesions in humans, (and thus, it cannot attribute them to DXM, ketamine, PCP, dogshit or anything else--since we don't know if they exist).

    HOWEVER, just because his deductive methodology was flawed certainly does NOT suggest that these lesions do NOT exist! That's like saying that when your local grocery store doesn't have any strawberries in stock for 3 months straight, that there ISN'T a shortage in the local strawberry supply, just because you don't have any proof that there IS a shortage! It's impossible to prove a negative statement without proper investigation, and this is a serious fallacy in logic that I believe the internet has helped propagate. This is a new sort of "group-think."

    In other words: Let's say that I have a belief that is totally WRONG. Like, for example, I believe that it's OK, and even 'good for my health' to drink a little shot of gasoline every single day. Now, with the internet, I can find other 'gasoline-drinkers.' (not really! :p) Just because I can now assemble a group of 14 people, 400 people, or 2,000 people all together from all over the world, into a chat-room, who all agree with me on something that is simply WRONG or UNFOUNDED, that does NOT mean that I am now CORRECT. I'm still WRONG just like the other 19,999 people in the chat-room.


    There have been several DXM overdose deaths documented in medical and media reports. Even taken by itself, DXM overdoses have been FATAL. Lethal toxicity starts at around 20mg/kg (about 2,000mg for a 220lb person).

    Overdose is possible while redosing; occasionally, an overdose has come from a person who is already under the influence of DXM after attempting to "re-dose." Why does this cause overdose? Several possible reasons, but the main cause is because of a cumulative effect on dosing, starting from the original dose. Also, it has been speculated that the user may not be able to accurately weigh the next dose, or may forget how much s/he has already taken.

    It is suggested that those who plan to redose with pure DXM weigh all doses in advance, then set their supply in a place where it is inconvenient to reach.

    Methods of DXM Administration.
    Oral: Best, and essentially, the only method of taking.
    Injection: almost impossible; doesn't dissolve except in enormous quantities of water & hazardous
    *Smoking: DXM is toxic to smoke. DXM HBr releases ammonia and other toxins and should never be smoked.

    William White claimed high doses of DXM may cause brain damage in the form of NMDA antagonist neurotoxicity. Olneys lesions, also known as "NMDA Antagonist Neurotoxicity" or "NAN", are a form of brain damage caused by high doses of NMDA antagonists...

    White's article has been challenged by Cliff Anderson in his paper The Bad News Isn't In. White has later retracted his original claims in a response to Cliff Anderson's paper though he still warns of possible long term damage from DXM.

    --There is much information left to post in this area---


    Before any use of DXM, extra caution should be taken by those taking either prescribed prescription or OTC medications, particularly antidepressants. Why?
    1. Serotonin Syndrome. With antidepressants there is risk of developing serotonin syndrome (Serotonin syndrome is a condition caused by an excess of serotonin in the brain. A rare, but serious, potentially life-threatening medical condition. Symptoms may be classed into three groups:
    a. cognitive effects: mental confusion, hypomania, agitation, headache, coma
    b. autonomic effects: shivering, sweating, fever, hypertension, tachycardia, nausea, diarrhea
    c. somatic effects: myoclonus/clonus (muscle twitching), hyperreflexia, tremor

    2. Liver Enzyme Inhibition. MANY meds are substrates or Inhibitors of the SAME liver enzyme used to clean out toxic DXM.
    Harmala alkaloids are also found many other plants, including tobacco and passion flower.


    Toxicity, in the setting of DXM abuse, can arise from additional sources. Over-the-counter cough formulations frequently contain, in addition to DXM, other pharmaceutical agents such as chlorpheniramine, acetaminophen, or pseudoephedrine.30

    Most over-the-counter cough medicines contain other drugs besides DXM and can be quite dangerous when taken in high doses. These ingredients include acetaminophen (aka: Tylenol, Panadol, Phenaphen, Tempra and paracetamol or APAP) which carries a high possibility of fatal liver damage with as few as EIGHT! pills.

    Overdose of acetaminophen, an antipyretic and analgesic that is a component of over 100 cough and cold preparations, produces delayed hepatic injury and, potentially, death.

    Acetaminophen: There are 3 enzymatic pathways used in the liver to break Acetaminophen down, and the 2 typically found are safe for the body. When these two become overwhelmed, the third pathway processes acetaminophen into a chemical that is EXTREMELY TOXIC TO THE LIVER.

    Fatal liver damage can occur before any symptoms become evident. THIS DEATH is a PAINFUL, LINGERING DEATH, taking place over 2-3 days, and sometimes WEEKS.


    Chlorpheniramine is an H1-receptor antagonist. Consequently, individuals who have abused chlorpheniramine-containing DXM formulations may also exhibit anticholinergic signs and symptoms (eg, tachycardia, warm, dry, flushed skin, dry mucosa, mydriasis, agitated delirium, urinary retention, and gastrointestinal dysmotility).

    Severe chlorpheniramine intoxication has also been associated with seizure activity, rhabdomyolysis, and hyperthermia.8 BTW, all these 3 syndromes are associated with brain damage of on their own account.

    ALSO: Chlorphenamine, an anticholinergic and antihistamine, is broken down by the SAME liver enzyme that decomposes DXM. This combo is VERY DANGEROUS, especially to those individuals with a CYP2D6 enzyme deficiency. Also CCC can cause SEVERE allergic reactions! CCC or Coricidin should NOT be used recreationally. CCC has caused many DOZENS of hospitalizations, several DEATHS (that we KNOW about!) and the general advice is do NOT take it! More information about Chlorpheniramine dangers here.

    Guaifenesin, Guafenesin, or Guaiphenesin is an expectorant (mucous softener) which contributes to the nausea and vomiting that MANY people experience when taking this drug.

    pseudoephedrine is a stimulant related to ephedrine used as a bronchodilator to treat bronchitis and asthma. Taken WITH DXM, Pseudoephedrine can raise your blood pressure through the ROOF! This can cause GLAUCOMA--damaging the optic disc and impairing vision, and sometimes progressing to BLINDNESS!
    DXM with pseudofed can also cause HYPERTENSIVE CRISIS, HEART ATTACKS, STROKES, and... DEATH!

    Don't take DXM for fun.
    Never exceed more than 1500mg of DXM, ever.
    If you have never taken DXM before, *always* start with a low dose, because you may be unknowingly CYP-2D6 deficient, or have some other negative reaction.
    It's wise to have a sober trip-sitter with you, especially for first DXM experience.
    Do not use frequently (more than once or twice a month.)
    I don't recommend using DXM recreationally at all.
    It is my firm belief that Death is a shitty side effect.
    Last edited by a moderator: Sep 10, 2017
    1. 2/5,
      Careful, wild extrapolations with no studies to back them up speaks to dubious credence and would unnecessarily alarm lurkers
      Jan 19, 2017
    2. 5/5,
      outstanding work . I will show this to my naive dxm abusing friend.
      Jun 28, 2014
    3. 3/5,
      Lots of misinformation and exaggeration. Lots of USE OF SCARY CAPS that are obnoxious and don't lend to the post's credibility. Needs many citiations.
      May 19, 2014
    4. 5/5,
      Its about time someone compiled this; invaluable, harm-reducing, reasonable, well-presented and relevant.
      Nov 10, 2013
    5. 3/5,
      Great post, very valuable information
      Aug 31, 2013
    6. 4/5,
      this post may save lives!!! and i agree, Death is an extremely shitty side effect.
      Aug 1, 2013
    7. 5/5,
      Fucking excellent work, Richard! This has taught me so much about a substance I know very little about.
      Jul 28, 2013
    8. 3/5,
      very good read. never taking DXM again lol
      Jun 29, 2013
    9. 3/5,
      Great post sir, glad to have you here on DF
      Jan 21, 2013
    10. 3/5,
      Very helpful. Education is critical and this delivers
      Dec 12, 2012
    11. 3/5,
      Lots of valuable info here ty
      Jul 15, 2012
    12. 3/5,
      Thank you, very in depth and informative to someone who has never tried, cheers!
      Jan 30, 2012
    13. 3/5,
      Awesome read - thanks for the insight on the OTHER truth about DXM
      Jan 11, 2011
    14. 3/5,
      Varied and necessary information, DXM is NOT good to OD on.
      Jun 17, 2010
    15. 5/5,
      Informative and critically important
      Oct 16, 2009
    16. 4/5,
      In depth and highly informative. An invaluable resource to the DXM sub forum.
      Jun 16, 2009
    17. 3/5,
      This thread improved my life
      Jun 3, 2009
    18. 3/5,
      Good stuff man provides a very good and critical look on dxm usage
      Mar 6, 2009
    19. 3/5,
      Great thread
      Mar 1, 2009
    20. 3/5,
      thorough and informative; I learned a lot
      Jan 12, 2009
    21. 5/5,
      great post which deserves many reps - you may want to add under "inhibitors of cyp-2d6" that many recreational drugs (MDMA e.g.) are competitive for this enzyme and present particular risks
      Jan 3, 2009
    22. 3/5,
      excellent informative dxm article cheers
      Jan 3, 2009
    23. 4/5,
      wow, good effort in this one. thanx.
      Dec 4, 2008
    24. 4/5,
      Nice thread!
      Oct 24, 2008
    25. 5/5,
      Excellent work! Thanks for calling attention to this issue!
      May 26, 2008
    26. 3/5,
      Jan 17, 2008
    27. 3/5,
      Very thorough research, nice compilation
      Apr 9, 2007
    28. 4/5,
      nice compilation
      Jun 20, 2006
    29. 5/5,
      As always, fantastic stuff! Well researched & collated, & backed up with more info & humour in the posts afterwards. Glad you're here mate!
      Jun 11, 2006
    30. 4/5,
      Very good work!
      Jun 10, 2006
    31. 4/5,
      VERY good post my friend!
      Jun 10, 2006
    32. 3/5,
      Very nice post, good information.
      May 2, 2006
  2. sands of time

    sands of time Gold Member

    Reputation Points:
    Nov 4, 2003
    I have always felt that DXM is a dirty substance because there are so many unknowns. The long term effects have not been fully established, and I think it will be quite some time before we get the full picture of the damaging effects. We live in a society were alcohol is the socially accepted drug, so we can't really bash something like DXM though hehe.

    When you read info like this, it's not hard to see why most DXM users are under the age of 18. It's legal and easily accessible, but the damaging effects often times keep adults from abusing it. Also, many adults have a hard time believing that a worthwhile recreational drug is being sold at every local corner store. Do you think DXM inflicts any damage when taken as recommended?
    1. 3/5,
      i agree here. not only dirty physcially, but mentally. it seemed like a dirty ecstasy roll
      Jun 29, 2013
  3. Richard_smoker

    Richard_smoker Gold Member

    Reputation Points:
    Sep 19, 2005
    from U.S.A.
    I'd bet the farm on it: no.

    reason: any drug that has been around this long and was not only passed by the FDA, but it has been taken REGULARLY at so-called 'recreational' doses by high school kids all over the world for upwards of 10 years solid. Although these doses are by NO means safe, they are unique in that these super-high doses are equivalent to the super-high doses that scientists give rats, in an attempt to induce cancer and other problems... remember saccharine? there are plenty of other drugs, foods, & beverages that will KILL consistently when you ingest that much more than the recommended amount.
    Last edited: Apr 22, 2006
  4. psyche

    psyche Palladium Member

    Reputation Points:
    Feb 28, 2006
    30 y/o from finland
    Still one really shouldn't use it as pregnent, but quite 'no' would be my guess too. I've always tried to be causious with dxm, by only using it three times in period of two years, never exeeding 400mg.
  5. bewilderment

    bewilderment Drug Geek Extraordinaire Platinum Member & Advisor

    Reputation Points:
    Oct 29, 2005
    from U.S.A.
    Has anyone been able to find many case studies on deaths related to dxm use? I've been curious about this for some time because whenever I type "dxm deaths" into a search engine I only come up with a bunch of local news reports which sound as if the writer has no idea what they're talking about and there aren't many details given such as what organs were damaged to cause actual death or if there were any other medications, chemicals, etc. present in the system of the person, etc. There are short anecdotes in the FAQ and other such sources, but they still give hardly any information. It seems as if many of the deaths are simply due to people being ignorant, taking CCCs, combining with SSRIs, or just taking much much more than would be recommended for a recreational dose. But, that's just speculation on my part because I haven't seen many reports with relevant information. Also, the dangers due to the inactive ingredients can be remedied by doing an extraction. I also wonder about the use of Zicam cough mist as far as limiting the amounts of gunk ingested because only a small amount (just a shot glass) of thin liquid has to be taken.

    I agree that dxm has many dangers and is very hard on the body and the brain. It used to be swim's drug of choice until she noticed that her concentration and memory were being shot to hell. After cessation of the drug she believes that in her case this was due to neurotransmitter depletion and *very hopefully* no permanent damage (doesn't appear to be unless the brain's plasticity is being put to work). She still misses the effects and wonders if anyone knows of any substances which have effects akin to dxm minus the toxicity (I think ketamine might be similar but has never heard of it being available in her neck of the woods).
  6. Aaron

    Aaron Silver Member

    Reputation Points:
    Dec 21, 2005
    Excellent post. There are dangers with DXM, nobody can dispute that. Do the dangers outweigh the benefits? This is the question you have to ask yourself before taking any drugs. There is no such thing as a "safe" drug. No matter what it is you are doing, the potential exists for something to go wrong and kill you. Knowing the dangers is important, and this post certainly points them out.

    Does this mean everyone should stop taking DXM to get high? No it does not; but it means everyone needs to carefully weigh the risks/benefits before choosing to do so.
  7. Alfa

    Alfa Productive Insomniac Staff Member Administrator

    Reputation Points:
    Jan 14, 2003
    117 y/o from The Netherlands
    To me this is a very clear indication that the dangers outweigh the benefits by far.
  8. Richard_smoker

    Richard_smoker Gold Member

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    Sep 19, 2005
    from U.S.A.
    Exactly. I think that another thing that everyone must keep in mind, is that, although I tried to be as objective as possible... with my original intention being to discuss ONLY the DANGERS of DXM... all the rest of the discussion was sort-of me getting off the subject. mostly because i was so fascinated with the history, etc.

    I think the point is that just because it's there (on the shelves of EVERYWHERE!), we can't be rash and pretend like it's the 'new' beer or cigarette--just because technically it is legal--to buy and have anyways. Now, I can hear everyone already. Yes, I know that alcohol and tobacco cause more deaths each year than ANYTHING... so, if i got onto THAT subject, I would certainly be telling everyone something that they already knew.

    But in terms of my OPINION, DXM is far more dangerous than alcohol. You can get DRUNK on alcohol (not just a glass of wine... i mean WASTED) every night for 10 days straight. However, someone I knew a long time ago tried DXM (dose: about 15-20 30mg geltabs) 3 nights within the same 2 weeks (weighed about 180lbs?), and he continued to experience recurrent weird feelings, emotions, and terrible body-load, even woke up in the middle of the night, actually experiencing the full-blown experience again, with full-blown DXM "click, click, click" visuals in his bedroom, and these strange effects lasted upwards to 3-4 days AFTER his last dose... BTW, these 3 times were his ONLY times to experiment w/DXM.

    When I think about these apparently not-good (toxic) effects versus the effects of being drunk EVERY NIGHT for 10 days, it makes me very aware of the subjective sense that DXM is a really 'bad' drug. Bad for you. Just think about it compared to the 'evil' drug--alcohol. DXM is SO much worse! you can even TELL that it's not good for you. to SWIM, it was pretty obvious that it's fucking-up SOMETHING important inside his brain.
  9. psyche

    psyche Palladium Member

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    Feb 28, 2006
    30 y/o from finland
    I thought it was dangerous, but I considered it to be about equal to alcohol. Well, I haven't been reading anything on DXM for a long time. It was little after I realized all drugs don't unpredictably kill you or make you jump out of the window, so especially at that time it was very hard to relate drugs due to the public climate; which source to believe.

    I thought, up until this post, it was more dangerous than N2O but no more dangerous than ketamine. What would you say? I still think ketamine is relatively safe considering it's dissosiative. Is it true it doesn't suppress the gag reflex?
  10. bewilderment

    bewilderment Drug Geek Extraordinaire Platinum Member & Advisor

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    Oct 29, 2005
    from U.S.A.
    I've read that a single dxm experience is about as hard on the body and brain as a week long bender on alcohol. That's a rough comparison though since it's difficult to compare damage between drugs when they affect biochemistry differently. So I would say that if someone does dxm for a few days with moderate dosage then it's definately going to do more damage than drinking for a couple of weeks...maybe do damage equivalent to staying wasted for a few months although the damage could very possibly be MUCH worse than the lasting efffects of alcohol use. The difference is that if one is using dxm for exploration purposes and not just to get "to' up" like alcohol then one (if they're the sort of person who enjoys the effects) can learn much more from the experience than one can from drinking themselves silly...but really one can learn whatever is it they seek during a one time experience or experiences spread out over long lengths of time. DXM is certainly no substitute for alcohol although I have a feeling that those too young to buy alcohol will sometimes use it as such and that's how major damage occurs...that and it's so much easier to abuse than drugs which are not available at your local supermarket not to mention that dxm is just more interesting than picking up a case of beer and a pack of cigs. As far as the damage of dex compared to ketamine, I've read that ketamine is much less toxic, at least in regard to NMDA antagonist neurotoxicity.
  11. unico_walker

    unico_walker Newbie

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    Jan 25, 2005
    You need to realize there is a lot of "double speak" when medical papers are written about drugs, especially new and exotic ones. A lot of the "symptoms" described are the normal effects just cast in a negative light, I could write a paper about marijuana use causing "toxic psychosis" and "dizzyness" and everyone who had actually used it would know it was bullshit.

    Now as for long term psychological and emotional change, this is something DXM like all psychedelics can cause just on the insights they can provide.
    I am not talking about cognitive difficulty, I am speaking of changes in personality and thinking that profound experiences often cause.
    I personally was helped greatly by DXM, it destroyed a lot of mental barriers I had constructed for myself. Things like social phobia, depression, and anxiety attacks. It has been more then a year since I used DXM and these changes have stayed with me, having my ego annihilated and standing outside my childish fears and anxieties was a eye opener. It caused lasting mental change when nothing else could and I am eternally thankful, it let me rebuild my life.

    Now if you are not thinking I am totally biased, I agree that DXM is not by any means a safe drug and should not be used recreationally, it is not something to take lightly and should be reserved for serious psychological exploration.

    But as long as doses do not exceed 1 gram and do not occur more often then every 6 months there will be no permanent damage.
    This is based on personal and anecdotal evidence from others, liver enzyme assays included.

    One thing that seems to be unknown about DXM, the "dysphoria" following heavy use is I believe a depletion of serotonin. The euphoria of DXM is almost certainly serotonergic activity, less pronounced then MDMA. During heavy use or repeated dosing serotonin is depleted and it can take several weeks to be restored. The above paragraph is based only on my personal hypothesis and observation, as the DXM "dsyphoria" feels exactly like the same from MDMA use.
    1. 5/5,
      Much agree that in contrast to the many negative-hypothesis/commentary about DXM, it is very possible to consciously apply and subsequently derive positively-integratable, psychologically-constructive experience from DXM use.
      Apr 10, 2015
    2. 4/5,
      hmm... interesting point. Thank you for the very inciteful criticism. you are most kind in rebutting---unlike the angry mob! Thanks, :)
      Jul 5, 2007
    3. 4/5,
      No comment was given
      Apr 24, 2006
  12. Alfa

    Alfa Productive Insomniac Staff Member Administrator

    Reputation Points:
    Jan 14, 2003
    117 y/o from The Netherlands
    As DXM is marketed by the pharmaceutical industry on a world wide scale, one would expect thorough clinical on the long term health risks to be done by the companies marketing this. Well think again. It seems like they have gone out of their way to avoid touching the subject. Richard Smoker has digged deep to find the above. If these companies would have published the above data or would have done more research on this, I doubt that DXM would ever have been approved by the authorities.
    Unico, I would be very interested in those liver enzyme essays.
  13. PhoenixOnPhire

    PhoenixOnPhire Newbie

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    Jan 2, 2005
    temporal lobe complex partial seizures

    I'm pretty sure i'm getting these.

    you say that brain damage is linked to these opposed to the DXM.
    has there been any studies that show DXM as a cause or has the ability to further increase these?
  14. bewilderment

    bewilderment Drug Geek Extraordinaire Platinum Member & Advisor

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    Oct 29, 2005
    from U.S.A.
    DXM does cause seizure-like activity in the brain and will most definately increase seizures in those with an underlying disorder and can also cause seizures in those who aren't really prone to them to begin with. Brain damage will be greatly increased in those with a seizure disorder if they are using dxm. I would definately discontinue use if you think you are having these. There's mention of a guy who was abusing dxm while unknowningly having a seizure disorder and he seems to have suffered permanent brain damage...I think he was also using dxm very heavily. He's mentioned in the DXM FAQ and I'd look it up and link to it if I had more time right now, but if you browse through the FAQ online (it's found in many places and is easily found through a search) then it's not difficult to find the mention. Good luck!
  15. kemistudent

    kemistudent Silver Member

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    Jan 25, 2006
    from earth
    A potential problem in a short term manner, is seizures.
  16. Richard_smoker

    Richard_smoker Gold Member

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    Sep 19, 2005
    from U.S.A.
    PheonixonPhire, why do you say that you are having these seizures, do you FEEL WEIRD??

    It occurred to me a few days ago the relationship between Temporal Lobe Seizures and dissociatives in general. Temporal Lobe Seizures are the ones that cause you to feel like you've been "speaking to God" after a dissociative trip--i.e. after nitrous, or DXM, or K or pcp...

    Other spiritual-type 'feelings'... more like "experience" include Deja-vu: a phenomenon proved several years ago to be caused by temporal lobe seizures--that is, unless you actually HAVE been somewhere before, with the exact same people, all the same age, same year, etc. :)

    Here are some specifics regarding the seizures in question. Also, this might shed some insight onto HOW these "flashbacks" might occur--i.e. an actual MECHANISM for what causes the flashback to occur! (never heard of any such mechanism before!)

    "aura" : the period immediately preceding the seizure; usually a funny taste or smell or feeling.

    "postictal period" : the period of time directly AFTER the seizure.

  17. PhoenixOnPhire

    PhoenixOnPhire Newbie

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    Jan 2, 2005
    Actually, im pretty sure I had one or 2 seziures before I did any drugs. I never heavily abused DXM, and the largest dose I took at any time was a 3oz delsym bottle. I am not sure that there is truly any link to my sezieures and taking DXM, but they are definately happening. I going to see a doctor soon, and probably will never take DXM again.

    If you guys wana know more specifics as to what exactly i am referreing to as my seziures are please ask.
  18. Richard_smoker

    Richard_smoker Gold Member

    Reputation Points:
    Sep 19, 2005
    from U.S.A.
    Yes, please. Do tell... are they temporal lobe seizures??? do you 'experience' or 'feel' things? or do you have the 'jacksonian march'? or does your body just go into all-out seizing?? 2 totally different things.

    Seizure disorder that you had prior to DXM is probably unrelated.

    1 3oz bottle of delsym is only 540mg with time-release properties. although this is a decent/average dose, i seriously doubt that you'd have ongoing seizures from it.
  19. PhoenixOnPhire

    PhoenixOnPhire Newbie

    Reputation Points:
    Jan 2, 2005
    Well bascially what happens: I am very relaxed and waiting to go to sleep late at night. I get an "aura" or a feeling of something coming on. Usually this is me either having some kind of intense thought about something very abstract and of something that I did not purposely think about. Shortly after I will have an overwhelming sensation that would be linked to an out of body experience.

    I remember two of these "preminitions":

    1) I was on the football field walking towards a couple of my friends. I feel as if I am looking at myself as well, but my sight is not as certain as it is in reality. I know it isn't real but the sensations and sounds and everything else force me to feel as if it were. I approached my friends and realized that they were older so I felt as if it were in the future. All of the sudden there was a loud noise and then I saw my friend on the ground bleeding. Then I 'woke up' from the seizure. I felt a great deal of pressure in my head (top right of my forehead to mid section). I felt very confused and tired.

    2) I remember being very sleepy and then having some weird thoughts where I was on a bed with a girl where sexual acts may or may not have occurred. She said ,”Don’t you have to say OCD?” And then I felt confused and then said “O..C…D..” then I began repeating it over and over and then it almost became so constant it sounded like an electronic noise. And then I came out of it. And felt confused and afraid to relax and sleep for about 10 minutes.

    Any more ?'s
  20. Richard_smoker

    Richard_smoker Gold Member

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    Sep 19, 2005
    from U.S.A.
    You might have narcolepsy; the first description sounds like cataplexy/hypnagogic hallucinations (dreamlike experiences during waking that often incorporate elements of the environment. They usually occur when narcoleptics are most sleepy.) tell me this:

    do you ever 'fall out' when you get emotional--like laughing or embarrassed--like you lose all muscle tone?

    are you sleepy during the day?

    the second experience sounds like it could be a seizure or some kind of dissociation. You didn't mention what the girl noticed/observed. also, were you under the influence of anything at all when that happened???

    The reason i first think of narcoleptisy is because the problem is a quick shift into deep REM sleep for no apparent reason--like you just lose all touch w/reality, and shift into a very vivid dreaming experience. it's very very confusing and people with narcolepsy often report problems when falling asleep rather than the daytime sleepiness... another example is being 'frozen' while awakening from sleep--like you're in some kind of coma. It is a paradox that we can discover narcoleptics from their sleep rather than from their major distinguishing feature--excessive daytime sleepiness.