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DXM (Cough Syrup) Abuse In Adolescents

depressed teenager

Dextromethorphan (DXM) is an ingredient that is commonly found in over-the-counter (OTC) cough and cold medications (i.e. Robitussin, Nyquil, Vicks Formula 44, etc.). The U.S. Food and Drug Administration (FDA) approved DXM in 1958. When used as directed, and in small doses DXM does not result in any serious side effects. When abused and/ or taken in large amounts it can lead to distorted awareness, altered perception of time and hallucinations. The abuse of cough syrup has been a problem in America for decades. DXM is currently available in several forms such as capsules, powder, or pills. The typical recommended safe dosage for use of DXM ranges between 15 mg to 30 mg taken within a four-hour period. Young people that abuse DXM could take 240 mg to 1,500 mg of DXM at a time. 

Signs and Symptoms

The signs and symptoms an adolescent struggling with DXM abuse will vary, as they are entirely dependent upon the individual. Common examples of signs exhibited and symptoms presented in a teen abusing DXM include any combination of the following:

  • Secretive and/ or evasive behavior
  • Appearance changes
  • Diminished personal hygiene practices
  • Hostility
  • Aggression
  • Deceptive behaviors
  • Shifts in appetite
  • Mood swings
  • Poor coordination
  • Socially and emotionally withdrawn
  • Difficulty focusing
  • Changes in relationships with friends and/ or family

DXM is widely available and an extremely accessible substance. It is important to note that standard drug tests will not detect DXM, which is likely another reason why teenagers abuse the substance in the first place. 

Side Effects

Every teenager is different and will metabolize DXM at a distinct rate. There are several potential side effects that can occur as a result of DXM abuse, which can include any combination of the following, as provided by the Mayo Clinic:

  • Impaired judgment
  • Hot flashes
  • Panic attacks
  • Nausea
  • Dizziness
  • Vomiting
  • Lethargy
  • Slurred speech
  • Gastrointestinal issues
  • High blood pressure
  • Rash
  • Confusion 
  • Slowed breathing
  • Rapid eye movement
  • Hallucinations 
  • Paranoia 

The National Institute on Drug Abuse (NIDA) assert that persistent abuse of DXM can lead to:

  • Liver damage when taken in conjunction with acetaminophen
  • An excess buildup of acid is the body fluids
  • Brain damage and damage to other organs due to hypoxia (decreased oxygen to the brain)
  • Substance use disorder
  • Respiratory complications associated with chronically decreased breathing rates

The severity and duration of the side effects will depend on the teen’s personal health history, how long he or she has been abusing DXM, the amount and frequency of DXM abused, as well as if he or she simultaneously abused additional substances. 


There are a variety of treatment options available for an adolescent struggling with DXM abuse. Treatment for a teen abusing DXM generally consists of a number of different components including a detox phase, some type of formalized substance abuse treatment program, and an aftercare plan. Depending on the needs of the teenager, an overall specialized substance abuse treatment plan can include a combination of different therapeutic modalities including individualized therapy, group therapy, creative arts therapies, and more. Unfortunately, DXM abuse remains prevalent among the adolescent population in America, and if left untreated can result in severe long-term consequences. 

For Information and Support 

Seeking help is never easy, but you are not alone! If you or someone you know is in need of mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person for the long term. The earlier you seek support, the sooner you and your loved ones can return to happy, healthy and fulfilling lives.

Our admissions team is available to answer any general questions regarding mental health issues, treatment, and/or specific questions about the program at Pacific Teen Treatment and how we might be able to help your family. We can be reached by phone 24/7 at 800-531-5769. You can also contact us via email at or through our contact form.

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