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Is Your Teen Abusing DXM (Cough Syrup)?


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Dextromethorphan (DXM) is an ingredient found in cough and cold medications (e.g., 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 rarely results in any serious side effects. However, when abused and/ or taken in copious amounts it can lead to distorted awareness, altered perception of time and hallucinations. 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 as much as 240 mg to 1,500 mg of DXM at a time. According to Stanford Children’s Health DXM can be found in at least 70 common over-the-counter (OTC) cough and cold medicines, making it widely available and an extremely accessible substance for teenagers to abuse. Further, standard drug tests will not detect DXM, which is likely another reason why teenagers select this substance to abuse. 

Signs and Symptoms

To be able to tell if your teenager is abusing DXM, it is essential to become aware of common signs and symptoms associated with its use. Please note that the signs and symptoms an adolescent struggling with DXM abuse will vary, as they are entirely dependent upon the individual. The severity and duration of symptoms 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. Teens Health provides a list of common examples of signs exhibited, and symptoms presented in a teen abusing DXM some of which 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  • Socially and emotionally withdrawn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

It can be challenging to detect if your teen is abusing DXM, as some of the signs of DXM abuse mimic typical adolescent behaviors. Not all teenagers that exhibit one or more of the above examples are undoubtedly abusing DXM. There are a variety of treatment options available for a teen struggling with DXM abuse. If left untreated, habitual abuse of DXM can result in severe long-term consequences. When in doubt it is best to err on the side of caution and have your teen evaluated by a medical professional.

For Information and Support

Seeking help is never easy, but you are not alone! If you or someone you know needs 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

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