Substance guides

DXM abuse: Cough medicine that can harm and kill

Published December 4, 2024 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

DXM (dextromethorphan) is found in over-the-counter cough medicines and is abused for dissociative effects at high doses.

Effects by dose

Therapeutic dose (15-30mg): cough suppression. 100-200mg: mild euphoria. 200-400mg: dissociation. 400-600mg: intense dissociation, hallucinations. 600mg+: complete dissociation, risk of serotonin syndrome and psychosis.

Dangers

Serotonin syndrome (potentially fatal) especially combined with antidepressants. Liver damage from acetaminophen in combination products. Respiratory depression. Psychosis. Physical harm from impaired coordination.

Adolescent vulnerability

DXM abuse is most common among teens due to OTC availability. Coricidin (Triple C) is particularly dangerous due to additional active ingredients. Purchase restrictions exist in many states.

Authoritative sources

This article references guidelines from: SAMHSA · NIDA · ASAM

Frequently asked questions

Can you overdose on cough medicine?

Yes. High-dose DXM produces dangerous dissociation, serotonin syndrome risk, and respiratory depression.

What is robotripping?

Slang for intentional DXM intoxication at doses far exceeding therapeutic use.

Is DXM addictive?

Psychological dependence can develop. Physical dependence is mild but withdrawal symptoms (insomnia, dysphoria) occur.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.