DXM Withdrawal Symptoms And Detox From Dextromethorphan

Last Updated: June 3, 2020

Stopping of long-term abusing dextromethorphan drug may cause specific withdrawal symptoms, such as cravings, nausea, hypertension, and accelerated the heartbeat. They may be experienced by patients either attempting to detox by their self, or merely suffering from DXM withdrawal due to the dependence syndrome. When withdrawal from DXM appears, addicts may find that its toll on both the mind and the body, making it essential to seek help and detox under the aid of a professional. Withdrawal from dextromethorphan drug category may be unpleasant and even painful process in some severe cases.

What Is Dextromethorphan Withdrawal?

Despite the DXM MOA activity doesn’t manifest addictive properties, this drug may cause specific effects on the body after the stop of using it for a long time.

It can only be identified directly through the symptoms that may start within 24 hours after taking the last dose of Dextromethorphan. While most users find the effects the most pronounced on the first day itself, the severity depends on specific factors such as the regular dosage of the drug – 100mg DXM daily, for example. Other factors include drug interactions, such as frequent DXM and caffeine mixing (because of legality and accessibility of second), or the presence of substances such as SSRIs in the system, which all affect serotonin levels.

This mainly causes the mind and body to overstrain due to the close link between dextromethorphan withdrawal and dependence syndrome. This means that the body has become dependent on the drug to function on the level it has used to. Withdrawals from DXM are thus seen upon hospitalization or if the user attempts detoxification on their own.

DXM Withdrawal Symptoms And Effects

Dextromethorphan withdrawal symptoms usually are not harmless. DXM withdrawal effects (especially heavy DXM use withdrawal symptoms) can take a toll on the body in addition to the internal damage being done by the overuse of the drug itself. These can manifest as:

  • excessive sweating
  • flaring up of a hypersensitive nervous system
  • sudden drops and hikes in blood pressure
  • the patient being constantly lightheaded and fatigued
  • impaired judgment and mental clarity
  • insomnia
  • restlessness
  • disassociation
  • high blood pressure
  • an excessively rapid heart rate
  • weight loss as a result of these symptoms
  • depression, high levels of anxiety, suicidal ideation

In most cases, the DXM withdrawal symptoms can themselves require medical attention. Therefore, the presence of a healthcare physician or rehabilitation and addiction expert during a DXM detox is crucial.

These symptoms present during a detox also compound and affect the overall physique of the patient, causing sudden weight loss. This can be in part due to compulsions and cravings that can include the need to get more of the drug, or the body requiring an “alternative.”

DXM Withdrawal Timeline

How long does withdrawal from DXM last? The DXM withdrawal timeline always varies from case to case. The sufficient in-depth research is still not done, and the exact timeline is dependent on factors such as dextromethorphan metabolism, and how much of the drug was in the patient’s system (and for how long) at the start of the detox. While symptoms grow more gradually as compared to other drugs, conducted surveys indicate that it can last up to at least a few weeks.

what is dxm withdrawal timeline

Dextromethorphan Withdrawal Treatment

Withdrawal from dextromethorphan can be treated via a professional detox. Trying to detox at home can make it affect the body in worse ways that can be anticipated. Additionally, a non-professional cannot adequately monitor the progress of rehabilitation and regression of the addiction.

Dextromethorphan withdrawal treatment requires a proper treatment plan and significantly differs from DXM overdose treatment. DXM withdrawal treatment plan must be created and managed around the clock by trained healthcare professionals, staving off the effects of even severe DXM withdrawal for specific cases.

An evidence-based consensus guideline for out-of-hospital management describes the measures to be taken for each case.

Different ways of taking dextromethorphan may also require additional treatment options. For example, smoking DXM in the form of powder or crystals may cause increased toxicity in the body and lung damage. The danger is also present in mixing DXM with alcohol, doubly worsening the effects of both and increasing pain. Pure DXM powder is different from cough syrup dextromethorphan, and the withdrawal effects of such pure form are incredibly potent and harmful. Dealing with each case requires different ways of treatment. Considering that the drug can come in different forms that effect will affect the dextromethorphan toxicity, only a professional can gauge the level of help needed and choose the right medication.

Dextromethorphan Detoxification

Dextromethorphan detox is the process of cleansing the body of the presence, traces, and effects of the use of dextromethorphan with the use of therapy and medication. Detox programs for DXM take place in specialized rehabilitation centers under the care of professionals, as how to DXM detox is not something that a DXM user with an impaired sense of judgment can best take care of. Particularly with the constant level of monitoring needed, as well as the necessity of a safe space and full-time care.

planning dxm detox program

The process of dextromethorphan detoxification is closely linked to managing the withdrawal symptoms. These detox programs for DXM can last for as long as needed and are built keeping in mind:

  • the personal capacity of the patient to tolerate the drug
  • physical, vital signs
  • the time that the patient has been abusing dextromethorphan for
  • as well as mental attitudes

The last point is very important as DXM is still not being considered a harmful drug (even though some products contain both medicines acetaminophen and dextromethorphan). With around 55% of youngsters polled by the Partnership for a Drug-Free America displaying a lack of belief in cough syrup being addictive. This means that patients might not even recognize withdrawal symptoms when faced with them.

DXM Withdrawal Medications

There are currently no medications for DXM withdrawal in use or development. However, a variety of medication can be used to treat some specific symptoms. Simply flushing the dextromethorphan from the system with fluids is a well-employed method. Naloxone may reverse poisoning symptoms caused by dextromethorphan and normalize mental health. It also reduces the toxicity in the body, caused by the medication, and works as an antidote. Benzodiazepines can also be used, particularly to counter the exciting effects of the dextromethorphan and induce patterns of normal levels of relaxation in the brain cells. Valium is an example of a drug that might be used in such a case.

Finding Professional Help For DXM Withdrawal

DXM withdrawal help can be found in many centers across the United States and provide rehabilitation services along with medication and full-time care. Rehab centers provide information for potential addicts and those going through withdrawal, house individual and group therapy facilities as well as providing safety and support, and counseling about the symptoms and possible relapse. Holistic therapeutic methods such as yoga, reflexology, and Ayurvedic medicine might also help under the guidance of these professionals. Depending on the form and the level of symptoms presented, the rehab center must define individual treatment options to make the healing process as quick and efficient as possible.

Page Sources

  1. Jochen Mutschler, Anne Koopmann, Martin Grosshans, Derik Hermann, Karl Mann, Falk Kiefer. Dextromethorphan Withdrawal and Dependence Syndrome. 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925345/
  2. Chyka, Erdman AR, Manoguerra AS, Christianson G, Booze LL, Nelson LS, Woolf AD, Cobaugh DJ, Caravati EM, Scharman EJ, Troutman WG; American Association of Poison Control Centers. Dextromethorphan poisoning: an evidence-based consensus guideline for out-of-hospital management. 2007. https://www.ncbi.nlm.nih.gov/pubmed/17849242
  3. Office Of The National Drug Control Policy, Executive Office Of The President. A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse Among the Nation’s Teens. Prescription for Danger. 2008. http://publichealth.lacounty.gov/sapc/resources/prescription_report.pdf
  4. Schneider SM, Michelson EA, Boucek CD, Ilkhanipour K. Dextromethorphan poisoning reversed by naloxone. 1991. https://www.ncbi.nlm.nih.gov/pubmed/2018593/

Published on: August 6th, 2019

Updated on: June 3rd, 2020

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.


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