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    DXM (dextromethorphan) is a cough-suppressing ingredient found in a variety of over-the-counter cold and cough medications, usually sold in the form of a liquid, tablets or gel caps. Like PCP and Ketamine, dextromethorphan is a dissociative anesthetic, meaning DXM effects can include hallucinations.[1]

    DXM may produce euphoria and mind-altering effects when taken in quantities greater than the recommended treatment dose. People who misuse DXM describe different “plateaus” ranging from mild distortions of color and sound to visual hallucinations and “out-of-body” sensations, and loss of motor control.

    When being misused, common slang terms for DXM include dex, robo, skittles, triple C and tussin.

    Understand the risks

    Common DXM effects can include confusion, dizziness, double or blurred vision, slurred speech, impaired physical coordination, abdominal pain, nausea and vomiting, rapid heartbeat, drowsiness, numbness of fingers and toes, and disorientation.

    Over-the-counter medications with DXM may also contain decongestants, pain relievers, and/or antihistamines (which may make you drowsy). High doses of these mixtures can significantly increase the harmful effects of DXM abuse and could cause potentially fatal liver injury, cardiovascular effects and over-sedation. DXM is also sometimes misused with other drugs, like alcohol, which can cause additional harmful effects.[2]

    Identify and address misuse

    Signs of DXM misuse include confusions, dizziness, slurred speech, abdominal pain, nausea and vomiting, and disorientation. If you’re concerned your child may be misusing DXM or other substances, the following resources can prepare you to address the behavior more effectively.

    A few simple tips and guidelines can go a long way toward spotting issues with drug use earlier rather than later.
    Learn more
    So your kid has been using drugs or drinking. Is this just what kids do? Is it going to become a problem? Don’t leave the answers to chance.
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    It can be scary if your child is using drugs or alcohol, and it's important to confront it. We're here to give you tips and strategies on how to do it.

    Last Updated

    October 2023

    [1]MedlinePlus, U.S. National Library of Medicine, 15 Feb. 2018,

    [2]“Dextromethorphan overdose.” MedlinePlus, U.S. National Library of Medicine, 23 Sep. 2018,

    Additional sources:

    U.S. National Library of Medicine
    Drug Enforcement Agency (DEA)