Robotripping: The Effects of DXM Abuse

Last Updated: March 24, 2023

Editorial Policy | Research Policy

Over-the-counter medications may seem safe due to their nonprescription status, but abusing them can be problematic.

Robotripping refers to the abuse of the cough medicine dextromethorphan or DXM. However, DXM abuse also goes by other names, including “skittling” or “dexing.” Although DXM can be safe at recommended doses to treat cold and flu symptoms, it can also be misused for hallucinogenic effects and lead to serious side effects in overdose. Understanding the effects of DXM abuse is the first step in seeking help for yourself or a loved one.

DXM Abuse

DXM can be a helpful medication to treat a cough from a cold or the flu. However, the medicine is also prone to abuse for its effects at high doses. The abuse of cough and cold medicines like DXM is most common in adults. In 2021, cough medications like DXM were misused by approximately:

  • 173,000 children under 18
  • 243,000 young adults aged 18–25
  • 1.2 million adults aged 26 or older

Among children, DXM abuse differs by age. As of 2022, approximately 3.2% of 8th, 3.9% of 10th and 2.4% of 12th graders admitted abusing cough and cold medicines like DXM over the past year.

The Effects of Abusing DXM

DXM can cause a range of psychiatric effects, including:

  • Euphoria (extreme joy)
  • Hallucinations (seeing/hearing things)
  • Dissociation (feeling outside your body)

These effects occur because of DXM’s activity on the brain’s NDMA and sigma-1 receptors, which are also involved in the effects of other psychoactive drugs like shrooms, LSD and ketamine.

Although psychiatric symptoms are rare at recommended doses and generally limited to excessive amounts, some people do not easily break down DXM in their systems and may have psychiatric effects even at low doses.

Robotripping Plateaus

Different doses of DXM can result in different psychiatric effects. Four dose ranges or plateaus exist for DXM:

  • Plateau one: At a dose of 100 mg–200 mg, psychiatric effects like restlessness and euphoria can begin.
  • Plateau two: At a dose of 200 mg–500 mg, a person may start having hallucinations, even when their eyes are closed.
  • Plateau three: At a dose of 500 mg–1000 mg, a person may begin to see and hear things that aren’t there, have an altered state of consciousness, have mood swings, panic and may start to dissociate themselves from their surroundings.
  • Plateau four: At a dose over 1000 mg, people may suffer hallucinations and delusions and completely dissociate from their surroundings.

DXM Abuse and Dangerous Behavior

DXM abuse has been linked to dangerous behavior that can be violent. Cases have been reported of people high on DXM who have committed suicide or homicide or assaulted others. Although the reason for the dangerous behavior is unclear, experts think it may have to do with the drug’s dissociative effects.

Other Potential Side Effects

Besides its psychiatric symptoms, DXM can also cause physical side effects. These can include:

  • Over-excitability
  • Energy loss
  • Coordination problems
  • Slurred speech
  • Sweating
  • High blood pressure
  • Nausea or vomiting
  • Eyeball spasms

Contact your doctor if you take DXM and experience psychiatric or physical symptoms from the medication. Although most people will only experience side effects from high DXM doses, others may have side effects from lesser amounts. 

Long-term Effects of Abusing DXM

The long-term effects of DXM abuse are unknown, especially in younger people, making it even more important to avoid abusing DXM.

DMX Overdose

Taking too much DMX can lead to an overdose. This is especially true in those who don’t break the medication down easily in their bodies, meaning the drug can last longer than expected in their systems. DMX overdose symptoms include:

  • Blurred vision
  • Drowsiness
  • Dizziness
  • Hallucinations
  • Unsteady gait
  • Blood pressure changes
  • Muscle twitches
  • Nausea or vomiting
  • Fast or pounding heartbeat
  • Fever
  • Stomach spasms
  • Slowed breathing
  • Bluish nails and lips
  • Seizures
  • Unresponsiveness

A DXM overdose is dangerous and can be fatal in some cases. If you think someone is experiencing a DXM overdose, immediately call 911 for emergency medical care or the Poison Help hotline at 800-222-1222.

Is DXM Addictive?

Although DXM abuse can occur, scientists are still unsure about the extent to which DXM is addictive. DXM remains an over-the-counter medication in the U.S. and is not a controlled substance.

Nonetheless, because DXM addiction is possible, it is important to be aware of addiction signs, which include:

  • Needing increasing amounts of DXM to achieve a high
  • Relationship, work or school problems because of DXM
  • Unsuccessful attempts to cut back on or quit DXM
  • Spending a lot of time taking or recovering from DXM
  • Continuing to take DXM even though you know it is causing you problems

Because withdrawal symptoms can occur if you regularly take high doses of DXM and suddenly stop, it is important to seek medical advice before quitting DXM. Withdrawal symptoms can include:

  • DXM cravings
  • Sweating
  • Nausea
  • High blood pressure
  • Rapid heart rate

Fortunately, DXM addiction can be overcome. People have been successfully weaned off DXM in a medical detox setting with round-the-clock care with the help of doctors, nurses and therapists.

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