What is DXM?

Dextromethorphan (DXM) is a cough suppressant that, in high doses, acts like a dissociative similar to ketamine. DXM is sometimes included as an adulterant in pills sold as ecstasy. Some pills sold as ecstasy have been found to contain only DXM. What is considered a "high dose" of DXM may be included in a single pill.

What Are The Effects of DXM?

High doses of DXM can cause nausea, itchy skin, visual and auditory hallucinations, loss of motor control, and will make you feel very "stoned" and "out of it". People who use DXM recreationally for its dissociative effect usually do so at home, where it is safe and they can relax. It does not produce energy, and makes it rather difficult and undesirable to dance.

Important Information!

High doses of DXM can contribute to rave-related heatstroke. The risk of overheating in a rave environment is greater with DXM than with MDMA. This is because DXM can prevent sweating. This "drying out" property of DXM is what makes it a good cough suppressant as well as a dangerous drug to take in high doses in a hot environment.

DXM is more dangerous if combined with "real ecstasy" (MDMA). Both drugs are metabolized through the same liver enzyme which means that if you combine them your liver will not be able to break down either drug as efficiently as it should.

The chances of heatstroke are greater if you have consumed DXM instead of MDMA, and greater still if you have consumed both MDMA and DXM together.

There are also documented reports of individuals experiencing seratonin syndrome (a heatstroke-type reaction) after combining DXM with antidepressants such as MAOI's and SSRI's.

Be Careful

Physical exertion and body temperature are contributing factors in most cases of heatstroke, whether it is drug-related or not. You can reduce the risk by taking breaks from dancing, resting, avoiding hot environments and staying hydrated.

Other Adulterants in Pills

Many other drugs are commonly passed off as ecstasy as well. Some of these like PCP, DOB, and ketamine, can impair motor control and produce intense hallucinations. Such dramatic and unexpected psychological effects can be traumatic, particularly to those expecting the relatively mild empathy and mood-elevation produced by MDMA.

Other drugs found in "ecstasy" tablets have included speed, cocaine, atropine, 4-MTA, various prescription and over-the-counter medications, and many, many others.

While no drug is entirely safe, including MDMA, many of the fake tablets, as explained above are far more dangerous. Adulterant screening is therefore a vital and necessary harm reduction service.

The information in this flyer was collected and composed by Dancesafe, a US National Harm Reduction Group.