Seriously, holy shit it has a terrible reputation it really does not deserve. Unfortunately it's the OTC high of choice for desperate teenagers, and nigh universally found in cough syrups and cold remedy gel caps where it is accompanied by acetaminophen and guaifenesin.

Acetaminophen overdose is a horrid way to go. It will absolutely wreck your liver if you try to use an associated DXM product in tripping quantity.

Guaifenesin is a lot less horrifying, but at high doses will give you intense nausea and make you vomit. It's not hard to see why this would ruin the headspace of any trip.

And last but not least, cough syrups and gel caps are not meant to be taken in large quantities needed to get an effective dose of DXM. They are full of artificial sweeteners that will give you bad diarrhea and a painful, upset stomach.

All of this is to say, most people who try DXM end up with a horrible, shitty experience. In the worst case, the acetaminophen will literally kill you. Most prospective drug users are savvy enough to avoid formulations with APAP, but this is where DXM get its reputation as a particularly hard drug on your liver and kidneys. It's not, it's actually almost as physically benign as opiates are, it's metabolized in the exact same way and has a similar chemical structure despite the fact that it doesn't activate opioid receptors. There is a rare possibility of bladder damage, but this is a property it shares with Ketamine and other dissociatives.

Recently the FDA approved a new prescription antidepressant called Auvelity that features a combination of DXM and Bupropion. It's approved for daily use at a much larger dose than recommended by cough medicine, so I'm not talking out of my ass here when it comes to the safety profile.

Finding OTC formulations without guaifenesin is hard, though. Even harder still is finding non-gel cap/non-cough syrup formulations. Taking any of those is very likely to make you feel as if you poisoned yourself. When DXM is the only active ingredient, people are going to blame that before they blame the inactive ingredients.

And that was how I thought of DXM for a long time because my first experiences with it came in the form of gel caps. I recently had the opportunity to try a more pure formulation of Dextromethorphan HBr, and it is amazing. It doesn't feel like a dirty high at all, and the comedown comes with this peaceful, dreamy, almost opiate-like afterglow feeling.

In smaller doses you get an intoxicating alcohol-like high without any of the downsides like hangovers, liver damage, or obvious loss of motor control.

In larger doses you get what many compare to a more psychedelic, more introspective Ketamine-like trip. But unlike psychedelics, there is a far lower chance of having a bad trip because of how dissociative it is. In my experience, it totally blunts feelings of paranoia and anxiety.

Anyway, I'm on a DXM afterglow right now and thought I'd use this vibe to put my thoughts to paper on it.

  • cosecantphi [he/him]
    hexagon
    ·
    edit-2
    5 months ago

    Yeah, Mu opioid receptors are the main ones responsible for opioid highs. There is data showing that DXM and some of its metabolites can activate them, but the binding affinity is orders of magnitude lower than actual opioids to the point where any opioid action must be either totally negligible or mediated indirectly.

    I'm on a daily dose of Buprenorphine maintenance, 16mg. That causes a blockade effect at the mu opioid receptor, if I used Heroin on that I wouldn't feel shit. Yet lower dose DXM still feels almost like an opioid without causing opioid withdrawal upon cessation.