Subjective effects of DXM

Dextromethorphan molecule diagram.
This article is part of an ongoing project to apply the subjective effect index to specific psychoactive substances in order to document their phenomenological effects in a comprehensive and formalised manner. This will initially be achieved by the sites founder employing her first-hand knowledge of hallucinogenic substances and the subjective effects they induce. Eventually we will establish a more refined methodology by employing a small team ingesting these substances at a range of dosages, and documenting their experiences through the use of standardized trip reports using our SEI form system. We will then analyse this collected data in order to further detail and substantiate the effects that are induced at specific dosage ranges, their levels of intensity, style variations, and approximate frequency of occurrence. DXM is a dissociative hallucinogen within the morphinan chemical class. It is widely available for purchase at many pharmacies throughout the world in the form of cough syrup and tablets. The substance itself induces dissociative anaesthesia alongside a disproportionately intense amount of psychedelic effects in comparison to other more traditional dissociatives, such as ketamine and MXE. As this article will exclusively focus on this compound's subjective effects, if you would like to learn more about DXM's chemistry, pharmacology, history, legality, and potential dangers, then please see its PsychonautWiki article here.

Duration

It is extremely important to note that the duration listed above applies to only the majority of people, as DXM is metabolised through the CYP2D6 enzyme, which has significantly reduced activity in approximately 10% of the population. [1] This means that for certain individuals, DXM may be metabolised much more slowly than average in a manner which can result in a duration of up to 36 hours alongside of greatly increased uncomfortable side effects such as overstimulation and itchiness. [2] This article assumes that the person ingesting DXM has a normally functioning CYP2D6 enzyme. The duration of DXM trips can often be felt to be split into four separate stages which feel subjectively distinct from one another. The first stage occurs while the user is still coming up on the substance. It typically consists of progressively more intense feelings of nausea and dissociative effects which culminate at the start of the peak with either vomiting and/or significantly reduced nausea. This nausea increases in its intensity proportional to the dosage consumed and is considerably more prevalent under the influence of DXM that comes in the form of cough syrup as opposed to an extracted tincture, pure powder, or pills. The second stage lasts throughout the duration of the peak and can be described as feeling close to that of a traditional dissociative with a range of disconnective effects and cognitive suppressions. However, during the offset, the effects shift into the substances third stage in a manner which feels significantly more psychedelic, with an increase in high-level geometry, dream-like internal hallucinations, introspective thought patterns, and profound feelings of increased spirituality. The final stage usually occurs during the day after the experience, once the user has slept. Depending on the individual's neurochemistry, it typically consists of either an afterglow or a hangover, with the afterglow feeling like an increase in energy, mania, mood elevation, and physical euphoria. This typically wears off approximately half way through the day and subsides into a general sense of sleepiness and lethargy. However, if the person is more prone to a hangover or has taken an overly heavy dosage, then they will likely experience feelings of lethargy, anxiety, inattentiveness, and mild depression. This will usually subside before the end of the day but may last multiple days in extreme cases.

Intensity Scale

This intensity scale breaks the subjective effects of DXM into six distinct levels, in which each tier typically contains an expanding list of effects that proportionally intensify relative to the dosage consumed. The approximate frequency of occurrence is also listed alongside each effect. For an explanation of the terms used within this frequency measuring system, please see the article here. Furthermore, it is important to note that the dosages provided here are average measurements that are comparable to recommendations made by PsychonautWiki and Erowid. The DXM dose required to reach a given range of effects seems to vary widely between individuals, depending on both body weight and neurochemistry. This variation in dosage sensitivity appears to be far more common among DXM users than almost any other hallucinogenic substance. For example, while some people may find themselves unusually sensitive to this compound, others will require a much higher dose than those recommended by this article and other reliable sources. It is therefore common for people within the psychonaut community to use DXM calculators which predict the required dosage depending on body weight. These dosage calculators usually refer to a 5 tier plateau system that was popularised in 2002 by Erowid's DXM FAQ. Although the levelling system documented on this page here is approximately—although not entirely—analogous to this plateau system, it is important to keep in mind that there are many subtle differences.

1. Subtle (100 - 200 mg)

At the lowest level, DXM typically induces a small range of subtle cognitive effects which may be beneficial for enhancing a person's sociability, energy levels, relaxation, and creativity. There may also be a sensation that the body feels lighter, resulting in a sense of bounciness and ease of movement. However, these changes may be difficult to distinguish between that of genuine alterations and the placebo effect, unless the person is already familiar with the substance. This level of DXM intensity is roughly analogous to a state which is colloquially referred to as the "first plateau". The specific subtle effects which generally occur at this level of intensity are described and documented within their own dedicated articles, listed below:

2. Mild (200 - 400 mg)

At this level, the effects of DXM can be generally described as a subtle dulling of the senses and a vague feeling of subjective detachment from the external environment, which is accompanied by a distinct sense of mood elevation, sociability, and stimulation. The increase of sociability experienced at this dosage range is mildly entactogenic and can be described as forcibly induced feelings of love, empathy, and talkativeness. Although it is comparable in its style to the entactogenia induced by substances such as MDMA, it is much subtler in its intensity and forcefulness in a manner which is similar to that of 2C-B. In terms of its intensity, however, it is usually only present at these lower levels of intensity as when the dosage is increased, and eventually gives way to more typical dissociative effects. These effects are accompanied by mild but pleasurable spontaneous bodily sensations which is commonly referred to as a "body high." The specific details of which can be described through its style variations as moving in its motion, spontaneous in its occurrence, sharp in its sensation, euphoric in pleasurableness, and location specific in its position that often remains localised to the hands, feet, or head. At this point, the user may have to pay direct attention to the effects of the substance for them to be recognisable, or they may be noticeable but will not necessarily demand the user's attention. This level of DXM intensity is roughly analogous to a state which is colloquially referred to as the "second plateau". The specific subtle effects that generally occur at this level of intensity are described and documented within their own dedicated articles, listed below:

Sensory

Cognitive

Physical

3. Distinct (400 - 700 mg)

At this level, the environment starts to feel physically further away in distance and increasingly disconnected from a person’s sensory perception. Partially blurred and double vision sets in, and anaesthetic-like effects such as tactile numbness begin to take place. Other physical faculties such as motor control, coordination, and balance become somewhat suppressed in a manner that is partially compensated for by a feeling of the body being in a state of "autopilot". Interestingly enough, this suppression of motor control is unique in its style as it frequently results in users moving around in a robotic and mechanical like gait that does not seem to present itself under the influence of other dissociative substances. Within the DXM community, this is colloquially referred to as a "robo walk". These physical effects are also accompanied by a pronounced feeling of sedation that begins to overtake the stimulation that is felt at lower dosages, and is accompanied by other cognitive suppressions such as thought deceleration. Alongside of this, the user will likely feel a sense of persistent dry mouth or mild dehydration that often requires periodic sipping of water to keep it from reaching significant levels of discomfort. Various adverse effects such as itching and rashes may also occur at this dosage range and above. Although it is uncommon, it is worth noting that a certain percentage of people seem to experience itchiness on DXM that is comparable to that which occurs on opioids such morphine, kratom, and heroin. This is colloquially referred to as a "robo itch" within the DXM community and is likely a result of histamine release. In terms of auditory perception, the clarity of sound itself may seem as if it has become vague, muffled, and distant. Nonetheless, one's sense of music appreciation will have profoundly increased. Regarding visual effects, some inconsistent and brief distortions may also occur spontaneously during dissociative experiences. These distortions can include alterations in perceived distances between objects, visual segmentation of one's vision into glitch-like cubes or slices, and changes to the perceived size of one's body or the environment. During this level, if one allows themselves to relax while closing their eyes, they may find that they are fleetingly and partially drifting off into a darkened hallucinatory void filled with vague psychedelic geometry alongside simplistic shapes, forms, and structures. This is usually a very brief and indistinct experience which can quickly be interrupted by external stimuli such as noises or other distractions. With DXM in particular, it is worth noting that its geometry is typically much more distinct, colourful, pronounced, and psychedelic-esque in comparison to that of other more commonly used dissociatives. Although it does not usually extend beyond level 5 geometry and is not entirely on par with a typical psychedelic in terms of complexity, it can often come very close in terms of its intensity, colour palette, and vividness. This effect will typically begin to manifest at this level subtly, and its intensity increases proportional to the dosage consumed. It can be comprehensively described through its style variations as intricate in complexity, algorithmic in style, synthetic in feel, unstructured in organization, brightly lit in lighting, multicoloured in scheme, glossy in shading, soft in edges, small in size, slow in speed, smooth in motion, equal in rounded and angular corners, immersive in-depth and consistent in intensity. There is also a distinct possibility that the user may experience sterotypical psychedelic drifting which causes the environment to appear to warp, morph, bend, and flow. However, although this effect is more common on DXM in comparison to that of other more common dissociatives, it is still substantially less common in comparison to that of a traditional psychedelic. When it does occur, it can be described through its style variations as simplistic in its details, slow in its movement, smooth in its framerate, fleeting in its stability, and unrealistic in its appearance. Depending on the person's level of experience with this substance, these effects can be allowed to occupy a predominant role within the person's perception, or they may be partially ignored and made somewhat secondary to other chosen activities. This level of DXM intensity is roughly analogous to a state which is colloquially referred to as the "third plateau". The specific distinct effects which generally occur at this level of intensity are described and documented within their own dedicated articles, listed below:

Sensory

Cognitive

Physical

4. Strong (700 - 800 mg)

At this level, the sensory and cognitive disconnection has begun to completely block out one's perception of the external environment. It is here where the person may find themselves undergoing an out-of-body experience as they float in a variety of directions and orientations through a "dissociative hole", which can be described as an expansive darkened void containing a wide array of internal hallucinations and structures. These structures are usually formed from solid materials which can take the form of any shape. Common examples include vast and monolithic pillars, columns, tunnels, blocks, buildings, slides, monuments, wheels, pyramids, caverns, and a variety of abstract or fractal shapes. The internal hallucinations that occur at this level will usually consist of vivid, ever-changing dream-like scenes and imagery. They can be comprehensively described through their style variations as a combination of lucid and delirious in believability, fixed in style, primarily new experiences over memory replays in content, autonomous in controllability, and a combination of solid and geometry based in style. Although they are substantially less common than internal hallucinations, external hallucinations can also occasionally occur at heavy dosages of DXM. These are typically deliriant-like in nature and consist of solid hallucinations of objects or people blending seamlessly into the external environment. The most common theme seems to be the hallucination of conversing with other people in the environment who were not actually present throughout the trip. However, it is important to note that despite this effect being more common under the influence of DXM in comparison to that of other dissociatives, it is still quite rare and may never be experienced even by regular users. Alongside these disconnective hallucinatory effects, the user may experience feelings of altered cognition that feel as if they direct one's thought stream towards topics of introspection, an analysis of the details of their life, and a general sense of spiritual or philosophical contemplation. This is the level at which the effects become powerful enough to render the person undergoing them as incapable of functioning, interacting normally, or thinking in a sober manner. At this level, the effects of the substance are apparent and can no longer be ignored in any capacity, leaving the user entirely engaged in the experience whether they wish to be or not. In terms of how this looks from an outsiders perspective, the person will usually appear to be either heavily sedated or even almost entirely unconscious. This level of DXM intensity is roughly analogous to the lower end of a state which is colloquially referred to as the "fourth plateau". The specific distinct effects which generally occur at this level of intensity are described and documented within their own dedicated articles, listed below:

Sensory

Cognitive

Physical

5. Heavy (800 - 900 mg)

At the highest level, the dissociation and detachment from the person's senses and consciousness has become intense enough for their long-term memory and feeling of selfhood to cease functioning. This leads into a state which is commonly referred to as "ego death" due to the way in which the person completely loses their ability to recall and comprehend their own sense of identity. This state of ego loss is accompanied by extremely vivid hallucinatory voids, structures, geometric forms, sensory disconnection, internal hallucinations, delusions, and occasionally life-changing spiritual or transpersonal experiences. It is worth noting that during this dosage range, feelings of sudden anxiety, panic, or even an impending sense of doom can spontaneously occur at any point throughout the trip for no discernible reason. Although this is relatively uncommon, it can occur regardless of the users level of experience and can even suddenly manifest during the offset of the drug when the person has begun to feel almost entirely sober. This experience typically lasts any where from thirty minutes to a couple of hours and seems more likely to manifest for people who use this substance on a regular basis. This level of DXM intensity is roughly analogous to the upper end of a state which is colloquially referred to as the "fourth plateau". The specific distinct effects which generally occur at this level of intensity are described and documented within their own dedicated articles, listed below:

Sensory

Cognitive

Physical

6. Extreme (900 - 1200 mg +)

The highest level of detachment occurs when a person loses all sensory awareness and normal cognitive functioning. This renders the person unconscious and consistently leaves extended gaps in a person’s memory with large periods of amnesia which are generally impossible to recall once the experience is over. It is at this level of dissociation that drugs such as ketamine are used in medical procedures for their anaesthetic effects. At this dosage range, the person will experience the effects typically associated with the previously described level during the onset and offset of their trip. During the peak, however, they will black out and become unconscious for a prolonged period of time that is directly proportional to the dosage consumed. Although this extreme dissociative state may be attractive to certain individuals, it is worth noting that this level of intensity is not only potentially dangerous but also less therapeutic and exploratory than the previous levels. With DXM in particular, it is said by sites such as Erowid that dosages between 2,500 mg and 20,000 mg are capable of resulting in death. However, this seems unusually high to me, and I would not personally be surprised if dosages closer to 1000mg were capable of causing a fatal overdose within certain individuals that have either a lower body weight or a higher sensitivity.

Experience Reports

Anecdotal reports which describe the effects of this compound within our experience index include:

Personal Commentary

In my opinion, DXM is tragically overlooked and underrated by the mainstream psychonaut community. It is easily one of my favourite hallucinogens, as for me personally, it induces therapeutic introspection alongside profound feelings of spirituality enhancement in a manner that is more consistent than almost any of the other 120+ substances which I am experienced with. In fact, the only other hallucinogenic substance which is as consistently equal to me in this regard is ayahuasca. However, it is worth noting that I very much seem to be an outlier when it comes this. Over the years I have witnessed many other people under the influence of DXM, and while they usually hold it in high regard, only a small fraction of them seem to benefit from its effects to quite the same extent that I do. However, in an attempt to diminish my bias as much as possible, I have been sure to take this into account within the documentation above. I suspect the reason that I benefit from DXM so much stems from a combination of having a compatible physiology, as well the way in which its unique effect profile results in a trip which is seemingly 75% dissociative and 25% psychedelic — allowing me to simultaneously experience the positive aspects of both hallucinogenic classes, all within a single compound. I usually find that the first two-thirds of the experience is primarily dissociative in its effects with the last third being primarily psychedelic, with a headspace that also changes into something reminiscent of tryptamines. It's during this latter phase in which I typically undergo the aforementioned feelings of therapeutic introspection combined with a sense of profound and contemplative spiritual reverence towards my place within this universe. For many people, DXM seems to have a reputation of being a "kiddie drug" that presumably stems from a number of factors. For example, its ease of availability results in young teenagers commonly using or abusing this substance when they cannot access anything else. In addition to this, approximately 10% of users cannot metabolise it correctly which likely results in them reporting disproportionately adverse side effects that people fail to realise will not occur for the majority of the population. It is also commonly taken in the form of cough syrup which many people are understandably apprehensive about ingesting while remaining unaware that is also commonly available in other forms. Despite this reputation, however, DXM is an incredibly powerful hallucinogen that can potentially offer as much depth to it as any of the other classical dissociatives or hallucinogens. It's because of this that I would highly recommend any budding psychonaut to consider either revisiting this compound or giving it an honest try if they have yet to do so.

Commentary by Josie Kins


References

  1. Woodworth, J. R., Dennis, S. R. K., Moore, L., & Rotenberg, K. S. (1987). The polymorphic metabolism of dextromethorphan. The Journal of Clinical Pharmacology, 27(2), 139-143. | https://accp1.onlinelibrary.wiley.com/doi/abs/10.1002/j.1552-4604.1987.tb02174.x
  2. Capon, D. A., Bochner, F., Kerry, N., Mikus, G., Danz, C., & Somogyi, A. A. (1996). The influence of CYP2D6 polymorphism and quinidine on the disposition and antitussive effect of dextromethorphan in humans. Clinical Pharmacology & Therapeutics, 60(3), 295-307. | https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1016/S0009-9236%2896%2990056-9

Tags

DXM
Dissociative
Morphinan

Contributors

The following people contributed to the content of this article:

JosieEnki