Right now, DXM is legal for over-the-counter use in most places. This seems to be for two reasons primarily. First, there is no substitute for DXM that does not also have abuse potential. Nor is there likely to ever be one; everywhere the cough reflex can be blocked involves some type of receptor associated with recreational drug effects. Second, pharmaceutical companies don’t want to lose a major chunk of their income. DXM works as a cough suppressant, and it works well. Besides, nobody wants to have to go to the doctor to get a prescription every time they get a cold. However, it is possible that DXM-only preparations might disappear from the market. This would be unfortunate, both for recreational users and for the general public; the most likely additive - guaifenesin - makes some people
vomit even at low doses. Another possibility would be the addition of
something which would be harmless at regular doses but induce nausea (or other unpleasant effects) at recreational doses.
The best answer is probably prevention, which unfortunately involves two conflicting goals. On the one hand, it is essential that DXM related deaths do not occur - this was my primary motivation in making this FAQ in the first place. Several DXM cough medicines can be dangerous if consumed recreationally, due to the presence of other ingredients. There is also the problem of drug interactions, e.g., DXM + SeldaneTM, which can be fatal. On the other hand, the spread of information to keep people from hurting themselves is also likely to inform people who didn’t know about DXM, and will want to try it. DXM is still an unknown to many people (although not as big an unknown as most think - pockets of recreational DXM use have
existed as long as DXM has). I’ve come to the conclusion that I’d rather have a bunch of people doing it safely than a few doing it dangerously but then again, I’m also in favor of sex education.
Thus, I encourage anyone who may want to try DXM or tell her or his friends to try it (which I again explicitly tell you not to do) to make sure and emphasize all the risks and dangers involved. Don’t rush into high dosages. Don’t trip alone, or without a designated sober person. Don’t encourage people who are not psychologically mature to experiment with DXM. And please use common sense and be safe.
In the event that DXM-only preparations do get pulled, the best answer is probably to have an isolation method that will separate the DXM from other ingredients. In my opinion, the most likely additive is guaifenesin (although people were using Robitussin DMTM long ago, and just toughing out the inevitable extreme nausea). I’ve been working on a way to separate the DXM from guaifenesin, using commonly available substances, and producing a pure, safe product. We don’t want another “cat” (methcathinone) media-scare on our hands. Currently I offer a method for evaluation only; this method
is not proven. I’m posting it with the FAQ so that other people can give it their consideration. In conclusion I’d like to remind everyone that we may be walking on thin ice here. I’ve tried my absolute hardest to make this FAQ as accurate and scholarly as possible, so that if anyone who matters ever does get a look at it, they’ll get bored somewhere around the explanation of P450-2D6 polymorphism. Still, please use common sense.
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