Dextromethorphan, or DXM, a common active ingredient found in many over-the-counter cough suppressant cold medicines, is used as a recreational drug and entheogen for its dissociative effects. It has almost no psychoactive effects at medically recommended doses. Dextromethorphan has powerful dissociative properties when administered in doses well above those considered therapeutic for cough suppression. Recreational use of DXM is sometimes referred to in slang form as “robo-tripping,” whose prefix derives from the Robitussin brand name, or Triple Cs, which derives from the Coricidin brand. (The pills were printed with “CCC” for “Coricidin Cough and Cold.”) However, this brand presents a danger when used at recreational doses due to the presence of chlorpheniramine.

In over-the-counter formulations, DXM is often combined with acetaminophen (paracetamol, APAP) to relieve pain and to prevent recreational use; however, to achieve DXM’s dissociative effects, the maximum daily therapeutic dose of 4000 mg of APAP is often exceeded, potentially causing acute or chronic liver failure, making abuse and subsequent tolerance of products which contain both DXM and APAP potentially fatal.

An online essay first published in 1995 entitled “The DXM FAQ” described dextromethorphan’s potential for recreational use, and classified its effects into plateaus.

Owing to its recreational use and theft concerns,[citation needed] many retailers in the US have moved dextromethorphan-containing products behind the counter so that one must ask a pharmacist to receive them or be 18 years (19 in New York, California, and Alabama, 21 in Mississippi) or older to purchase them.[citation needed] Some retailers also give out printed recommendations about the potential for abuse with the purchase of products containing dextromethorphan.

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