The Dangers of Mixing Dextromethorphan and Alcohol

Key Takeaways

• Dextromethorphan (DXM) is an over-the-counter cough suppressant with the potential for abuse and psychoactive effects at high doses.
• Alcohol affects the central nervous system and can lead to chronic diseases and other serious health issues.
• Mixing DXM with alcohol can lead to heightened side effects, respiratory depression, and an increased risk of overdose.
• Medical professionals advise against combining DXM with alcohol due to the risk of serious health consequences.
• Prevention of negative effects from DXM and alcohol interaction includes education, careful medication management, and seeking professional treatment when necessary.

Dextromethorphan, commonly called DXM, is an over-the-counter medication widely recognized for its cough-suppressant properties. It is found in numerous cold and flu remedies, often under brand names like Robitussin, and is designed to alleviate coughing associated with common illnesses.

Dextromethorphan is largely considered safe for most healthy adults when used as indicated. However, when combined with alcohol, dextromethorphan can be dangerous and cause potentially fatal complications. 

We’ll explain everything you need to know about dextromethorphan and alcohol below. 

What Kind of Drug Is Dextromethorphan?

Dextromethorphan is used to relieve coughing caused by colds or other respiratory conditions. It comes in several forms, including syrups, tablets, capsules, lozenges, and powder. It is often combined with other ingredients such as antihistamines, decongestants, or pain relievers in multi-symptom cold and flu medications.

DXM works by affecting the brain’s cough center in the medulla, which is responsible for triggering the cough reflex. By altering the signals sent to this area, DXM reduces the urge to cough. At higher doses, DXM acts on the NMDA (N-methyl-D-aspartate) receptors in the brain. This interaction can lead to dissociative and psychoactive effects, including altered perceptions and hallucinations. 

However, these effects are generally not seen at standard therapeutic doses.

At recommended doses, common side effects of DXM may include:

• Drowsiness: DXM can cause sedation or excessive drowsiness.
• Dizziness: Some users may experience lightheadedness or dizziness.
• Nausea and Vomiting: Gastrointestinal discomfort, including nausea or vomiting, can occur.
• Constipation: DXM can slow down bowel movements, leading to constipation.
• Dry Mouth: A dry, uncomfortable feeling in the mouth may develop.
• Stomach Upset: Some people report stomach discomfort or cramping.

• Headache: Mild to moderate headaches can occur.
• Blurred Vision: Some users might experience visual disturbances or blurred vision.
• Confusion: In some cases, especially at higher doses, confusion or disorientation may occur.
• Mood Changes: Changes in mood, including irritability or mood swings, can be experienced.

• Hallucinations: At high doses, DXM can cause hallucinations and altered perceptions of reality.
• Dissociation: High doses can lead to a dissociative state where users feel detached from their body or surroundings.
• Respiratory Depression: In very high doses, DXM may cause slowed or difficult breathing, though this is rare.
• Seizures: Overdose or high doses of DXM can potentially lead to seizures.
• Allergic Reactions: Rare but serious allergic reactions, such as rash, itching, or swelling, may occur. Severe reactions require immediate medical attention.

It is also important to recognize that DXM presents some abuse risks. At high doses, DXM can produce effects such as euphoria, hallucinations, and a dissociative state. This has led to its misuse, especially among adolescents and young adults seeking recreational effects.

Overuse or abuse of DXM can result in serious side effects, including severe agitation, hallucinations, impaired motor function, and potentially dangerous conditions like seizures or respiratory depression.

What Kind of Drug Is Alcohol?

Alcohol is classified as a central nervous system (CNS) depressant. As a CNS depressant, alcohol slows down the activity of the brain and nervous system. This leads to various effects, including relaxation, drowsiness, and impaired cognitive and motor functions.

Alcohol enhances the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity. This leads to calming effects, reduced anxiety, and impaired coordination.

It also inhibits the effects of glutamate, an excitatory neurotransmitter. This reduction in excitatory signaling contributes to the depressant effects, including impaired cognitive and motor functions.

Finally, alcohol also increases the release of dopamine, a neurotransmitter associated with pleasure and reward. This can create feelings of euphoria and relaxation.

Alcohol can trigger a number of side effects and health problems, including:

• Relaxation and Euphoria: Initially, alcohol can induce feelings of relaxation and euphoria.
• Lowered Inhibitions: It can lead to increased sociability and lowered self-control.
• Impaired Judgment: Alcohol affects decision-making and can lead to risky behaviors.
• Coordination and Motor Function Impairment: Impairment in coordination and motor skills can lead to accidents and injuries.
• Slurred Speech: A common effect of alcohol consumption, particularly at higher doses.
• Nausea and Vomiting: Gastrointestinal upset can occur, especially with excessive drinking.
• Drowsiness: Alcohol can cause drowsiness or fatigue.
• Dehydration: Alcohol acts as a diuretic, leading to increased urination and potential dehydration.
• Liver Disease: Chronic alcohol use can lead to liver conditions such as fatty liver, alcoholic hepatitis, and cirrhosis.
• Cardiovascular Problems: Long-term use is associated with hypertension, arrhythmias, cardiomyopathy, and increased risk of stroke.
• Gastrointestinal Issues: Chronic use can lead to conditions such as gastritis, ulcers, and pancreatitis.
• Neurological Damage: Long-term alcohol use can cause peripheral neuropathy, cognitive decline, and memory problems.
• Depression and Anxiety: Long-term alcohol use is associated with an increased risk of mood disorders, including depression and anxiety.
• Cognitive Impairment: Prolonged use can affect cognitive functions such as attention, memory, and executive functioning.

It’s important to understand that alcohol may also interact with other drugs. 

For example, when combined with other CNS depressants (such as benzodiazepines, opioids, or sedatives), alcohol can have synergistic effects, increasing the risk of severe respiratory depression, overdose, and other life-threatening complications.

The Hazards of Mixing Dextromethorphan with Alcohol

While typically safe on its own (when taken as indicated), DXM can interact with other drugs and medications, such as alcohol. 

In fact, mixing DXM with alcohol can lead to serious health risks due to the synergistic depressant effects both drugs will have on the central nervous system. When these substances are mixed, individuals may experience heightened side effects such as dizziness, drowsiness, and impaired judgment.  

Acute risks associated with this combination include respiratory depression, which can manifest as irregular, slowed, or stopped breathing, and dissociative states, such as feeling out of the body. These effects can induce panic and lead to dangerous behaviors. 

In extreme cases, the synergy between DXM and alcohol can result in brain lesions, memory loss, cognitive impairment, emotional and behavioral changes, seizures, and even epilepsy. The risk of respiratory suppression can escalate to unconsciousness, coma, and potentially fatal outcomes.

Both DXM and alcohol also act as central nervous system depressants. Their combined use can significantly slow brain activity and reduce the function of vital organs, leading to a potentially lethal decrease in heart rate and suppressed breathing. The additive effect of mixing these substances is particularly hazardous, with the potential to lead to coma or death.

It is critical for individuals to understand the severe risks of mixing dextromethorphan with alcohol and to avoid the combination to prevent life-threatening consequences.

Strategies for Preventing and Treating Dextromethorphan and Alcohol Interaction

Interactions between dextromethorphan, a common cough suppressant, and alcohol can lead to serious side effects, including dizziness, drowsiness, impaired thinking, and even more severe consequences like respiratory depression and cognitive impairment. 

Preventing these negative effects starts with education and awareness. It is crucial for individuals to understand the risks associated with mixing these substances and to adhere to medical guidance regarding the use of dextromethorphan-containing products.

Prevention strategies include:

• Avoiding the consumption of alcohol while taking dextromethorphan.
• Reading medication labels carefully to identify dextromethorphan as an active ingredient.
• Consulting with healthcare providers before taking new medications.

The treatment of adverse effects resulting from the combination of dextromethorphan and alcohol typically involves supportive care. This may include:

• Monitoring and supporting respiratory function.
• Managing symptoms of dissociation and panic.
• Addressing any cognitive or behavioral changes.

In cases of suspected overdose or poisoning, immediate medical attention is required. The management may involve aggressive monitoring and intervention to stabilize the patient’s condition. For those struggling with misuse or addiction, seeking professional treatment from facilities like The Recovery Village can provide the necessary support for recovery.

Ultimately, the best approach is to avoid mixing dextromethorphan with alcohol altogether and to seek medical advice promptly if negative interactions are suspected.

Help Is Available for Those with Alcohol Addiction or Mental Health Struggles

For those seeking addiction or mental health treatment, The Recovery Village Indianapolis Drug and Alcohol Rehab stands as a beacon of hope. Located within the heart of Indy, we offer an array of treatment options, including medical detox and inpatient rehab for substance abuse and a residential rehab program for mental health disorders.

When you or a loved one are ready to embark on the path to recovery, our Recovery Advocates are here, ready to assist. Reach out to learn more about our tailored treatment programs, designed to cater to your specific needs and situation.