This is a very brief FAQ dealing with DXM. Others have already covered this topic with much greater breadth and depth. For more information, read William White’s FAQ (hosted by Erowid) or visit one of the links found at the end of this FAQ.

What is DXM?
DXM is dextromethorphan. It is commonly found in OTC cough suppressants and sometimes put in bunk pills.

What is DXM’s legal status
Australia – Uncontrolled
Canada – Uncontrolled
UK – Controlled, prescription only
US – Uncontrolled

What is DXM’s recreational value?
DXM can produce a disconnected, dreamlike trip. DXM is a dissociative, creating a sensation of separation from the body. It can also cause visual and auditory hallucinations, an elevated mood and an increased sensitivity to stimuli. For a more detailed description of the effects, see the DXM Mega-FAQ (link at the top).

The effects of DXM are made more attractive to some people because in most countries, DXM is legal and can be bought over-the-counter.

Why are the dangerous effects of DXM?
Dangerous side effects include loss of motor control, hyperthermia, nausea, psychosis, and (sometimes) death.

Bear in mind that what some perceive to be positive effects (disconnected feeling, loss of motor control, visuals, etc) may be very unpleasant if you are not expecting them (as would be the case with a bunk pill).

Erowid notes that there are only a handful of known deaths that occurred as a result of DXM alone; and that several more deaths (no exact figure is given) have resulted from the use of DXM in combination. This site puts the number of deaths at 5-15.

THIS DOES NOT MEAN DXM IS SAFE!

What else should I know before consuming DXM?
This section will not go into great detail, but will just touch on some dangerous possibilities and interactions. For more information, see the Mega-FAQ or other DXM-related links.

• DXM is often included in cough syrups that contain other active ingredients. In order to get an active dose of DXM, one usually needs to consume a lot of cough syrup. In consuming the requisite dose, it is entirely possibly to consume a dangerously high dose of another ingredient.
• DXM may inundate the enzyme (P450) that metabolises many non-drowsy antihistamines. When taken in combination, this interaction can cause heart problems.
• The combination of DXM with MAOIs, SSRIs, MDMA, or other serotonin agents may cause serotonin syndrome.

Why is DXM sold as MDMA?
DXM is sometimes sold as MDMA for several reasons:

• DXM is legal, inexpensive, and widely available. In most countries, DXM is available over the counter. The methods used to extract DXM from a source are not nearly as difficult or dangerous as the methods used to produce MDMA. Moreover, MDMA manufacture/possession is entirely illegal, and many of its precursors are very difficult to obtain.
• At low doses, DXM can cause effects that a n00b may deem to be Ecstasy-like, resulting in them believing that they bought a good pill. In particular, the increased sensitivity to touch, etc. and mild visual hallucinations may cause a user to believe that they bought a good pill, and perhaps take more pills in order to boost the effects. This may lead to a very unpleasant experience, as a higher-dose DXM trip does not resemble the effects of MDMA.
• DXM produces a reaction to the Marquis reagent that may be confused with an MD__ reaction. MDMA will cause the reagent to quickly go to purple/black, and DXM will first smoke a bit, then slowly go to grey/black. Not only is the end colour very similar, but test samples have been know to smoke a bit if the sample has a very high MDMA content. If the test is performed in poor or erratic lighting conditions (as may be the case at a party), the reactions are even easier to confuse.

From the perspective of a scamming manufacturer, DXM is basically the ultimate substitute for MDMA. It is a substance that allows them to have maximum deception and reward with relatively minimal risk.

How do various reagents react to DXM?
Marquis – Smoke to dark grey/black, generally slower than an MDMA reaction (takes 5-10 seconds)
Mecke – Yellow
Mandelin – No reaction

DXM-related websites
The DXM Mega-FAQ
Lycaeum’s DXM page
INCHEM DXM page
Erowid’s DXM Vault
London Toxicology Group’s DXM page
The DXM Harm Reduction Project
The Dextroverse