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Related Experiment Video

Updated: Jun 9, 2026

Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder

Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder

Published on: June 23, 2023

Dextromethorphan withdrawal and dependence syndrome.

Jochen Mutschler¹, Anne Koopmann, Martin Grosshans

¹Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Universität Heidelberg. jochen.mutschler@puk.zh.ch

Deutsches Arzteblatt International

|August 26, 2010

Summary

Dextromethorphan, an over-the-counter cough medicine, is increasingly abused as a psychoactive drug. This case highlights its potential for dependence and withdrawal, suggesting a need for reclassification.

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Area of Science:

Pharmacology
Addiction Medicine
Psychiatry

Background:

Dextromethorphan (DXM), an NMDA antagonist, has been available OTC as an antitussive since 1954.
Reports indicate a rise in DXM abuse, particularly among young individuals seeking psychoactive effects.
Limited data exist on the extent of DXM abuse and its implications for addiction medicine in Germany.

Observation:

A 44-year-old man developed dependence on DXM over six years of non-prescription abuse.
Daily intake reached 1800 mg, leading to neglect of personal and professional life.
Hospital admission revealed DXM in urine, followed by a vegetative withdrawal syndrome during detoxification.

Findings:

Dextromethorphan abuse can lead to significant psychological dependence and physical withdrawal symptoms.
High-dose DXM use results in severe functional impairment.
Withdrawal symptoms included craving, diaphoresis, nausea, hypertension, and tachycardia.

Implications:

Dextromethorphan possesses abuse potential and can cause dependence.
Reclassifying dextromethorphan as a prescription-only medication should be considered.
Further research is needed to understand the full scope of DXM abuse in Germany.