Of all the drugs on our chart, dextromethorphan (DXM) is different: You can get it over the counter.

A common ingredient in cough and cold medicines, dextromethorphan abuse can produce psychoactive effects when taken in high doses. Known as robotripping, skittling, or dexing, DXM abuse is relatively uncommon … and unsafe.

What is Dextromethorphan (DXM)?

DXM medications are often combined with acetaminophen, which in high doses damages the liver. Some people can’t process DXM, leading to severe side effects. Plus, DXM has nasty interactions with a wide variety of medications, particularly antidepressants. And since high amounts can slow breathing, you can overdose on it as well.

Drug abuse describes behaviors, not substances, and a drug doesn’t have to be a narcotic to be abused. Detoxing from DXM is best done in a safe, monitored environment.