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ABSTRACT: Dextromethorphan (DXM), a nonprescription psychoactive drug that may lead to spiritual or transpersonal altered states of consciousness, has legitimate therapeutic applications that are being investigated by clinical researchers. It is easily available in over-the-counter cough medicines, and due to its psychoactive properties, DXM is an increasingly popular drug of abuse. Nonmedical use of DXM can lead to dependence and death. Clinical research related to nonmedical DXM use is limited, but many theories and experience reports have been published on the Internet. Nonmedical DXM users may consist of two types: those who seek recreation and those who want to explore their mind (psychonauts). Given the potential importance of DXMfacilitated transpersonal experiences, this article suggests research be conducted on the chemical. The experiences of others must be taken into account before any adequate theory of DXM can be formulated.
Dextromethorphan (DXM) was introduced over-the-counter (OTC) in 1958 (American Medical Association, 1988) as a nonprescription antitussive (cough suppressant). DXM is an opioid, "the D-isomer of levorphanol, a semisynthetic morphine derivative" (McFee, Mofenson, & Caraccio, 2000, p. 123). Several fields of medicine have used DXM therapeutically, which is a relatively safe drug when used for medical purposes (Bem & Peck, 1992; Steinberg, Bell, & Yenari, 1996). DXM is primarily of clinical and research interest because of its neuropharmacological properties. DXM binds to four distinct neuron receptor sites; these are most likely the sigma1, PCP2, sigma2, and NMDA receptor sites (Zhou & Musacchio, 1991). DXM also indirectly inhibits the reuptake of serotonin (International Programme on Chemical Safety [IPCS], 1996). Although DXM was derived from the opiate levorphanol, it does not bind to any of the opiate receptors.
When individuals ingest doses five or more times the recommended dose, DXM becomes psychoactive and has been classified as a dissociative drug (National Institute on Drug Abuse [NIDA], 2001) and a club drug (Parks & Kennedy, 2004). Occasional clinical case reports appear of individuals ending up in the hospital related to negative side effects of their substance use. DXM, however, does not produce withdrawal symptoms characteristic of physically addictive substances, although tolerance does occur (Wolfe & Caravati, 1995).
Existent evidence from outside clinical settings suggests the chemical dextromethorphan (DXM) can facilitate transpersonal experiences. Researcher Stan Grof (1988) defined a transpersonal...