Dextromethorphan (DXM) in the States

Background

Dextromethorphan (DXM) is a common cough suppressant found in many over-the-counter cold and cough medicines in the U.S. Therapeutically, it serves as an effective antitussive active ingredient providing relief from disruptive unproductive coughs via a mechanism distinct from opioids, allowing both children and adults 12 years and older immediate access without a prescription per federal FDA rules.

The Issue

DXM preparations have faced sporadic issues of misuse by minors seeking to exploit extreme dissociative effects from intentionally exceeding recommended therapeutic doses. In light of valid concerns to protect adolescents from harming themselves via reckless consumption encouraged on social media, many states have passed age restrictions requiring purchasers to be 18 or older while retaining OTC availability for the intended adult population who rely on approved products for their intended purpose. This social responsibility approach honors federal guidance allowing this useful ingredient for those who use DXM preparations responsibly while giving individual states recourse to curb localized purchase abuse trends. Reasonable age controls deter underage availability without limiting adult access to legitimate therapies containing regulated levels of DXM as an appropriate cough aid.

CHPA’s Position

Dextromethorphan serves as a safe, effective antitussive ingredient in many critical over-the-counter cough and cold formulations relied upon by millions of responsible adults. While reasonable state-level age restrictions of 18+ may curb adolescent misuse without limiting adult access, lawmakers should refrain from unnecessary additional barriers that deputize pharmacists or risk depriving populations who legitimately use approved preparations as directed for cough relief. Targeted age controls strike the right balance between safety and availability.

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