Dextromethorphan: Treatment and rehabilitation
While there is a general belief that dextromethorphan is not addictive, there is an increasing amount of information that suggests otherwise. The fact that many abusers repeatedly abuse the drug makes it a strong possibility that dextromethorphan is an addictive drug.
Conventional treatment programs can help those who abuse dextromethorphan, but they must become informed about the specific features of the drug. These programs must also test for the drug using a less familiar test.
There are two types of dependence when addictive drugs are used for a significant period of time. Physical dependence is when the body becomes physiologically adapted to having the drugs in the body; it is not the same as being addicted. Physical dependence does not usually develop to a clinically obvious degree until after the drug has been used for several weeks. Physical dependence occurs when withdrawal symptoms develop after the drug is no longer being used. There is no known withdrawal syndrome associated with the cessation of dextromethorphan use. It is unlikely that dextromethorphan causes physical dependence.
Psychological dependence is synonymous with addiction. Persons with a psychological dependence on a drug generally have a history of compulsive behaviors and a propensity to become involved with drugs for nonmedical reasons. Addiction may or may not occur with physical dependence or tolerance. Patients with legitimate medical needs for a drug usually do not become addicted and can receive increased doses over time without becoming addicted. Of the two types of dependence, dextromethorphan is more likely to cause some type of psychological dependence. However, there is no scientific confirmation of this yet.
The general treatment program for dextromethorphan abuse and potential dependence should be similar to other drug treatment regimens. The patient should receive extensive counseling, education, and monitoring to end the cycle of abuse and dependence. However, dextromethorphan use probably does not need to be gradually tapered down to prevent or reduce withdrawal symptoms as there is no current evidence that dextromethorphan is physically addictive. Dextromethorphan urinalysis testing requires a special test that is typically not used for other types of abused substances.
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