An autopsy case of a young man with a single overdose of dextromethorphan.

A man in his early twenties was found dead at home with no external injuries or obvious internal lesions. Toxicological analyses revealed extremely high concentrations of dextromethorphan (DXM), an over-the-counter antitussive, and no other drugs were detected. This appears to be the first reported death caused by a single overdose of DXM in Japan. While DXM is commonly used worldwide and has become popular among young people for its euphoric, hallucinogenic, and dissociative effects, fatal cases of DXM poisoning are rare and usually involve multidrug ingestion. The authors argue that public awareness should be increased about the risks of massive DXM ingestion.

Study at a glance

Abstract

Dextromethorphan (DXM) is an over-the-counter antitussive that is commonly used worldwide. Recently, DXM has become popular among young individuals because of its euphoric, hallucinogenic, and dissociative properties. Despite an increasing number of patients with DXM addiction, fatal cases of DXM poisoning are rare, and patients with fatalities often ingest DXM along with other drugs. Here, we report an autopsy case in which DXM was detected without multidrug ingestion. A man in his early twenties was found dead at home; no external injuries or obvious internal lesions were found during the autopsy. The toxicological analyses revealed extremely high concentrations of DXM, and no drugs other than DXM were detected. To the best of our knowledge, this is the first case report to describe a death caused by a single overdose of DXM in Japan. Public awareness regarding the risks associated with a massive ingestion of DXM should be increased.