The Dextromethorphan FAQ (Psychological Effects) ================================================ Psychological Effects of DXM Use This section discusses some of the effects you might expect to feel if you were to use DXM (which I again do not recommend). This is a difficult question to answer, because DXM's effects tend to vary widely depending on the person, their set and setting, other drugs, their physiology, and so on. DXM, probably more than most drugs, tends to exert its (recreational) effects on plateaus, rather than being linearly dose-dependent. Within a given plateau, a given set of effects will occur (at a roughly dose-dependent strength). On the other hand, once the next plateau is reached, the feel may change entirely. A reasonable analogy is water -- it exists in three states (solid, liquid, and gas) which all can exist at varying temperatures, but which have different characteristics. One important phenomenon reported to me -- DXM taken in divided doses seems to be much less potent than when taken in a single dose. In fact, the strength of a given DXM dose seems to drop dramatically with the amount of time it takes for it all to be absorbed. I have absolutely no idea why. Interestingly, this seems to involve only some of the psychological effects (usually the more interesting ones). As to how many plateaus DXM exhibits, this is debatable. I previously listed three; however, some daring (or foolish) individuals have pushed into a qualitatively different level which I call the fourth plateau. Some people will undoubtedly disagree with this classification method, but I think this is the best way to represent DXM's effects. Note that both the third and fourth plateaus have significant dissociative characteristics. Keep in mind that the effects in different plateaus can be very different. For example, on the first plateau, DXM tends to have a stimulant effect, often quite potent. Upon reaching the second plateau, however, the stimulant effect is no longer present. The end of a DXM trip can come abruptly. Often, the user will just know when it's starting to end, often by noticing the return of normal sensory processing. Coming down from there may take a significant amount of time. As a general guideline, 1.5mg/kg to 2.5mg/kg is first plateau, 2.5mg/kg to 7.5mg/kg is second plateau, 7.5mg/kg to 15mg/kg is third plateau, and above 15mg/kg is the fourth plateau. This will vary considerably from person to person, by as much as 5 times! Also, these mg/kg figures should evidently be adjusted down for higher mass (e.g., maybe 6mg/kg to 13mg/kg third plateau for a 150kg adult). Note that kg = pounds * 0.45. The specific effects at each plateau will be listed according to the following categories: Sensory, Motor, Cognitive, Memory, and Emotion. What are the effects of a first plateau dose? ============================================= The first plateau generally occurs around 1.5 to 2.5 mg/kg, but this may vary enormously depending on weight, metabolism, etc. Please keep in mind that these are general effects, and that individual results may vary considerably. A first plateau trip usually takes between 20 and 40 minutes to start (on an empty stomach), peaks about 1.5 to 2 hours later, and lasts between 4 and 6 hours. Hangovers are very rare from this plateau, but if they do occur, they tend to consist mainly of lethargy. The primary effects of the first plateau are general euphoria, euphoria specifically linked to music and motion, slight disturbances in balance, moderate stimulation, and very slight intoxication. The intoxication and balance disturbances are similar to that induced by alcohol, but much weaker and without the mental confusion. It is interesting to note that there is little if any mental sluggishness or confusion with a first plateau trip. SENSORY EFFECTS Most of the effects of the first plateau relate to the senses. The best known, and probably the most responsible for DXM's popularity as a recreational drug, is the effect upon hearing (specifically upon music). Sounds may seem richer or deeper, and music in particular is affected (the difference between listening to music on DXM versus sober has been compared to the difference between music in a concert hall versus on a cheap radio). In addition to the change in the nature of hearing itself, music can bring a sense of euphoria, often quite intense. In comparison to the positive effects on music reported by some users of cannabis, the DXM music effect is usually characterized as much speedier. The type of music with which this effect most strongly occurs will tend to vary from person to person. Rave music is one of the most commonly affected, possibly due to the regular beat (at higher plateaus especially, much of DXM's sensory effects seem beat or rhythm related). Classical and Celtic/folk also seems to be popular. Really, though, the strongest indicator of personal response to a given piece of music seems to be 1) that the user enjoys it, and 2) that it has an intense or thematic quality. Visual effects are not particularly profound at this plateau. If present, they usually consist of motion trails (as if afterimages of each frame of vision were not clearing quickly enough). There may be some deterioration of stereoscopic vision (and thus depth perception). Colors may seem slightly more vivid. Taste, smell, and touch do not seem to be appreciably affected, although some users have reported that taste and smell are enhanced and mildly euphoria-linked. Others have reported the same effect for touch. Balance and body position sense can be significantly affected, ranging from a mild disturbance (some call it sea legs) to a near total loss of position and balance sense (generally this only happens on upper plateaus). The changes seem to relate to an anaesthesia of this sense in particular. The effect (like the other sensory DXM effects) can be euphoric; some users like to roll around, do cartwheels, dance, march, whatever. Interestingly, I have not heard any reports of motion sickness (as might be expected if balance sense were blocked). MOTOR EFFECTS The other main characteristic of a first plateau DXM trip is its effect upon motion and motor skills. Users tend to walk and move in specific ways (varying somewhat from person to person) characterized by large, fluid movements. In fact, it may be difficult to perform small or abrupt motion. Motor tasks initiated may continue beyond their targets (this can range from fun to distracting). To an outside observer, this can seem quite strange, especially the changes in gait. It is possible, however, to move normally. These changes may be related to euphoria linking of body kinetic sense (see Sensory Effects, above) which would make large and sweeping motions more enjoyable. It is also possible that something more directly involved in the planning and carrying out of complex motor tasks may be at work. COGNITIVE EFFECTS Even though DXM has a slight stoning or intoxicating effect on the first plateau, there are surprisingly few deficits of cognitive function. Language is the most strongly affected, although these effects are usually limited to occasional word and syllable repetition (especially in already-repeated syllables such as banana), spoonerism (e.g., share boulders; instead of bare shoulders;), and difficulty coming up with a specific word. Some users report that they feel more creative and capable of non-linear thought on DXM, and this seems to be maximized on the first and second plateaus. Whether this is, in fact, true, or just seems true because of the drug, I have no idea; to my knowledge there are no studies on this. Another cognitive characteristic that occasionally occurs at the first plateau (but more commonly at the second) is that things can seem much more interesting, or at least much less dull and boring, than they usually are. There may be an overall increase in approach-related behaviour. Many DXM users report a moderate to strong stimulant effect at the first plateau, which disappears at higher dosages. This seems to be enhanced by caffeine. One user reported being able to stay up for 48 hours by maintaining a moderate first plateau level. (Note that I don't recommend this). MEMORY EFFECTS The memory effects of a first plateau trip are slight but usually noticeable. Most of the effects probably come from a general deterioration of short-term memory. Working memory (the train of thought) can become stuck in repetitive thoughts; other times it can be very easy to become distracted. Recall of events prior to the trip does not seem to be degraded. Encoding (i.e., making new memories) may be worsened, so that after the trip there is some difficulty in recalling events during the trip. Also probably because of the deterioration of short-term memory, it may be easy to lose track of time. EMOTIONAL EFFECTS Mood enhancement is the most regular effect of the first plateau; many people find themselves fairly bouncy and happy. Unlike many drugs, there is not usually much let-down when the trip ends. Fear is rare at the first plateau. There may be a sense of energy or drive. The effects upon libido evidently tend to vary from person to person. Some people report an increase in sex drive; others find that playing, physical contact, music, etc., seem much more interesting and enjoyable than sex. The effects on sexual performance itself are not very strong at the first plateau, though males may have some difficulty in achieving orgasm. What are the effects of a second plateau dose? ============================================== With the second plateau (around 2.5-7.5mg/kg), several new effects become evident. The most profound is that DXM begins to take on a heavier stoning characteristic, and senses and cognitive function are affected accordingly. Hallucinations start for some people on the second plateau. Some of the first plateau effects, e.g., the music and motion linked euphoria, may diminish or stop entirely. SENSORY EFFECTS The most general sensory effect of the second plateau is phlanging. Phlanging, also called flanging, phasing, stop-action, framing, etc., is the sensation that continuous sensory input has been chopped up into frames (as if you were watching a badly animated cartoon), often with some echo effect of each frame. There does not seem to be any loss of sensory content; instead, it is as if the ability to keep sensory input time-continuous were disturbed. The best analogy from other drugs may be the effects of nitrous oxide upon sound. The best analogy from non-drug experiences is listening to a voice through an echo/delay line (which is where the term phlanging comes from). An interesting and probably associated sensory phenomenon is that it seems as if one is aware of several temporal stages of sensory processing all at once. In other words, a sentence may be heard not sound for sound or word for word, but all at once (this is difficult to describe). Similarly, visual images may be jumbled together with previous images. This may be due to an excessive persistence of sensory buffering. Vision in particular is changed on this plateau. Depth perception is often lost, and the ability to keep both eyes focussed on the same thing is diminished (leading to slight double vision). This is most noticeable in people without a dominant eye. Sound, as already mentioned, tends to be phlanged. With the sense of touch, there is not necessarily phlanging so much as a noticeable delay between the stimulus and recognition of it. Pain especially tends to be somewhat dissociated. Taste and smell are simply dulled. The sense of balance is severely disrupted, as is body position and kinetic sense. Note that the dissociation of pain and the disruption of body sense together make physical exertion somewhat risky, as it is possible to over-exert and not notice. Hallucinations tend to begin at the second plateau (and in fact are the reason I distinguish this from the first plateau). Usually these are not true hallucinations, but instead are considerable enhancement of imagination, up to fully eidetic imagery (i.e., you experience lucidly what you imagine). This is especially powerful with memories; some users are able to re-experience past events, or simulate future events, as if actually there, interacting with the environment (I call this the Holodeck effect). Many users report this to be quite useful for introspection. Actual hallucinations, if they do exist, tend to be abstract and cartoon-like. There seems to be an emphasis on linear structures -- long, thin lines, or long queues of simple objects. There may also be Lilliputian hallucinations (everything seems either way too big or way too small, or both). Some people find considerable similarity with fever hallucinations. Note that this can be unpleasant to some people. Note that your experiences throughout the day will influence the hallucinations you see and the imagery you can create. For example, if you have spent the day playing DOOM, your hallucinations are likely to involve scenes and elements from the game. Eidetic imagery works a little different -- you can conjure up images, but they are likely to have a DOOM-esque; feel to them (bitmapped textures, ugly walls, etc). This is an interesting effect which was just recently reported to me, and my hunch is that DXM hallucinations and imagery may be very dependent upon what's already stored via LTP (likely in the hippocampus) at the time -- in other words, short term memory. So it might be worth planning the events of the day with your trip objectives in mind. This may also be possible to some extent during the trip itself; e.g., if you want to imagine yourself in space, go to a planetarium. MOTOR EFFECTS The first-plateau effects on motor skills continue to exist, and may be considerably stronger. Some users find themselves contorting their limbs into rigid positions, others may extend and stretch themselves. These effects are not always immediately apparent; when they are, the user usually reports that it just feels right to be in that position. It is still possible to override this. Another accentuation of first-plateau motion effects that sometimes occurs is that the large, sweeping motions, once initiated, may continue for considerable time (looking somewhat like a cross between modern dance and Huntington's disease). Again, it just feels right to do. COGNITIVE EFFECTS Higher reason is still not appreciably affected at the second plateau; in fact one of the more interesting aspects of DXM at the first and second plateau may be its ability to disturb one aspect of the mind while leaving another almost untouched. One interesting cognitive effect that is pronounced at the upper second through the third plateau is a change in self-referential thinking. Self-referencial thoughts or ideas (e.g., this statement is false) may seem much more easily understandable, both in the abstract and on a gut level. Thoughts can, in fact, get quite abstract, sometimes to the point of seeming meaningless to other observers. Language becomes difficult, partly due to cognitive changes (as in the first plateau) and partly due to difficulty in coordinating the mouth and tongue motions. Similarly, interpreting spoken language is difficult due to sensory phlanging. However, thinking in language is still fairly easy. MEMORY EFFECTS Short-term memory and working memory may be severely disturbed, although experience with DXM seems to help people compensate. Possibly because of the changes in memory, it may be very difficult to get bored, even with repetitive tasks. At this plateau, a lot of time may get lost, and the more mundane aspects of the trip are easily forgotten after it is over. EMOTIONAL EFFECTS The other primary characteristic of the second plateau (hallucination being the first) is probably the motivational aspects. Repetitive, mundane, boring tasks suddenly become doable, and (if one can avoid distraction) may be easily accomplished, even if they take hours. There is often a fairly considerable stimulant effect at the second plateau. The euphoria from the first plateau continues, although it may diminish as dosage across the second plateau increases. What are the effects of a third plateau dose? ============================================= At the transition between the second and third plateau, (roughly 7.5 to 15mg/kg), several unrelated effects may occur. These probably belong more to the transitional stage than to a given plateau, and will be dealt with here. The first is a sensation that has been described as the opening of nasal passages, being full of helium, losing one's body, or having one's heart stop beating. The actual effect is most likely a sudden cutoff of sensory input from within the body -- everything from all the little aches and pains to the awareness of one's own heartbeat go away. This can be very disturbing if a naive user interprets it as heart failure! The second transitional effect is a temporary loss of all sensory input (this does not always occur), as if one were in an isolation tank. This is often accompanied by severe Lilliputian hallucinations, probably because there is no internal size reference (since the rest of the universe has just gone away). One user reported feeling as if he shrunk down to the size of a proton, and the rest of the world were light-years away. It is my opinion that these transitional effects occur because a critical level of NMDA receptor antagonism has been reached, which profoundly changes the nature of the applicable neural networks (e.g., the hippocampus). DXM seems to show two of these major transitions, once at the beginning of the third plateau and once at the beginning of the fourth. Other NMDA blocking drugs (dissociative anaesthetics) tend to have only one such transition. The effects at the third plateau itself tend to be very intense, and often very different from earlier plateaus. It is much less recreational and much more shamanic. Keep in mind that a third plateau trip can be terrifying to people who are not psychologically comfortable and prepared. SENSORY EFFECTS The phlanging of visual effects, coupled with the loss of stereoscopic vision, become so profound that the brain seems to give up trying to process vision entirely, leading to a sort of chaotic blindness. Simple images (e.g., a candle flame) are still parseable, although given the loss of stereoscopic vision one tends to see two of everything. More complex images, especially images that are not sharply defined, are difficult if not impossible to recognize. Simple sounds are still recognizable, and one can usually understand language, although it may be necessary for the speaker to phrase it in a complex rhythm (see Cognitive Effects). Music euphoria is rare. Touch, smell, and taste are subject to considerable anaesthesia, and pain especially may be completely dissociated (it's still there, it just doesn't seem to apply). Body position, kinetic, and balance senses are similarly disrupted. Hallucinations may continue, although they tend to be more abstract and pre-sensory rather than being predominantly visual. Oftentimes there is an overall sensation of being surrounded by grey, which increases to white light as the dosage increases. It is worth noting that at the third plateau, the phlanging of sensory input occurs both on a raw level (sounds, images) and on higher levels (words, phrases, faces, etc.) This is, to my knowledge, unique to DXM. MOTOR EFFECTS At the third plateau it may be impossible to perform coordinated movements. The large, sweeping motions of the first and second plateau are no longer present. Instead, many users lack both the desire and ability to move at this plateau. Well-learned motor tasks (e.g., speaking and typing) are still possible at this plateau, provided the user doesn't attempt to think about them. In particular, some users have reported that they were able to express their thoughts via typing, without even thinking about it or realizing they were doing so; however, when they looked at the screen or keyboard, they were no longer able to type. This is evidently a phenomenon unique to dissociative anaesthetics. COGNITIVE EFFECTS Cognitive function becomes severely disrupted at the third plateau. Complex tasks, such as mathematics, are very difficult. Reaction time is significantly delayed. Decision-making is somewhat degraded, although conceptual thought is less affected than concrete thought. Language changes can be quite profound. Sentences may stretch on and on, or alternately be very terse (I call this the Hemingway effect). Words, syllables, and phrases are commonly repeated. This may be related to problems with working and short-term memory. Speech may occur in a very rigid (but not necessarily simple) rhythm, and the user may not respond to speech unless it is in a similar rhythm. The normal chatter that goes on inside everyone's brain tends to slow down or stop at this plateau, leaving a feeling of mental peace and quiet. One person reported this as it felt like the top of my skull was opened into a clear blue sky;. MEMORY EFFECTS Working and short-term memory are seriously impaired. Thoughts may get stuck in at loop. Encoding of the more mundane experiences of the trip tends to be very bad; expect to forget a lot after the trip is over (a few people report that they begin to recall events from the trip a few days after it has ended; I know of no mechanism for this). The sense of time can be quite distorted, both in terms of chronological placement of events and in the sense of the passage of time. The day after a third plateau DXM trip, some users feel as if there were a break in the continuity of their memory, almost like the close of one chapter and the beginning of another. Some find this a very positive feeling, like a rebirth or rite of passage. It can be disconcerting if experienced without adequate foreknowledge and preparation. One of the most significant memory effects that can occur at the third plateau is the spontaneous recall of memories, often memories which were hidden (consciously or not). This can be a positive experience if one is prepared to review the darkest secrets of one's past; otherwise it range from somewhat embarrassing to very very unpleasant and disturbing. The user may also feel compelled to tell her or his companions about these memories (not always a good idea). EMOTIONAL EFFECTS Mood can range from absolute mania to panic. Many people have independently reported feeling as if they were dying, with some sense of fear, although some people do not seem to associate fear with this. Some people report a great increase in approach behaviour, as if every event and object were a new experience; others find irrational fears occuring (possibly due to body load). Panic attacks have occurred at the third plateau. This can be a scary experience, especially if one finds one's heart rate skyrocketing due to the panic attack and doesn't know why. The best way to cope with this is to try and calm down, much the same as one would with a bad trip on any other hallucinogen. DXM on the third plateau has a very shamanic feel to it. Part of this is due to the sense of rebirth, part from the recall of suppressed and/or partially forgotten memories (some similar effects which I formerly placed on the third plateau (e.g., feelings of contact with other beings) I now place on the fourth plateau as they tend to occur at substantially different dosage levels). Complete annihilation of self can occasionally occur (up to the point of forgetting one's identity) but does not seem to be especially dangerous. Note that, to sober observers, the effects of a third plateau trip can seem very unusual and unpleasant (often much more than to the person tripping). What are the effects of a fourth plateau dose? ============================================== Information pertaining to the fourth plateau (roughly, above 15mg/kg) is limited, and what I have gathered will be presented as a general overview. Please note that dosages in these ranges are approaching the danger zone, and under no circumstances should anyone take this much DXM without a sober assistant who can take you to the hospital if the need arises! Fourth plateau doses are similar to fully dissociative doses of ketamine. Generally, people entering the fourth plateau report that they lose all contact with their bodies, often suddenly. This can be somewhat frightening. In particular, the sense of breathing is one of those missing, and people have occasionally interpreted this as evidence that they were dead. The surrounding environment may be evenly colored (usually grey or white), or it may appear vividly realistic, or cartoon-like, or anywhere in between these. Many users have reported experiences very similar to out of body and near death experiences. In such cases, many report that they have contacted other beings, whose reaction to the user is usually somewhere between curiosity and amusement. Contact with superior being(s) has also been reported, sometimes as a raw force, sometimes personified in some way. In the reports given to me, the superior being image is more often female than male. Delusions can become fairly involved at this plateau; the crucial factor seems to be whether or not the individual realizes that the belief or thought is drug-induced. Some people, especially those more experienced at this level, have reported that although they were aware that their thoughts were delusional, they didn't really care at the time. In general these delusions are fairly harmless (e.g., I am a flower in the middle of a field). Generally an individual in this plateau won't be moving at all, which can be frightening to observers. In many ways this state resembles dreaming. If someone in this plateau does attempt to move, his or her attendants should be very sure that he or she is conscious of these actions, and not responding to a delusional environment. Somewhat surprisingly, many cognitive abilities are still intact. Basic computational skills and long-term memory recall do not seem to be particularly affected. It is also possible for the body (actually body and some parts of the mind) to undergo fairly complex tasks while the conscious mind is dissociated. There may be yet another plateau beyond the fourth. Given the toxicity of DXM at doses much higher than this, I don't think anyone should try and go there. You might not be able to come back. What are the effects of chronic, high-level use? Chronic, high-level use (e.g., 6-10mg/kg daily) tends to result in several undesirable effects. Psychological dependence is certainly possible and there are numerous examples of this occurring (also personal communications). Physical dependence is debatable, but if it does occur, it is probably with very high dose levels (10mg/kg per day and up) as a result of chronic NMDA blockade (see NMDA receptors). Amotivational syndrome has been reported (usually when the drug wears off). Memory problems seem to be fairly common (but this seems to resolve upon stopping DXM use). I have one report on a DXM addiction which may be cause for concern (related to me personally from the individual in question). The individual was roughly 60kg, and took a dose of 480mg, three or four times a day. The total dosage was thus 1440mg to 1920mg, i.e., 24 to 32mg/kg. This individual took the dosage regularly to maintain a constant state of profound intoxication with a great deal of opiate-like effects; neglecting the dose led to withdrawal symptoms consistent with opiate withdrawal, and possibly also withdrawal from a depressant. The individual had no history of psychological problems. The individual developed severe depression, leading to a suicide attempt and several months in drug rehabilitation. Exactly why some individuals seem to have drug dependence problems with DXM is unknown; it may be a function of chronic high-level use, or it may be a function of individual physiology. PLEASE NOTE that this user built up to this dose over a considerable time; a similar dose in a drug-naive individual could well be fatal. Some users report beneficial effects of chronic high-level use. The effects usually include some antidepressant activity (entirely reasonable given the possible significance of PCP2 receptors, stimulant activity, long-term motivational effect, and cognitive and creative enhancement (this has not been quantified and may be entirely subjective). It is arguable that chronic DXM use may actually be self-medication for depression in some people. On the other hand, a very new article (Hinsberger A, Sharma V, Mazimian D; Cognitive deterioration from long-term abuse of dextromethorphan: a case report; J. Psychiatry Neuroscience 1994 Nov) which presents a case of cognitive impairment associated with long-term use. I've got it on order; the local library doesn't carry the journal in question. Until I can evaluate it, here's the abstract: Dextromethorphan (DM), the dextrorotatory isomer of 3-hydroxy-N-methylmorphinan, is the main ingredient in a number of widely available, over-the-counter antitussives. Initial studies (Bornstein 1968) showed that it possessed no respiratory suppressant effects and no addiction liability. Subsequently, however, several articles reporting abuse of this drug have appeared in the literature. The drug is known to cause a variety of acute toxic effects, ranging from nausea, restlessness, insomnia, ataxia, slurred speech and nystagmus to mood changes, perceptual alterations, inattention, disorientation and aggressive behavior (Rammer et al 1988; Katona and Watson 1986; Isbell and Fraser 1953; Devlin et al 1985; McCarthy 1971; Dodds and Revai 1967; Degkwitz 1964; Hildebrand et al 1989). There have also been two reported fatalities from DM overdoses (Fleming 1986). However, there are no reports describing the effects of chronic abuse. This report describes a case of cognitive deterioration resulting from prolonged use of DM. I take exception to his definition of acte toxicity which he uses to refer to the psychoactive effects. More on this soon. Why is there so much individual variance in response? Several reasons. First off, there is a liver enzyme known as cytochrome P450-2D6 (also CYP2D6, or debrisoquine 4-hydroxylase), which metabolizes DXM. Some people lack this enzyme, and of those who have it, subtle genetic variations can result in different activity. Thus, while one person may metabolize DXM quickly, another may not (there are other pathways which are much slower). Certain drugs -- such as fluoxetine (Prozac™) can inhibit this enzyme Second, it is hypothesized that some of the effects of DXM, especially at higher dosage levels, may actually be due to dextrorphan, which is more similar to PCP and ketamine in its neuroreceptor activity. Some individuals may metabolize high doses of dextromethorphan to dextrorphan. Incidentally, my opinion -- based on anecdotal evidence of recreational DXM use while on fluoxetine -- is that DXM, and not dextrorphan, is responsible for the psychoactive effects. More evidence is mounting to show that it is DXM and not dextrorphan which is responsible for the psychoactive effects. Third, NMDA receptors are intimately involved in most areas of the brain, unlike the biogenic amine neurotransmitters (serotonin, dopamine, noradrenaline, histamine, and acetylcholine); the biogenic amines are usually secreted by small, distinct bundles of nerves (there are exceptions). It is possible that, due to this extensive involvement, many different cortical and limbic circuits may be affected. In fact, DXM affects at least four different binding sites (see How does DXM cause its psychoactive effects?) and each of these is subject to subtle variance from person to person. There are probably a gazillion other reasons why DXM has such a wide range of effects. The involvement of NMDA receptors in long- term potentiation may be part of the reason. Subtle differences in brain chemistry, notably in terms of sigma receptors, may also be involved. Is there a connection between DXM and out-of-body or shamanic journeying experiences? Maybe. It is somewhat established that many aspects of DXM trips, especially higher plateaus (3rd and 4th), have shamanic or out-of-body characteristics. Some users have reported experiences which are very similar to published out-of-body and/or near-death experiences (many of the users who reported these are fairly skeptical about that sort of thing). One note though -- DXM hallucinations and imagery tend to derive to a great extent from what you've encountered throughout the day. If you've played DOOM all day, you're going to have a difficult time coming up with any images other than muck-walls and demons. I can think of two explanations for the shamanic character of higher DXM plateaus.. The first one, which I prefer, is less fun but probably a lot more useful. Basically, it is possible that many of the aspects of out-of-body or shamanic journeying experiences derive from neural network states which DXM can approximate. To start with, unlike most drugs which target very specific, limited clusters of neurons, DXM tends to affect entire neural nets (via the NMDA receptor). A generalor interference with some of these neural nets may produce many of the experiences associated with near-death, and could possiblybe mimicked by DXM. Some (very simple) models have demonstrated spontaneous memory recall effects when the network is severely disrupted or disconnected; again, DXM may mimic this. The only problem here is that the NMDA receptor, although extensive, is involved in learning more than ordinary neural network signals. There is also a somewhat different, and possibly more compelling, neural network model. It is possible that, in addition to encoding short-term memory, NMDA receptors are involved in synchronizing or interfacing the conscious mind to the rest of the brain and body. When enough NMDA receptors are blocked, the mind and body/brain lose the ability to communicate. Each is still capable of doing its thing, however; in particular this might explain why it is possible to undertake fairly complex tasks under partial or full dissociative anaesthesia, but attempting to consciously control these taks fails. I'm also of the opinion that hypnosis and trance states may involve the same processes. Although the exact reason is unknown, several techniques for inducing shamanic journeying involve the use of regular, even drumming. Several high-dose DXM users have reported phlanging of sound in a very similar pattern and frequency to this drumming. If the phlanging is the result of the uncovering of a regular neural network sweep wave, it is possible that drumming may induce network states similar to those caused by DXM. At higher levels especially, there is considerable saturation of sigma receptors. These receptors may be involved in psychotic states and schizophrenia. While I don't believe that people who have out-of-body experiences are psychotic, it is possible that these states may be temporarily inducible in anyone. The other explanation, which is considerably further out on a limb than I want to go, is that DXM, by disconnecting the senses from the mind, allows the mind to wander freely in the spiritual universe. Some users have reported feeling like this at the time, in particular feeling that the physical world wasn't real, that they weren't a part of it anymore. I wouldn't advise testing this out. In any case, and regardless of what you choose to believe, there are some general guidelines that seem to be fairly universal to most systems of shamanic journeying. Accept or reject them as you see fit (remember, though, better safe than sorry). If you go somewhere, always return by the same path. Treat any entity you encounter with respect. They can't physically hurt you, but they can make your trip (and possibly your life) distinctly unpleasant. You can't really hurt them, either, but your chances of being able to make their lives unpleasant are probably a lot slimmer. Unpleasant entities generally feed off fear and anger; avoid getting stuck in a vicious cycle. If an entity gives you its name, consider it your secret, and don't tell anyone else.