DXM is usually ingested as a hydrobromide salt. Large amounts of bromide
ions can cause sedation and eventually lead to bromism (bromide poisoning),
which affects (among other things) the skin and nervous system (see Section
6.3.15. I don’t think this is terribly relevant for users of DXM
(recreational or not); however it is one more reason to avoid prolonged
high-dose use. You can avoid bromide ions by converting the DXM to free
base and/or hydrochloride salt (see Section 11.1). Some physicians do
believe that prolonged heavy use of DXM may lead to bromism (144).

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