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Cough and Cold Medicine Abuse

Most parents are aware about the dangers of illegal street drugs like marijuana and cocaine. But many of us may not realize that some teens are abusing legal, over-the-counter (OTC) products like cough medicine, to get high.

How does a child get “high” off of taking cough and cold medicine? The “high” is caused by taking a large amount of dextromethorphan (known as DXM), a common active ingredient found in many cough medications.

What is dextromethorphan? Dextromethorphan is a safe and effective active ingredient found in many nonprescription cough syrups, tablets, and gel caps. DXM has gradually replaced codeine as the most widely used cough suppressant in the United States. When used according to medicine label directions, the ingredient dextromethorphan produces few side effects and has a long history of safety. When abused in large amounts, it can produce a “high” feeling as well as a number of dangerous side effects.

What are other terms used for dextromethorphan? Other terms that may be used include Dex, DXM, Robo, Skittles, Syrup, Triple-C, and Tussin.

What cough medicines contain dextromethorphan? There are well over 100 OTC medicines that contain dextromethorphan, either as the only active ingredient or in combination with other active ingredients.

Some examples include:

  • Alka-Seltzer Plus Cold & Cough Medicine
  • Coricidin HBP Cough and Cold
  • Dayquil LiquiCaps
  • Dimetapp DM
  • Triaminic cough syrups
  • Tylenol Cold products
  • Vicks 44 Cough Relief products and Vicks NyQuil LiquiCaps.

Why is abuse of dextromethorphan among teenagers becoming so popular?

  • Often, these teens are finding information about cough medicine abuse and effects of dextromethorphan on the Internet.
  • It is easily and legally available over-the-counter.
  • It is inexpensive.
  • The risk of danger from its use is perceived to be low.

How common is cough and cold medicine abuse? 

Dextromethorphan abuse was recognized as early as the 1960s; since the late 1990s, adolescents have been increasingly abusing over-the-counter dextromethorphan products.

In the 2006 annual Monitoring the Future survey, which includes almost 50,000 8th, 10th, and 12th grade students in about 400 public and private schools, a new question was included on the use of over-the-counter cough or cold medicines for the explicit purpose of getting high. The proportions of students reporting having used these drugs during the prior year for the purpose of getting high were 4%, 5%, and 7% in grades 8, 10, and 12, respectively.

In a research study published in the December issue of Archives of Pediatric and Adolescent Medicine titled “Dextromethorphan Abuse in Adolescence”, from 1999 through 2004 a 15-fold increase in adolescent dextromethorphan abuse cases was reported to the California Poison Control System and a 7-fold increase was reported nationally.

According to California Poison Control System reports in the above mentioned publication, Coricidin HBP Cough & Cold Tablets was the most commonly reported dextromethorphan-containing product abused, followed by dextromethorphan-containing Robitussin formulations.

DXM abuse, though not a new phenomenon, has developed into a disturbing new trend which involves the sale of pure DXM in powdered form. This pure DXM is often encapsulated by the “dealer” and offered for street use.

Several states, such as California and New York, have even proposed legislation to control the sale of dextromethorphan-containing products to minors.

What are the signs and symptoms of cough medicine abuse?

The effects of the abuse of cough medicines containing dextromethorphan vary with the amount taken.

Common side effects include:

  • confusion
  • dizziness
  • blurred vision
  • slurred speech
  • loss of physical coordination
  • abdominal pain, nausea and vomiting
  • rapid heart beat
  • high or low blood pressure
  • fever
  • hallucinations
  • seizure
  • coma
  • and even death

Cough medicine also is sometimes abused in combination with other medications, alcohol and illegal drugs, which can increase the dangerous side effects.

How can I prevent OTC Cough and Cold Medicine Abuse in my Child?




Educate Yourself Educate yourself about cough medicine abuse and share this information with others who are in contact with your teen, such as school administrators, coaches and counselors.

  • Make sure you’re aware of the signs of cough medicine abuse and what to watch out for.
  • Communicate with Your Teens
  • Make sure your teen understands that abusing cough medicine, just as abusing illegal drugs, can be very dangerous.
  • Talk to your teen what he/she is doing on the Internet and the web sites he/she visits.
  • Safeguard Medications at Home and Other Places
  • Know what medicines are in your home and pay attention to quantities.
  • Keep all medications out of reach and out of easily accessible places like medicine cabinets.

According to the article in the December issue of Archives of Pediatric and Adolescent Medicine titled “Dextromethorphan Abuse in Adolescence, preventive measures, such as placing dextromethorphan-containing products behind pharmacy counters as an effective action to limit this increasing trend of abuse in adolescents is stressed.