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Primer on Cough/Cold Medicine Abuse

Content provided by: Better Medicine from Healthgrades

Dextromethorphan (DXM) is a common active ingredient in many effective over-the-counter cough and cold remedies. Taken according to label directions, it has an established safety record.

However, when abused by taking many times more than the recommended dose, medications containing DXM can cause a euphoric high and dangerous side effects.

The Problem

DXM is an ingredient in more than 100 over-the-counter medicines, including Alka-Seltzer Plus Cold & Cough Formula, Dimetapp DM, Mucinex DM tablets, Sudafed cough products, TheraFlu cough products, Tylenol cough and cold products, Vicks 44 cough products, some Robitussin products, and others. Teens can get these products from the medicine cabinet, in stores, and on Internet sites.

One in 20 teens has taken large amounts of cough remedies to get high, estimates suggest. Less than half of teens believe it’s risky to abuse these medicines to get high.

Teens can learn how to abuse DXM on websites and social networking sites that offer guidelines on how to get high and how to buy DXM.

Methods of Abuse

Teens abuse these medicines in a number of ways. Some take as much as 25 to 50 times the recommended doses, which can amount to 80 pills a day. Others drink cough syrup straight from a bottle or mix it with soda or alcohol. Still others consume raw DXM ingredients purchased on the Internet.

Symptoms of Use

Teens who abuse DXM may go through mild distortions of color and sound, hallucinations, out-of-body experiences, confusion, slurred speech, and loss of motor control.

Dangerous side effects include high blood pressure, rapid heartbeat, and loss of consciousness.

Signs of Abuse

Warning signs of DXM abuse include:

• Empty cough medicine boxes or bottles turning up in your child’s room, backpack, or school locker

• Bottles or boxes of cough medicine missing from your medicine cabinet

• Use of slang terms for DXM abuse, including Skittling, Tussing, Robo-Tripping, Triple Cs, and Dex.

• Unexpected packages arriving in the mail for your child

Prevent Abuse

Parents can take these steps to help prevent abuse:

• Be sure your children know the dangers of DXM abuse.

• Insist your children not take any medications without your knowledge.

• Know which medicines (and how much of them) you have at home.

For more information, visit

Medical Reviewer: Gonnella, Joseph MD Last Annual Review Date: 2010-03-30 Copyright: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

Reference: Mental Health and Behavior section on Better Medicine

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Did You Know?

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In 2011, 2.7% of 8th graders reported having used over-the-counter cough and cold medicines to get high. For 10th and 12th graders, the number was higher – more than 5%.