• Tell a Friend
• Print

Overview

The materials found in this toolkit address the trend of young people taking large amounts of over-the-counter cough medicines containing dextromethorphan (sometimes abbreviated DXM) to get high. What’s alarming is the fact that parents and kids don’t know the harm these medicines can cause when abused in extremely large amounts. This, coupled with how accessible the medications are in home medicine cabinets, local retail stores, and on the Internet, is catching parents by surprise—especially once they learn that this kind of behavior can be extremely dangerous.

Is Cough Medicine Abuse on Your Radar Screen?

Do You Know What Skittling Is? How About Tussing? Chances Are, One in Every 10 Teenagers Does.

Recent research shows that while parents are aware of warnings against the dangers of illicit street drugs, both prescription drugs and over-the-counter (OTC) cough medicine often are overlooked as potential threats. While an estimated one in five teens has abused prescription drugs, an estimated one in 10 youths—or 2.4 million young people—has intentionally abused cough medicines to get high. Data collected in 2008 by the National Institute on Drug Abuse for its Monitoring the Future study estimate the intentional abuse of cough medicine among eighth, tenth, and twelfth graders is at 3.6 percent, 5.3 percent, and 5.5 percent, respectively.

What Is Dextromethorphan?

Dextromethorphan is a cough suppressant found in many over-the-counter cough and cold remedies, and is generally safe when taken in recommended doses. With over 100 medicines containing dextromethorphan on the market today, these medicines come in the form of liquids, capsules, gelcaps, lozenges, and tablets. Examples include Alka-Seltzer Plus Cold & Cough Formula, Coricidin HBP Cough and Cold, Dimetapp® DM, Mucinex® DM tablets, PediaCare cough medicines, certain Robitussin® cough products, Sudafed cough products, TheraFlu Cough products, Triaminic cough products, Tylenol Cough and Tylenol Cold products, Vicks 44 Cough Relief products, and certain Vicks DayQuil and NyQuil LiquiCaps. There also are a number of store brands that contain dextromethorphan, as well.

Since it was approved by the U.S. Food and Drug Administration in the 1950s, dextromethorphan has become the most widely used cough suppressant in the U.S.

Risks of OTC Cough Medicine Abuse

At recommended doses, OTC cough medicines have little or no physical or psychological side effects. When abused, medicines containing dextromethorphan are taken in extreme excess—sometimes 25–50 times the recommended doses. Large amounts can produce hallucinations and other effects similar to the high experienced with ecstasy. Dextromethorphan abusers experience mild distortions of color and sound, strong visual hallucinations, “out-of-body” sensations, confusion, slurred speech, and the loss of motor control. Other serious side effects include:

• Delusions
• Panic attacks
• Memory problems
• Blurred vision
• Stomach pain, nausea, and vomiting
• High blood pressure and rapid heartbeat
• Numbness of fingers and toes
• Drowsiness and dizziness
• Fever and headaches
• Rashes and itchy skin
• Loss of consciousness

Side effects can be worsened if the dextromethorphan-containing cough medicine being abused also contains other ingredients to treat more than just coughs. Cough medicine also is sometimes abused in combination with other medications, alcohol, and illegal drugs, which can increase the dangerous side effects.

Know the Signs of Cough Medicine Abuse

Signs that a child could be abusing OTC cough medicines or other drugs include:

• Empty cough medicine boxes or bottles in the trash of your child’s room or in your child’s backpack or school locker
• Purchase or use of large amounts of cough medicine when not ill
• Missing boxes or bottles of medication from the medicine cabinet
• Visiting pro-drug web sites that provide information on how to abuse dextromethorphan
• Internet orders (for example, note the arrival of unexpected packages, or payments by credit card or PayPal account)
• Changes in friends, physical appearance, or sleeping or eating patterns
• Declining grades
• Loss of interest in hobbies or favorite activities
• Hostile and uncooperative attitude
• Unexplained disappearance of household money
• Unusual chemical or medicinal smells on your child or in his or her room
• Hearing your child use certain slang terms for DXM abuse, such as Skittling, Tussing, Robo-Tripping, Triple Cs, Robo-tripping, and Dex

Want to Learn More?

StopMedicineAbuse, an effort by the leading makers of OTC cough medicines
Consumer Healthcare Products Association
StopMedicineAbuse.org

Preventing Teen Cough Medicine Abuse: A Parent’s Guide
Partnership for a Drug-Free America and Consumer Healthcare Products Association
OTCsafety.org/publications

Battling the Over-The-Counter High
Substance Abuse and Mental Health Services Administration
http://ncadistore.samhsa.gov/catalog/mediaDetails.aspx?ID=371

Teens: Make Up Your Own Mind About DXM
Partnership for a Drug-Free America
dxmstories.com

Our Partners