Teens and Cough Medicine Abuse

Over-the-counter (OTC) cough and cold medicines are safe and effective when they’re used as directed. But taking too much of them -- on purpose or by accident -- can make you feel high. That can lead some people to abuse them.

Before the FDA outlawed codeine in cough medicines in the 1970s, OTC cough medicines created a cheap and effective high. A substance called dextromethorphan (DXM) replaced codeine in cough medicines. At very high doses, it can mimic the effects of illegal drugs like PCP and ketamine.

Teens are more likely to abuse cough medicines because they can get them easily and without a prescription. What’s more, kids can learn where to buy the drug and how to use it to get high online.

You might not think twice if you find these meds in your teen’s book bag, but you should be aware of their potential for abuse.

How Much Is Too Much?

A safe dose of products with DXM is usually 15 to 30 milligrams over the course of 24 hours. It usually takes more than 10 times that amount to make you high.

There are usually several stages of DXM intoxication, depending on how much you take. Effects can range from a mild “buzz,” to an “out-of-body” feeling, to hallucinations, paranoia, and aggression. They can last anywhere from 30 minutes to 6 hours after you take the drug.

If you take that much and then get very active, your body can overheat and you might get a dangerously high fever. This is especially a problem for teens who go to dance clubs, where they can be sold DXM that looks like illegal club drugs such as PCP. When you take DXM with other drugs, or alcohol, it raises the odds of trouble.

DXM is usually found in medicines that have other ingredients to fight colds. Taking high doses of pseudoephedrine (a decongestant), acetaminophen (a pain reliever), and antihistamines (a remedy for sneezing and a runny nose) along with DXM can cause other health problems, such as:


Know the Warning Signs

Your teen might be abusing cough medicines if:

  • You find empty boxes or blister packs of cold medicine at home or school.
  • Cough or cold medicines go missing from your household.
  • You overhear your teen using terms such as “skittles,” “robo-tripping,” “triple-C,” or “dexing” -- all slang for DXM abuse.
  • Their friends become unfamiliar to you, their grades fall, or they lose interest in favorite activities.
  • They get unexpected online purchases at home.

As with most things regarding your children, you’re the first line of defense. Studies show teens are half as likely to misuse drugs if their parents talk to them about the risks. Because DXM products are sold legally without a prescription, many teens mistakenly believe those medicines have few dangers.

What Parents Can Do

DXM abuse by teens is down by nearly half during the last decade or so. Still, about 1 in 30 teens say they use DXM to get high, and 1 in 4 know someone who does. Some makers of OTC medicines with DXM have put labels on their packaging warning about the potential for abuse. And, as of 2018, 16 states have banned the sale of meds with DXM to minors.

To help keep your children from abusing these medicines:

  • Store them safely.
  • Buy them only when you need them.
  • Keep an eye on what your child does online.

Be proactive. Make sure your child knows the dangers of misusing OTC medicines. They might listen to you more than you think.

WebMD Medical Reference Reviewed by Amita Shroff, MD on March 22, 2019



Consumer Healthcare Products Association et al: “Stop Medicine Abuse.”

Drug Enforcement Administration: “Dextromethorphan.”

KidsHealth from Nemours: “Cough and Cold Medicine Abuse.”

Monitoring the Future: “National Survey Results on Drug Use, 1975-2017.”

National Institute on Drug Abuse: “Over-the-Counter Medicines.”

National Institute on Drug Abuse for Teens: “Cough and Cold Medicine (DXM and Codeine Syrup).”

Retail Leader: “Another State Bans Minors from Buying Cough Syrup.”

Substance Abuse and Rehabilitation: “Antitussives and Substance Abuse.”

Substance Abuse Treatment, Prevention, and Policy: “Dextromethorphan: A Case Study on Addressing Abuse of a Safe and Effective Drug.”

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