DXM: Cough Medicine

About one in 25 teens report using cough medicine to get high. Often, these teens are finding information about cough medicine abuse on the Internet.

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Class of drug: DXM is a synthetically produced opioid chemically related to codeine, but does not directly stimulate opiate receptors in the brain. It acts as a hallucinogen/dissociative drug at high doses.

Main active ingredient: DXM (dextromethorphan)

What it looks like: It is available in liquid, tablet, capsule, gel cap and lozenge cough preparations. It is also available in powdered form.

Street names: Robo, Dex, Tussin, Skittles, Triple C, Velvet

How it is used: Orally in cough medicines; inhaled in powdered form

Duration of high: The effects can last up to six hours.

Withdrawal symptoms: Restlessness, muscle/bone aches, insomnia, diarrhea, vomiting, cold flashes

Effects: Recommended doses (.17 - .33 oz of med. containing 15 mg to 30 mg DXM)—cough suppression

DXM abusers describe different “plateau” effects. 
                 Small doses (under 2 oz of med., first plateau)— mimic depressant effects: mild drunkenness
                 Medium doses (2 oz - 4 oz of med., second plateau) mimic stimulant effects with distorted visual perceptions
                 Large doses (4 oz - 10 oz or more of med., third and fourth plateaus)—mimic dissociative drugs: distorted perception of sight, time, body and sound, feelings of                        detachment, hallucinations, violence

                 Physical—Flushing, sweating, increased body temperature, nausea, seizures, high blood pressure, blurred vision, irregular heartbeat, numbness

                 Long-term—Liver damage (from medicines also containing acetaminophen) brain damage, coma, death

U.S. Information:

In several states, including California and New York, it is illegal to sell DXM containing medicine to anyone under the age of 18. Many store chains have also implemented restrictions such as requiring signatures for DXM sale and limiting quantities allowable for purchase. In 2013, 2.9 percent of 8th graders, 4.3 percent of 10th graders and 5 percent of 12th graders reported using cough/cold medicine To get high. (Monitoring the Future Survey)

Many teens are mixing cough medicine with soda and Jolly Ranchers to create a drink called “Lean,” “Sizzurp,” or “Purple Drank.” These drinks are usually made with prescription strength cough medicine containing Codeine or Promethazine. “Lean” has been popularized through hip hop and rap music.

Sources: NIDA Research Report Series, National Drug Intelligence Center. U.S. Department of Justice, The Partnership for a DrugFree America, National Institute on Drug Abuse, Monitoring the Future Survey, Drug Abuse Handbook