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Cough & Cold Medicine Abuse

Why Do People Use Cough and Cold Medicines to Get High?

There's an ingredient in many over-the-counter (OTC) cough and cold medicines called dextromethorphan. It's known as DXM for short and its purpose is to suppress the need to cough.

When people take too much DXM, they might have hallucinations and "out-of-body" sensations. DXM also depresses brain function, particularly the parts of the brain that control breathing and heart function.

Medicines that have DXM in them come as syrups, capsules, pills, or throat lozenges. But some people extract DXM from cough syrup and make it into a powder or capsule of "pure" DXM.

Short-Term Effects

Taking a lot of DXM causes hallucinations and out-of-body sensations similar to the ones caused by drugs like ketamine and PCP. These effects can last as long as 6 hours.

DXM also can make users have trouble controlling their limbs and cause blurred vision, slurred speech, dizziness, and impaired judgment.

Other short-term effects include:

  • paranoia and confusion
  • excessive sweating
  • nausea and vomiting (large quantities of cough syrup almost always cause people to throw up)
  • belly pain
  • irregular heartbeat and high blood pressure
  • restlessness
  • dry, itchy skin and facial redness

DXM might seem safe since it's sold over the counter. But large quantities can cause dangerous side effects, including loss of consciousness, seizures, brain damage, and death.

One particularly dangerous side effect of DXM is hyperthermia — extremely high fever. This is a big problem in hot environments or when DXM users physically exert themselves, like while dancing at a club. High body temperatures can quickly lead to brain damage or a coma.

Long-Term Effects

DXM isn't physically addictive, but users can grow emotionally dependent on the drug.

Scientists don't fully know the long-term effects of DXM abuse. It may cause learning difficulties and memory impairment. Some former users say they've felt paranoid or depressed from taking DXM.

Long-term use of DXM may contribute to heart and organ damage, as well as high blood pressure, a fast pulse, and breathing trouble.

Other Possible Problems

It's possible to overdose on too much DXM, especially if it's in pure powder form. Someone who overdoses may have brain damage or seizures, and might even die.

You've probably seen the warnings on cough or cold medicines about not driving or using heavy machinery. Obviously, if someone takes too much DXM, the user is even more impaired and at risk of causing accidents.

Medicines with DXM often have other drugs in them, like painkillers or antihistamines. For example, lots of cold medicines have acetaminophen, a pain reliever that can cause liver damage and failure when taken in large doses.

People using cold medicines to get high may not realize they are taking high doses of many drugs, not just DXM. Mixing DXM with other drugs or alcohol increases the likelihood of potentially life-threatening conditions. For instance, combining it with drugs like MDMA increases the risk of hyperthermia and can lead to brain damage, seizures, a coma, and death.

How Can Someone Quit?

Because DXM is readily available and not too expensive, it can be easy to develop a psychological dependence on it. Users who abruptly stop using DXM can experience trouble sleeping and depression.

If you or someone you know has been using DXM, you can start by working with a parent or friend to clean out the medicine cabinet and get rid of all the products containing dextromethorphan. Talking with a counselor or joining a support group or substance abuse treatment program can help make it easier to quit.

Avoiding DXM

Many people keep cough and cold medicines in their home. It might seem tempting to try them for a cheap high, but doing so isn't safe, especially when they have other ingredients. It's hard to imagine that an OTC medicine can kill or leave someone with brain damage, but that's a possibility with DXM when it's taken in large quantities or mixed with other things.

"Pure" DXM is a problem too — especially since it's impossible to know it's really "pure." Someone might offer you some at a party, but since you don't really know where it was made or what's in it, it's not safe. With DXM, it's best to stick to its intended use and approved dosages.

Date reviewed: February 2014

Note: All information on TeensHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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