Cough Medicine/DXM

Millions of Americans take cough and cold medicines each year to help with symptoms of colds, and when taken as instructed, these medicines can be safe and effective. However, several cough and cold medicines contain ingredients that are psychoactive (mind-altering) when taken in higher-than-recommended dosages, and some people may abuse them. These products also contain other ingredients that can add to the risks.

Two commonly abused cough and cold medicines are:

Cough syrups and capsules containing dextromethorphan (DXM). These over-the-counter (or OTC) — meaning they can be bought without a prescription — cough medicines are safe for stopping coughs during a cold if you take them as directed. Taking more than the recommended amount can produce euphoria (a relaxed pleasurable feeling) and dissociative effects (like you are detached from your body).

Promethazine-codeine cough syrup. These prescription medications contain an opioid drug called codeine, which stops coughs, but when taken in higher doses produces euphoria.

Cough and cold medicines are usually sold in liquid syrup, capsule or pill form. They may also come in a powder. Young people are more likely to abuse cough and cold medicines containing DXM because these medicines can be purchased without a prescription.

Some people mix promethazine-codeine cough syrup with soda or alcohol and flavor the mixture by adding hard candies, commonly known as “Purple Drank” or “Sizzurp”.

Other common nicknames for cough medicine abuse are: robotripping, robo, tussin, triple C, dex, skittles, candy, velvet and drank.

DXM abuse can cause:

  •         Loss of coordination
  •         Numbness
  •         Feeling sick to the stomach
  •         Increased blood pressure
  •         Faster heart beat
  •         In rare instances, lack of oxygen to the brain, creating lasting brain damage – when DXM is taken with decongestants

Promethazine-codeine cough syrup can cause:

  •         Slowed heart rate
  •         Slowed breathing (high doses can lead to overdose and death)

Also, cough and cold medicines are even more dangerous when taken with alcohol or other drugs.


Cough and cold medicines are even more dangerous when taken with alcohol or other drugs.