FAQs About Dextromethorphan

Dextromethorphan is a safe and effective active ingredient found in well over 100 over-the-counter cough and cold products. First approved by the U.S. Food and Drug Administration (FDA) in the 1950s, it is an effective, non-narcotic, non-addictive cough suppressant that works by raising the coughing threshold in the brain. It is the most widely used cough suppressant in the United States.

Yes. Dextromethorphan-containing medicines are safe when used according to the medicine label directions. These medicines have been on the market for more than 50 years and are used safely by tens of millions of Americans each year to relieve cough symptoms.

No, dextromethorphan is not addictive. We have seen no studies that show physiological dependence or withdrawal. While the ingredient is not physically addictive, there are isolated reports that people engaged in this sort of substance abuse behavior may develop a pattern of habitual abuse.

Yes, dextromethorphan is recognized by FDA as a safe and effective cough suppressant and has been available over-the-counter for more 50 years.

The highest prevalence of cough medicine abuse is among teens. While 97 percent of teens do not abuse dextromethorphan, we know from research that nearly 3 percent of teens have reported abuse in the past year (Monitoring for the Future survey, 2015). Teens are abusing dextromethorphan by taking large amounts of over-the-counter cough medicine — well beyond the recommended dose — to get high. In addition, there have been reports of teens ingesting the unfinished, raw form of dextromethorphan purchased off the Internet—a practice that we are aggressively working to make illegal.

Dextromethorphan abuse is preventable. Research shows us that parents have a large influence over their teens’ decision to abuse drugs and that teens who report learning about the risk of drugs from their parents are half less likely to abuse drugs. Substance abuse prevention experts tell us that a targeted effort to raise awareness about the dangers of abuse is the most effective way to keep kids from abusing all types of substances, including over-the-counter medicines containing dextromethorphan. To help prevent or stop teen medicine abuse, parents should:

• Educate themselves about the problem of teens looking to otherwise safe and beneficial products, like medications, as a means to a high and know the warning signs.
• Talk to their teens about all types of drug abuse, including cough medicine abuse.
• Safeguard their medicine cabinets and know what products they have and how many.
• Monitor their teens’ Internet use.
• Seek professional help if they think their child has a substance abuse problem.

The makers of cough medicines containing dextromethorphan are committed to doing everything we can to stop the intentional abuse of cough medicines and making parents aware of the potential for abuse. Parents need to be active, aware, and involved…and we’re helping them do that. For more information, visit StopMedicineAbuse.org.

The following are signs that abuse may be taking place:

• Empty cough medicine boxes or bottles in the trash of your child’s room or boxes or bottles missing from the medicine cabinet
• Visiting pro-drug websites that provide information on how to abuse dextromethorphan
• Changes in friends, physical appearance, 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

There are a number of pro-drug websites that promote dextromethorphan abuse and provide information on how to abuse dextromethorphan containing medicines.

To combat some of the misleading and dangerous information online, CHPA and the Partnership for Drug-Free Kids created WhatIsDXM.com to provide teens with accurate information about this substance abuse issue. In addition, there is information available for parents at StopMedicineAbuse.org.

In general, the physical effects from abusing dextromethorphan vary with the amount taken. Common effects include confusion, vomiting, dizziness, blurred vision, slurred speech, loss of physical coordination, and stomach pain. Side effects can vary from person to person. Those who have abused dextromethorphan describe different “plateaus” ranging from mild distortions of their surroundings, to visual hallucinations, “out of-body” dissociative sensations, and loss of motor control. The effects worsen as the dose increases.

Side effects can also be worsened when the cough medicine being abuse contains other ingredients to treat more than just coughs or when combined with alcohol or illegal drugs.

There are well over 100 OTC medicines that contain dextromethorphan, either as the only active ingredient or in combination with other active ingredients. StopMedicineAbuse.org includes a list of popular brand-name OTC cough, cold, and flu medicines that contain dextromethorphan (DXM).

Slang terms for dextromethorphan vary by product and region. Adults should be familiar with the most common terms that teens use, which include dex, DXM, robo, skittles, triple-C, tussin, robo-ing, robo-tripping, and skittling, among others.

CHPA worked aggressively since 2003 on numerous cough medicine abuse prevention and education programs. We have taken the lead role in creating targeted, meaningful, and effective interventions to address this serious issue.

Decades of drug abuse research shows that targeted education is the most effective intervention to combating substance abuse and that parents play a pivotal role in keeping kids from abusing drugs. We believe that research-based education interventions, coupled with commonsense legislative initiatives such as an age-18 sales restriction, are the best and most effective approach to preventing this teen substance abuse problem.

Our efforts to engage parents to talk to their children about the risks of medicine abuse include:

• An educational website and blog reaching millions of parents at StopMedicineAbuse.org and the Five Moms initiative.
• A website and social media campaign with the Partnership for Drug-Free Kids to educate parents and teens via WhatIsDXM.com and a series of YouTube videos and a Facebook app targeted to teens.
• An educational toolkit with the Community Anti-Drug Coalitions of America to engage communities throughout the country to help raise awareness about this form of substance abuse behavior.
• Curricula for 5th, 7th, and 9th graders and parents with D.A.R.E. America.
• A Home to Homeroom campaign with National Association of School Nurses reaching an estimated 1.4 million students nationwide.
• A collaborative educational destination with WebMD to bring information to parents.

Additionally, the industry supports legislative and retail efforts to implement sales restrictions prohibiting the purchase of products containing dextromethorphan by those under the age of 18 as well as federal legislation that would restrict the sale of raw, unfinished dextromethorphan to teens.

For more information on our efforts, visit StopMedicineAbuse.org.

While we strongly support a ban on the sale of dextromethorphan-containing medicines to teens under the age of 18, along with restricting access to bulk dextromethorphan, we continue to believe that targeted, research-based interventions are the most effective way to address cough medicine abuse. More than 35 years of research tells us that sustained education, and not regulation, will effectively impact abuse.

CHPA supports the DXM Abuse Prevention Act of 2015 (H.R. 3250) introduced into the U.S. House of Representatives by U.S. Reps. Bill Johnson (R-OH) and Doris Matsui (D-CA). CHPA‘s partners, such as the Community Anti-Drug Coalitions of America and the Partnership for Drug-Free Kids, are working with members of Congress to see the legislation enacted.

CHPA and its many partners have resources on teen cough medicine abuse. To learn more about the issue and how you can get involved, visit StopMedicineAbuse.org. In addition to practical and actionable tips, there are links to many programs and the websites of other organizations engaged in this effort, including the Partnership for Drug-Free Kids. If you think your teen needs professional help, call 1.800.662.HELP.