Robitussin, the brand name for dextromethorphan (DXM), is a medication sold over the counter for the treatment of cough and cold. When used as directed, the drug can be effective in the management of symptoms related to the common cold, helping the individual to sleep and allow for repair of the body.
When abused – that is, when taken in larger-than-recommended doses for the purposes of getting high – products that contain DXM can be exceptionally dangerous to the user, causing medical emergency, including overdose and accident under the influence. Regular Robitussin abuse can contribute to the development of addiction, and those who struggle with addiction can ultimately lose everything: their relationships, their mental health, their physical health, and everything they have worked for.
Though DXM abuse and addiction can be life-threatening, there is hope through treatment. Medical detox followed by intensive therapeutic treatment can help the person living with the disorder to get back on track and start living a life focused on health and wellness.
How DXM Is Abused
Robitussin and other DXM products usually come in liquid or tablet form. When the drug is abused, it is taken in huge doses. For example, rather than taking a single dose of a DXM cough syrup, a person using the substance with the intent to get high may drink an entire eight-ounce bottle or two, depending on tolerance.
Another form of abuse of DXM products has been popularized by hip hop culture. A number of rappers have popularized “purple drank” or “sizzurp,” a cocktail created by combining codeine-based cough syrup with colored candy like Jolly Ranchers or Skittles and soda for the purposes of getting high. Many young people who do not have access to codeine cough syrups, substitute DXM-based cough syrups to get a similar effect.
Slang Terms for Dextromethorphan
- Triple C
- Robo (or Robo-tripping)
- Poor Man’s PCP
Teens and Robitussin Abuse
Robitussin is most commonly abused among teens and young adults, especially those under the age of 21 who are unable to legally buy alcohol. Depending on local trends, it may be more or less likely that a young person will experiment with DXM abuse and potentially develop a problem with the substance, but there are a number of stories of young people who have struggled deeply with the consequences of using the drug and continued to use it anyway.
Additionally, because the purchase of DXM is monitored in many states in order to stop those who would abuse the drug, some locales do not allow anyone under the age of 18 to purchase products that contain DXM.
Use of Robitussin to get high can have all of the negative repercussions commonly found with teen substance abuse of any kind, including:
- Loss of academic progress
- Legal problems, especially if stealing the drug
- Increased mental health symptoms
- Increased risk of physical health problems, especially acute medical emergency and accident
- Loss of opportunities at school and in the community
Effects of Robitussin Abuse
The Drug Enforcement Administration (DEA) says that high-dose users of dextromethorphan products like Robitussin report experiencing different “plateaus” of stimulation based on the dose, including:
- 100-200 milligrams: mild sensory experience
- 200-400 milligrams: a high characterized by hallucinations
- 300-600 milligrams: altered vision and perception and decreased motor control
- 500-1500 milligrams: A persistent dissociative sedation
Depending on tolerance levels, other medications used, and frequency of use and abuse as well as the dose of the drug, users may experience a high defined by:
- Increased sense of perceptions and awareness
- Altered sense of space and time that is not in line with reality
- Hallucinations (usually visual)
- Unusual or excessive excitability or, conversely, extreme lethargy
Additionally, there are a number of physical symptoms caused by high-dose DXM use as well. These, too, will vary depending on the circumstances, but may include:
- Lack of muscle coordination and control
- High blood pressure
- Slurred speech
- Involuntary eye movements
Often, over-the-counter cold medications contain more active ingredients than just DXM, and some of those ingredients can cause their own complications when taken in high doses. For example:
- Pseudoephedrine: A stimulant drug, high doses of pseudoephedrine can cause elevated blood pressure and heart complications.
- Acetaminophen: Liver damage can be the result of high-dose acetaminophen use and is an increased risk when combined with high-dose DXM use.
- Antihistamines: High doses of antihistamines in combination with high doses of DXM can contribute to an increased chance of anticholinergic toxicity as well as cardiovascular and central nervous system toxicity.
- Other illicit substances: The use of alcohol and other drugs in combination with high doses of DXM products can increase the chance of medical emergency, including accident, overdose, and sudden death.
Robitussin Abuse and Addiction
Though not commonly a substance of focus in the ongoing conversation about illicit drug use and abuse, DXM-based products have long been a problem in the United States. The DEA reports that dextromethorphan was mentioned in more than 45,000 calls, included in more than 33,800 single exposures, and linked to six deaths, citing the American Association of Poison Control Centers.
Additionally, according to the 2011 Monitoring the Future (MTF) Report, sponsored by the National Institute on Drug Abuse (NIDA), an estimated 2.9 percent of 8th graders, 4.3 percent of 10th graders, and 5 percent of 12th graders reported use of cough and cold medications like dextromethorphan.
The high rates of use and abuse of over-the-counter cold medications like Robitussin for the purposes of getting high among young people indicate two significant issues. First, any use of mind-altering substances during adolescence and teen years can not only trigger sudden death due to medical emergency or accident, but also alter the development and function of the still-developing brain. Any drug or alcohol use during this time can cause irrevocable changes to both emotional and mental development, which in turn, can make it more difficult to establish oneself positively in adulthood.
Second, early use of any substance can also lead to a lifetime struggle with substance use disorders in general. Triggering the pleasure and reward system in the brain early can contribute to cravings for the high experienced with drug use. Additionally, using drugs and alcohol as a coping mechanism early in life precludes that ability to learn positive and sustainable coping mechanisms, creating negative behaviors that must be unlearned later.
Robitussin Detox and Treatment
The good news is that no matter how frequently over-the-counter medications like Robitussin are abused, the issue can be successfully treated with medical detox and therapeutic treatment. Though there is no cure for addiction, there are a wide range of therapies and treatments that have been identified as positive resources for individuals hoping to stop use of all substances of abuse and start living more balanced and healthy lives.
For each person, substance abuse treatment that addresses these issues will be a unique experience. Even among clients who share an addiction to dextromethorphan, the specific therapies that will be most helpful in recovery will vary. It is important to address all the issues contributing to the urge to use drugs – not just on the medical process of stopping drug use safely and learning how to avoid relapse. Thus, clients often undergo therapies that help them to address:
- Family issues
- Low self-esteem and self-confidence
- Co-occurring mental health disorders
- Life skills issues, like finding a job or connecting with safe housing