What Is DXM? Learn About Addiction and Treatment Options | Ambrosia Drug & Alcohol Addiction Treatment Center
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Over-the-Counter Cough/Cold Medicines

Over-the-counter medicines are available to anyone without a prescription from a healthcare professional. Most over-the-counter (OTC) medicines relieve aches, pains and itches while others prevent diseases like tooth decay and athletes foot. Cough and cold medicines contain the active ingredients Dextromethorphan and Promethazine-codeine cough syrup. The ingredients are mind-altering if taken at higher doses or abused.

  • Dextromethorphan® (DXM) is a cough suppressant that produces euphoria and dissociative effects (hallucinations, delusions) when taken in larger quantities.
  • Promethazine-codeine cough syrup® contains codeine, an opioid that produces relaxation and euphoria, and an antihistamine that acts as a sedative, known as promethazine HCI.

Various (EX: Robitussin®)
Robotripping, Robo, Triple C & Lean
Syrup & Capsule

Health Effects

Abusing DXM and codeine can lead to high risk of physical and psychologically harmful effects, such as:

  • impaired motor function
  • numbness
  • nausea and vomiting
  • increased heart rate and blood pressure
  • extreme agitation
  • the buildup of excess body fluids
  • liver damage
  • brain damage
  • slowing and stopping of the heart and lungs
  • fatal overdose

When abused, codeine cough syrup presents a higher risk of overdose due to its depressing effects of the central nervous system, which can slow or stop the heart and lungs.


The false, widespread belief that you don't need a prescription for the OTC drugs means they are less harmful than prescribed or illicit drugs can be a dangerous opinion to hold. The fact is, any substance abuse can be hazardous and even fatal.

Misuse of over-the-counter medications can distort your visual perceptions and damage your sense of judgement. High doses can lead to loss of coordination, dizziness, nausea, hot flashes and hallucinations.

Effects on the Brain

When taken as prescribed, cough and cold medicines can safely treat symptoms of lower or upper respiratory congestion caused by colds and flu. When abused, the cold medicines increase the amount of dopamine that is released into the brain to create the sedation and euphoric feeling.

Repeatedly using codeine or DXM can lead to addiction – or the inability to stop using a drug despite damaging consequences.


How Are They Abused?

Prescription and OTC drugs may be misused in the following ways:

Taking a medication that has been prescribed for somebody else. Most teenagers who abuse prescription drugs are given them for free by a friend or relative. People often unknowingly contribute to this form of abuse by sharing their unused medications with others.

Most teenagers who abuse prescription drugs are given them for free by a friend or relative. People often unknowingly contribute to this form of abuse by sharing their unused medications with others.

Taking a drug in a higher quantity or another manner than directed.

Most medications (prescribed and over-the-counter) are dispensed orally in tablets. However, some abusers crush the tablets and snort or inject the powder inside. These methods amplify the drugs effects into the bloodstream and brain.

Taking a drug for another purpose than directed. 

All of the drug types mentioned can produce pleasurable effects in sufficient quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them.

Diet Pills

Diet pills are infamous for being easily found and easily abused drugs. The active component, Ephedrine, found in diet pills is a dangerous ingredient if abused, including the herbal or “natural” weight-loss ingredients.
The stimulants found in diet pills affect the central nervous system, increasing the metabolism and heart rate.

There are many possible side effects of diet pills, such as:

  • Hair loss
  • Insomnia
  • Menstrual cycle disturbances
  • Urinary tract infections
  • Diarrhea
  • Vomiting
  • Blurred vision
  • Anxiety
  • Heart Attack

Frequently Asked Questions

Who regulates the sale of substances?

The Food and Drug Administration or FDA regulates the manufacture and sale of over-the-counter substances. The FDA requires all “new drugs” to obtain a New Drug Application to be recognized as a safe and efficiently controlled substance.

How many classes of over-the-counter drugs are there?

In the U.S., there are more than 80 classes of OTC drugs, ranging from allergy medicines to pain relievers to weight loss products.

Where can I find over-the-counter medications?

The medications are often located on shelves in pharmacies with easy access by patients, but may also be found in non-pharmacy outlets, such as grocery stores, convenience marts, and large discount retailers.


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