While millions of Americans safely rely on over-the-counter (OTC) cough medicine to temporarily relieve cough symptoms, approximately 1 in 27 teens reports abusing it to get high.
What is DXM?
Dextromethorphan (DXM) is the active ingredient in most OTC cough medicines.
Approved by the U.S. Food and Drug Administration in the 1950s, DXM is the most widely used cough suppressant ingredient in the United States. Millions of Americans rely on OTC cough medicines containing DXM for cough relief and when taken according to labeling instructions, these medicines safe and effective. However, when taken in excessive amounts higher than recommended doses, DXM can produce dangerous side effects.
Look for this icon on all OTC products that contain dextromethorphan.
What is DXM Abuse?
Studies show that roughly 1 in 4 teenagers knows someone who has abused OTC cough medicine to get high.
Since OTC cough medicines are more readily available and more affordable than prescription or illicit drugs, they are more accessible to teens. And the fact that they are legal and regulated products leads teens to think abusing them is less dangerous. In fact, some teens ignore labeling instructions and intentionally take large amounts of DXM — sometimes more than 25x the recommended dosage — to get high. This means ingesting multiple packages or bottles of OTC cough medicines.
Test your knowledge
How many adolescents talk to their parents about the dangers of substance use?
54%
Only 54% of adolescents between the ages of 12-17 report talking to their parents about the dangers of substance use.
How many teens in the 10th grade believe that abusing OTC cough and cold medicine to get high is risky?
32%
In 2024, only 32% of 10th graders reported that they see great risk in trying OTC cough and cold medicine (to get high).
How many teens have reported abusing OTC cough and cold medicines in the past year?
3.7%
The Monitoring the Future study has reported rates of OTC cough and cold medicine abuse since 2006. In 2024, the prevalence of abuse across 8th, 10th and 12th graders was reported at 3.7%.
How many 8th graders have abused OTC medicine?
4.4%
The percentage of 8th grade students who self-reported OTC medicine abuse in 2024 was 4.4%
Monitoring the Future Study
The Monitoring the Future study has been conducted under a series of research grants from the National Institute on Drug Abuse, a part of the National Institutes of Health. This study has tracked abuse rates of OTC cough and cold medicine across 8th, 10th, and 12th grade since 2006.
When used as directed, DXM is safe and effective. But when abused, it can cause harmful side effects.
Many DXM-containing medicines also include ingredients like antihistamines or decongestants. In large doses, these can lead to serious complications, including liver damage, heart issues, and extreme sedation.
Some teens mix DXM with alcohol, drugs, or energy drinks, further increasing the risk of harm.
Warning Signs
Empty medicine boxes or bottles in the trash or you’re your teens backpack
Purchase or use of large amounts of cough medicine when nobody is ill
Missing boxes or bottles of medicine from home medicine cabinets
Hearing your child use certain slang terms for DXM and DXM abuse, such as dexing, robotripping, and others (see full slang terms list)
Visiting websites that provide information on how to abuse DXM
Unexpected internet orders, the arrival of unexpected packages or unexplained payments
Changes in friends, physical appearance or 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 teen or in their room
Slang terms
Teens could be talking or texting about getting high on over-the-counter (OTC) cough medicine without you even realizing it. There are many slang words for dextromethorphan (DXM) abuse.
Learn them, listen for them, and talk to your teens if you hear them using the slang.
DXM or Dex
DXM: A common abbreviation for dextromethorphan, a drug in many cough and cold medicines.
Dex or DM: Street terms for cold and cough medicines with dextromethorphan.
Notably, Dex can also also be used as a slang term to describe dexedrine or dextroamphetamine, prescription stimulant medication primarily used to treat ADHD and narcolepsy.
Lean / Purple drank / Sizzurp / Dirty Sprite
Typically used to describe a combination of prescription cough syrup containing codeine, soda, and sometimes hard candy. Some teens use the term more broadly to describe dextromethorphan abuse as well.
Robo / Robotripping
Robo: Usually a reference to cough syrup with dextromethorphan. While it derives from the brand name Robitussin, it is common slang for any cough syrup.
Robotripping: Abusing products with dextromethorphan. The term refers to the hallucinogenic trips that people experience at high doses.
Syrup head
Someone who uses cough syrups or other products with dextromethorphan, codeine, or promethazine to get high.
Tussin / Tussing
Tussin: A term for cough syrup with dextromethorphan.
Tussing: A term for using products with dextromethorphan.
Dexing
A term for getting high on products with dextromethorphan.
Orange Crush
A term for some cough medicines with dextromethorphan or codeine. It may stem from the orange-colored syrup of certain brands.
Rojo
A term for cold and cough medicines with dextromethorphan. “Rojo” is Spanish for “red” and refers to the color of some syrups and pills.
Triple C’s or CCC’s / Red Devils / Red Hots / Skittles / Skittling
Triple C’s or CCC’s: A term for Coricidin tablets with dextromethorphan (slang from “Coricidin Cold and Cough”).
Red Devils or Red Hots: If you hear these terms, know your teen may not be talking about candy. They are both terms for cough medicine tablets or capsules which may be small and red.
Skittles / Skittling: Can be refer to Coricidin tablets with dextromethorphan and the abuse of these medicines as the tablets are similar in size and shape to the candy.
Velvet or Velvet Syrup
Terms for cough syrup containing dextromethorphan.
