PREVENTING TEEN OTCRESOURCES FOR MORE
INFORMATION
If you think your teen needs professional
help, your doctor, hospital, school nurse, orcounselor may be able to help. Or you can call
1.800.662.HELP(4357) or visit
findtreatment.samhsa.gov, the treatment
locator hotline and website of the U.S.
Substance Abuse and Mental Health Services
Administration. If you suspect a poisoning,call Poison Help at 1.800.222.1222.

CoughMedicine
Abuse

WHAT IS
COUGH MEDICINE ABUSE?
Over-the-counter (OTC) cough medicine abuse
is taking large doses of cough medicine to gethigh. The “high” is caused by dextromethorphan,which is often abbreviated DXM, a common active
ingredient found in many cough medicines. This
sort of abuse — whether it’s called cough medicine
abuse or dextromethorphan or DXM abuse — canbe dangerous.

SIDE EFFECTS
FROM DEXTROMETHORPHAN(DXM) ABUSE CAN INCLUDE:• Nausea and vomiting• High blood pressure• Stomach pain

• Physical impairment• Confusion• Double or blurred vision• Dizziness• Drowsiness• Slurred speech• Numbness of fingers & toes

• Rapid heart beat• Disorientation

What Are Slang Terms for
Dextromethorphan?
The most common terms include:

To learn more about medicine abuse andto get help for your family, visit Partnership
to End Addiction at drugfree.org or text
CONNECT to 55753 to be connected with aspecialist.

DXM

Dex/Drex

RoboSkittles

Syrup

Tr iple - C

TussinIs Dextromethorphan (DXM)
Addictive?
DXM, when used as directed, is not an addictive
substance. However, repeatedly seeking the “high” caused
by abusing DXM can lead to addiction.

Terms for abusing dextromethorphan include:
Robo-ingSkittling

Robo-tripping

LeanDexing

How Common Is
Cough Medicine Abuse?
According to the National Institute on Drug Abuse’s 2021

SLANG TERMS for dextromethorphan
vary by product and region. Adults should
be familiar with all of them.

Additional copies of this brochurecan be ordered free of charge from
StopMedicineAbuse.org.

Monitoring the Future survey, the number of American
teens who self-reported they abused OTC cough andcold medicine to get high in the last year declined from2020. Yet there is still work to be done — given that
3.5% of 8th graders reported abusing OTC coughWhat About Codeine?
OTC cough medicines containing dextromethorphan (DXM)

A PARENT’S GUIDE

should not be confused with promethazine-codeine coughand cold medicine in 2021, which is down from the4.6% who reported abuse in 2020 but still much higher
than the 1.6% who reported abuse in 2015.

medicines — also known as lean — which is a prescription
cough syrup also commonly abused by teens. While the termlean technically refers to the abuse of prescription coughmedicines containing codeine, teens may use the slangterm broadly to refer to the abuse of OTC cough medicinescontaining DXM.

2.7%of teens

have abused cough medicine

WHAT PARENTS CAN DO TO
PREVENT COUGH MEDICINE ABUSE
Educate Yourself• Educate yourself about cough medicine abuse
and share this information with others whoare in contact with your teen, such as school
administrators, coaches, and counselors.
• Know your state’s laws: 21 states prohibit
the sale of DXM products to minors (underthe age of 18). Find out if your state isone of them by visiting CHPA’s page on
Preventing Dextromethorphan Abuse athttps://www.chpa.org/about-consumerhealthcare/activities-initiatives/preventingdextromethorphan-abuse.
Talk to Your Teens• Be clear that you do not want your teentaking medicine without your knowledge.
• Teach your teens and younger children torespect medicines. Medicines are important
tools in healthcare, but they must be usedaccording to their directions.
• Make sure your teen understands thatabusing cough medicine — just like abusing
illegal drugs — can be very dangerous.
Safeguard Medications• Know what medicines are in your home andtake notice if they go missing.
• If your teen needs medicines during school
hours, speak with school officials about
medicine policies.

Where Are Teens Finding Information about
How to Abuse Cough Medicine?
Often, these teens learn about abusing coughmedicine on the Internet, particularly through theuse of social media sites and forums, as well as
elements of pop culture such as music. Some ofthese sources even recommend how much coughmedicine to take to get high; suggest other drugs tocombine with dextromethorphan (DXM); or, instruct
how to extract or “free-base” DXM from coughmedicines and promote drug abuse in general. Beaware of what your teen does on the Internet, thewebsites they visit, and the amount of timethey are online.

Recognize Signs Your Teen Is Using Drugs
Parents don’t always recognize their kids might beusing drugs.
While it can be hard to know, there are some general
warning signs. The fact is, any teen could be usingdrugs. As a general rule, changes that are sudden or
extreme may be a warning sign.
SIGNS your teen could beusing drugs include:• Change in friends• Change in eating or sleeping patterns• Changes in physical appearance and hygiene• Declining grades• Empty drug or medicine containers or drug
paraphernalia

MORE TIPS FORRAISING DRUG-FREE TEENS
Monitoring is an effective way you can help yourteen stay drug-free, and an important thing to doeven if you don’t suspect your teen is using drugs.
Monitoring means asking your teen questions
about where they’re going, what they’re doing,
and with whom they’re spending time, as well as
keeping tabs on their Internet use by using web
browser tools and software designed to blockcertain sites. If your kids ask you about
your monitoring, let them know that it is
not because you don’t trust them and thatyou are not trying to catch them in the act. Like
any parent, you are simply being good stewards oftheir well-being and future. Put some of these tips
to use, and your teens will benefit.

Know Where Your Teen Is
It’s important to know where your teen is and what
they are doing. Research has shown that children
without adult supervision are at significantly
greater risk of truancy from school, stress, receiving
poor grades, risk-taking behavior, and substanceabuse.

Introduce Your Teen to Adult Role Models
Find out what adult-supervised activities — likeclubs or after-school sports — interest your teenand help get them involved. Connect with otheradults who can help teens avoid the dangers ofdrugs, and reinforce the benefits of healthy,drug-free living.

• Loss of interest in hobbies or favorite activities

Know Your Teen’s Friends• Hostile and uncooperative attitude

Research by Partnership to End Addiction(drugfree.org) shows that teens are more likely totry drugs if they have friends who get high. Parents
need to know the friends with whom their children
are spending time.

• Unexplained disappearance of household money• Unusual chemical or medicinal smells on yourteen or in their room

Helping a Teen Who Is Using Drugs
The goal is to prevent a drug abuse problem inthe first place. If you fear, however, that your teen
may have a problem, sit down with them for an
open discussion. Voice your suspicions but avoid
direct accusations. Remain calm and rational,
ask your teen what has been going on in their life,and discuss ways to avoid using substances in thefuture. Do not have this conversation when yourteen is under the influence.
Be firm and enforce whatever discipline you’ve laidout in the past for breaking house rules. Remind
your teen that this discipline is grounded in care for
their health, happiness, and future. Be sure to also
discuss ways your teen can regain your lost trust,such as calling in, spending evenings at home, or
improving their grades. If you need help with theconversation, ask another family member, yourteen’s guidance counselor, or a physician.

What Cough Medicines Contain
Dextromethorphan, or DXM?
There are over 100 OTC medicines that contain DXM,
either as the only active ingredient or in combination
with other active ingredients.
A number of store brand cough medicines contain
DXM as well. To know if a product contains DXM,
look for “dextromethorphan” in the active ingredientsection of the OTC Drug Facts label. Also look for the“PARENTS” label shown above on the packaging ofmost OTC medicines containing dextromethorphan.