The idea that your child could be abusing alcohol or illegal drugs is scary enough. In fact, you also need to be aware that he or she could be abusing the over-the-counter medications in your home – a very real concern for parents of adolescents. This guest post by Peggy McKibben, a high school nurse, will tell you what you need to know and what to do.

headshot_peggyEver heard of DXM? If not, don’t worry. You’re not alone.

Dextromethorphan, or DXM, is the active ingredient in most over-the-counter (OTC) cough medicines, and is the most widely used cough suppressant ingredient in the United States. When taken as directed by labeling instructions, medicines that contain DXM are safe and effective. However, when taken excessively, DXM can produce dangerous side effects.

While millions of Americans rely on OTC cough medicines to relieve their cough, approximately one out of 30 teens reports abusing it to get “high”, and one out of three teens knows someone who has abused OTC cough medicine to get high. At times, this abuse involves taking more than 25 times the recommended dose of these medicines.

As a high school nurse, I hear about teens experimenting with OTC medicine abuse to find temporary relief from everyday stressors, such as academic or peer pressure. Some teens are particularly drawn to abusing OTC cough medicine because it is affordable, perceived to be easily available and misconceived to be safer than illicit drugs. Common myths about this type of substance abuse and a lack of awareness among parents are barriers to preventing it. Of course, the first step to preventing OTC cough medicine abuse is to educate yourself, so let’s dive in!

DXM is found in over 100 OTC medicines today. These medicines come in the form of liquids, capsules, gel caps, lozenges, and tablets. You can find a list of products that contain DXM here.

You can also identify products that contain DXM by taking the following actions: 1) Look for the Stop Medicine Abuse icon on boxes and bottles, and 2) Read the Drug Facts label to see if dextromethorphan is included in the list of Active Ingredients.


Now that you know what DXM is and how to determine whether it is an active ingredient in your medicines, let’s go over how to identify signs of OTC cough medicine abuse.

Common warning signs of OTC cough medicine abuse include:

  • Empty cough medicine boxes or bottles in the trash of your teen’s room
  • Missing boxes or bottles of medicine from home medicine cabinets
  • Hearing your teen use certain slang terms for DXM abuse, such as skittles, skittling, tussin, robo-tripping, robo, CCC, triple Cs, dexing and DXM
  • Changes in your teen’s friends, physical appearance or sleeping or eating patterns
  • Your teen’s loss of interest in hobbies or favorite activities

Common side effects of OTC cough medicine abuse include:

  • Nausea and vomiting
  • Confusion
  • Dizziness
  • Slurred speech
  • Drowsiness

Now that you’ve learned more about what teen OTC cough medicine abuse looks like, it’s time to get involved!

You can help prevent teen OTC cough medicine abuse by:

  • Talking with your teen about OTC cough medicine abuse. You can also visit with your teen to hear and discuss stories from real teens who have abused DXM.
  • Monitoring your medicine cabinets and your teen’s activities. Read the Drug Facts labels of your medicines, so you know which ones contain DXM. Take regular inventories of your medicines, so you can more easily determine when something has gone missing. Look for changes in your teen’s attitude and behaviors, so you can recognize warnings signs and side effects of OTC cough medicine abuse.
  • Sharing what you have learned with other parents and members of your community.

Learn more at

Peggy is a mother of two and a high school nurse with a passion for promoting good health among teens. As one of The Five Moms for the Stop Medicine Abuse campaign and through her involvement with the National Association of School Nurses (NASN), Peggy works to educate her students and her community on the dangers of medicine abuse. Join the conversation by following Stop Medicine Abuse on Facebook and Twitter.

Teenagers, Alcohol and Brain Damage

The impact of alcohol and drug abuse on the developing adolescent brain is the subject of Chapter 10 of my new book: How Your Teen Can Grow a Smarter Brain.

You can grow the bond with your child through better listening. Download the FREE ebook, Listening to Understand.