On my public health rotation as a third-year pharmacy student, I was assigned to investigate dextromethorphan (DXM) abuse in minors, with the goal of raising awareness of this problem in the community. To my surprise, DXM abuse turned out to be a larger problem than I had anticipated. There is an unfortunate public perception, especially in teenagers, that since DXM is an over-the-counter medication, it is not dangerous. It doesn't have the stigma of illicit drugs such as cocaine, methamphetamines, or heroin.
DXM is known by its street names: Triple-C, Candy, Dex, DM, Drex, Red Devils, Robo, Rojo, Skittles, Tussin, Velvet, and Vitamin D. Those who use the cough syrup to get high are sometimes called "syrup heads," and DXM abuse is often called "dexing," "robotripping," or "robodosing.
Minors and most of the public do not understand that DXM, a cough suppressant, is also a central nervous system depressant. Ingesting large quantities can lead to irregular heartbeats, blackouts, seizure, brain damage, and even death. Minors who ingest combination drugs for recreational purposes — for example, dextromethorphan and acetaminophen — risk developing other complications, such as liver damage, in addition to the effects caused by DXM.
A national survey of 45,000 teenagers conducted in 2010 by the University of Michigan's Institute of Social Research indicated that 3.2% of 8th graders, 5.1% of 10th graders, and 6.6% of 12th graders claimed that they had abused DXM during the previous year.
According to WebMD and the Consumer Healthcare Products Association, 1 in 10 teenagers say they've used DXM to get high; such a claim would make DXM more popular than LSD, cocaine, ecstasy, or methamphetamine.
In California, the Poison Control System reported that the subject of DXM abuse has been the most common telephone consultation provided to those between the ages of 6 and 17 since 2003.