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Abusing Cough Syrup: The Dangers in Doses

Abusing Cough Syrup: The Dangers in Doses

Author: Justin Mckibben

It truthfully isn’t anything new, although many people don’t often understand how prominent abusing cough syrup has become. There have been news stories and headlines before about teens abusing cough syrup, parents being warned of how to spot this kind of risk behavior, but still people don’t all seem to understand the gravity of this abuse.

Names like “sizzurp” AKA “purple drank” have been popularized by pop-culture, but these pertain to the cough syrup combination of codeine and promethazine, a harder to obtain mixture.

However medicine containing DXM is frequently sold over-the-counter. Although in some states, you need to be 18 years old to purchase it, it does not require a prescription which increases their general accessibility to those looking for a “household high.” The truth is, even over-the-counter this drug is deadly.

Abusing Cough Syrup

Cough syrup has been abused as a cheap high, but the dangers in the doses are so much more than many people suspect.

Dextromethorphan (DXM) is the active ingredient in many brand-name cough suppressants such as:

  • Coricidin
  • NyQuil
  • Robitussin

DXM has long been abused by young adults to achieve a high, but abusing cough syrup means users must take multiple times the doses recommended for treating colds. Some abuse cough medicine by consuming an entire pack of gel caps or even multiple bottles of syrup.

The reality is that most people underestimate abusing cough syrup because it is legal and such a common thing found in almost every medicine cabinet across the country. However the danger in these doses makes abusing cough syrup a potentially lethal legal high.

The effect experienced from the abuse of DXM is typically categorized into four stages:

  1. Mild stimulation
  2. Euphoria and hallucinations
  3. Dissociative out of body state
  4. Complete dissociation with unresponsiveness

Different DXM Drug Effects

Chlorpheniramine, the antihistamine in Coricidin, causes “anticholinergic” effect in high doses, which has effects including:

  • Agitation
  • Tremors
  • Delirium
  • Hallucinations
  • Coma

Acetaminophen appears as the last active ingredient in Coricidin, as well as myriad other over-the-counter and prescription medications. This ingredient is frequently taken with other medications sometimes also containing the drug, making accidental overdoses a fairly frequent occurrence.

An overdose of Acetaminophen can cause delayed liver damage and can do enough damage to require an organ transplant.

The combination of cough syrup abuse and other substances often exaherbates the effects of the DXM and other drugs included in the cough syrup’s formula. This puts those abusing these over-the-counter meds at an even more elevated risk of causing some devastating damage.

Stacking the SAMHSA Stats

The Substance Abuse and Mental Health Services Administration (SAMHSA) has taken some interest in cough syrup abuse, and according to their stats:

  • 1 million youth and young adults in the United States, ranging from ages 12 to 25, misuse over-the-counter (OTC) cough and cold medicines that contain dextromethorphan each year.
  • Non-medical abuse of DXM results in approximately 6,000 emergency department visits annually in the U.S.
  • Adolescents (ages 12 to 20) accounting for almost 50% of these emergency department visits

This phenomenon appears to be increasing throughout the country, even though cough syrup has never been as well known as other narcotic drugs. with potentially lethal consequences for those who partake.

A Medical Toxicology fellow at UCSF named Annie Arens stated calls to the California Poison Control Center concerning teens abusing Coricidin have jumped from 3% to 25% of all calls to the Center in the past few years, with no signs of slowing down.

Some teens are aware even of the dangers of acetaminophen overdose, purposely purchasing Coricidin to abuse that is acetaminophen-free. Yet they willingly take on the threats of overdosing on DXM and chlorpheniramine. Some are aware of the increased hazards of taking DXM with alcohol.

What many young people don’t seem to know is that when taken with antidepressants like MAO inhibitors or SSRIs, even in a regular daily dose, DXM may produce a life-threatening serotonin syndrome.

Either way despite all that has happened, some parents are still very unaware of the potential of abusing DXM cough syrups and how fatal it can be. Many parents and acquaintances often leave these substances around the house, oblivious to the perils that are blended into the medicine when young adults and teens misuse it to catch a cheap buzz. The truth is the buzz can kill, and the cost of life definitely should never be as cheap as a bottle of over-the-counter cough syrup.

Whether a drug is a street narcotic, prescription medication or an over-the-counter medicine drug abuse is dangerous and can even be deadly. Abusing drugs often leads to addiction and often stems from a much more complex problem, but there is real help out there. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135


Crazy Drug Trends: Loperamide Addiction?

Crazy Drug Trends: Loperamide Addiction?

Loperamide is an opioid drug used against diarrhea resulting from gastroenteritis or inflammatory bowel disease. In most countries it is available generically and under brand names such as, Imodium and Pepto Diarrhea Control.

Studies on How Loperamide Works

Loperamide is an opioid-receptor agonist and acts on the opioid receptors in the large intestine; by itself it does not affect the central nervous system. It works similarly to morphine, by decreasing the activity of the this part of the large intestine by increasing the amount of time substances stay in the intestine, allowing for more water to be absorbed.

It is a misconception that loperamide does not cross the blood–brain barrier. Loperamide does cross the blood brain barrier (BBB), although it is immediately pumped back out into non–central nervous system (CNS) circulation. Therefore, it is not considered to have a high potential for abuse.

Loperamide has been shown to cause a mild physical dependence during preclinical studies, specifically in mice, rats, and rhesus monkeys. Symptoms of mild opiate withdrawal have been observed following abrupt discontinuation of long-term therapy with loperamide.

Loperamide Addiction Potential

A specific clinical study designed to assess the abuse potential of loperamide at high doses resulted in a finding of extremely low abuse potential.

Studies in morphine-dependent monkeys demonstrated that loperamide hydrochloride at doses above those recommended for humans prevented symptoms of morphine withdrawal. However, in humans, the pupil test, which when positive indicates opiate-like effects, performed after a single high dose, or after more than two years of therapeutic use of loperamide hydrochloride, was negative. Orally administered loperamide formulated is both highly insoluble and penetrates the CNS poorly.

It was concluded that in its present form, i.e., capsules containing loperamide mixed with magnesium stearate, loperamide poses little threat of potential abuse.

To take enough loperamide in order to achieve any kind of “high” effect, one would have to take well over the recommended daily amount, which would cause lots of discomfort and harm.  Adverse drug reactions associated with taking high doses of loperamide include abdominal pain and bloating, nausea, vomiting and constipation. Rare side-effects associated with loperamide are bowel obstruction, dizziness and rashes.

Loperamide Addiction: Personal Testimonials

This writer has trolled some drug forum blogs to see what people are saying about loperamide addiction and if it’s possible to be addicted to Imodium and similar over-the-counter medications. Many of the contributors report that they have used Loperamide to help deal with, apparently somewhat successfully, with opiate withdrawal symptoms. Others report taking very high doses of 100 mg or more per day (not recommended) in order to achieve a euphoric affect. The experience, they report is not nearly as intense as that of narcotic painkillers but, they say, it lends a sense of overall well-being.

Loperamide Addiction: Physical Withdrawal Symptoms

The strongest indication of loperamide addiction and dependence is the withdrawal symptoms that follow once you stop taking it. There are, indeed, reports of experiences of opiate-like withdrawal symptoms from the cessation of Imodium and other loperamide-containing OTCs. Symptoms such as sweats, shakes, cramps, diarrhea, and muscle aches have been reported following abrupt discontinuation of long-term therapy with loperamide.


 If you or someone you know is struggling with drug dependence, substance abuse, or drug addiction please call toll free 1-800-951-6135












Everyday Things that Can Make You Fail a Drug Test

Everyday Items that Can Make You Fail a Drug Test

Anyone who has ever had a false positive on a drug test knows the frustration and stress it can cause. You find yourself in defense mode knowing you did nothing wrong and yet the test clearly shows you failed for THC, PCP, meth, whatever it is. How do you combat with scientific proof? You can’t really. This is why it is not only imperative to know what everyday things that can make you fail a drug test but also so the next time you get asked for a urine sample you can be prepared. The stress of a false positive and the repercussions just aren’t worth, say, that poppy seed bagel or Aleve.

Here are a few everyday things that can make you fail a drug test:

Poppy Seeds:

Heroin, morphine and opium as some of you may know are derivatives of the opium poppy (there is also just poppies which are flowers also, actually the state flower of California) and are all opiates. So how does this factor into everyday things that can make you fail a drug test? Well, even the poppy seeds you find on muffins, bagels and all kinds things contain trace amounts of what can make heroin and morphine. Poppy seeds have been causing false positives on drug tests for decades now. Many people have been wrongly fried or not hired because of them too.


Advil is just a brand name for ibuprofen and ibuprofen is an over-the-counter painkiller. Be wary though if you have a headache right before your drug test and want to pop a few of these though. If you have a drug test you might be better off taking something like aspirin or acetaminophen. Why? Ibuprofen can incorrectly be identified as THC. THC is the stuff in pot that causes the high. This type of false positive isn’t very common anymore but it is probably best that you mention if they asked if you took anything before the test, that you did in fact take ibuprofen or that you just keep it out of your system all together.


Sudafed is one of the worst culprits for false positives. It is definitely an everyday item that can cause you to fail a drug test. Sudafed can be mistaken on a drug test for a whole slew of hard-core drugs. This is because Sudafed’s primary ingredient is pseudoephedrine which is basically amphetamine. Pseudoephedrine is often used to make meth which is why it isn’t even sold over the counter in most states. So if you have a cold the night before your drug test, don’t take Sudafed.


Azo is one of the few things that you can take over the counter that will help with a urinary tract infection. The thing about Azo though is that many people who are actually taking drugs will use it to try and beat drug test. This is because Azo basically strips your urinary tract system. Someone who actual has done drugs will take a ton of Azo to try and pass their drug test. Azo will make your urine bright red or yellow and this is usually a red flag to the person administering the test. If the test is flagged it might just go through as a false positive until it is sent to the lab or you may just have to take the test again.

And there you have it! Those are a few of the everyday things that can make you fail a drug test. Next time you know you have a test coming up make sure to stay away from these things and you should be fine. Also stay away from actual drugs. Drugs are bad.

If you or someone you love is in need of alcohol or drug addiction treatment, please give us a call at 800-951-6135.


Over-the-Counter Drug Abuse

Over the counter drug abuse

Over-the-counter drug abuse is pretty common among drug users in general but is most common in teens. Over-the-counter drug abuse is appealing to teens because the drugs that they use to get high are widely available and totally legal. Many OTC (over-the-counter) drugs don’t require you to be any specific age to buy either. Here are some of the most common substances that are a part of over-the-counter drug abuse.

Over-the-counter drug abuse: DXM

The most common and queen bee of OTC drugs is dextromethorphan (DXM). DXM is the active ingredient in many nonprescription cough and cold medicines. Those products are safe when taken as recommended, but very large doses can lead to euphoria and impaired judgment — as well as nausea and vomiting, loss of coordination, and increased heart rate. DXM’s street names include “Orange Crush,” “Triple Cs,”  “Dex,” “Robo,” and “Skittles.” When combined with alcohol or other drugs, a large dose can lead to death. For example, Coricidin HBP Cough and Cold includes both dextromethorphan to treat a cough and chlorpheniramine to treat a runny nose. But chlorpheniramine alone abuse by itself has led to numerous deaths and hospitalizations. Dextromethorphan is also addictive and can cause withdrawal symptoms, including depression and difficulty processing thoughts, when the abuse stops. Not much is known about long-term abuse, but cases of bone marrow and nerve cell damage, high blood pressure, heart damage, and permanent brain damage have been reported.

Over-the-counter drug abuse: Pseudoephedrine

Pseudoephedrine is commonly found in nonprescription cold medicines. It’s used as an ingredient for making the illegal drug methamphetamine (“meth”). That’s why there are laws limiting the amount of pseudoephedrine-containing drug products that can be bought at a time. Abuse may be less common with pseudoephedrine than with other OTC medicines due to a federal law requiring it to be kept behind the pharmacy counter, limiting the purchase quantity, and requiring photo identification prior to purchase. However, people have taken pseudoephedrine to lose weight, and athletes have misused the medicine to increase their state of awareness and to get them “pumped up” before a competition. Dangerous side effects include heart palpitations, irregular heartbeats, and heart attacks. When combined with other drugs, such as narcotics, pseudoephedrine may trigger episodes of paranoid psychosis.

Over-the-counter drug abuse: Motion sickness pills

Motion sickness pills that contain dimenhydrinate (Dramamine) or diphenhydramine (Benadryl) taken in large doses can cause one to feel high and have hallucinations similar to street drugs. The dose needed to cause these symptoms varies widely according to body weight and tolerance. Some teens and adults may take as many as 40 pills of Dramamine, for example, to experience the desired high. Extremely high doses of Dramamine have caused dangerous irregular heartbeats, coma, heart attacks, and death. Long-term abuse can cause depression, liver and kidney damage, memory loss, eye pain, itchy skin, urine retention, and abdominal pain.

Over-the-counter drug abuse: Laxatives and herbal diuretics

Like diet pills, some teens and young adults also abuse OTC laxatives and herbal diuretics (water pills), including uva-ursa, golden seal, dandelion root, rose hips, and others, to lose weight. Laxatives and herbal diuretics can cause serious dehydration and life-threatening loss of important minerals and salts that regulate the amount of water in the body, acidity of the blood, and muscle function.

OTC drug abuse can be highly dangerous especially when mixing over-the-counter drugs with other substances. Anyone who is active in over-the-counter drug abuse is probably on a path if not already on one towards heavier drug abuse too so be aware.

If you or your loved one is in need of treatment for over-the-counter drug abuse please give us a call at 800-951-6135.


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