Addiction to Cough Medicine

10/02/19: Addiction Recovery
Cough syrup is intended to be used to ease flu-like symptoms that arise with viruses and infections such as the flu, bronchitis, and even the common cold. Prescription and over-the-counter cough medicine can provide much-needed relief from the uncomfortable symptoms of these illnesses, but unfortunately the same ingredients that work to suppress negative symptoms can also make the user feel high if over-consumed. This, like many substances that create the feeling of being “high”, can lead to addiction if abused over the long term. Cough syrup misuse is especially prevalent among teenagers, because it’s easily accessible as an over-the-counter medicine, and can be purchased at pretty much every pharmacy. Codeine is less likely to be misused because it is only available via prescription, however, it is still common enough to be a serious issue. In this article, we will outline the dangers of cough medicine, and how you can prevent friends and family members from falling victim.

What is cough medicine?

There are two types of cough medicines that are commonly abused:
  • Dextromethorphan (DXM) cough syrup, tablets, and gel capsules. This kind of cough medicine can be purchased over the counter (OTC), and are safe and beneficial in helping suppress coughs and cold symptoms if used as directed on the bottle. However, taking more than the recommended dose can actually produce a “high”, causing some to feel as if they are detached from their physical body (dissociative effects).
  • Promethazine-codeine cough syrup. This kind of cough medicine contains an opioid drug called codeine. This is more likely to get the user high if they take more than the prescribed dose, and may become addicted more easily.

Why do people abuse cough medicine?

Back in the 70s, codeine could be found in most OTC cough medicines, which meant that teens and adults alike could just walk to their nearest pharmacy and get their hands on an extremely dangerous and addictive substance without much effort. However, the Food and Drug Administration has since replaced codeine with dextromethorphan. Unfortunately, while this did cut down on the numbers of people abusing cough medicine, it didn’t solve the underlying issue of people using cough medicine to get high. Why? Well, it turns out they began to discover that dextromethorphan could also create a feeling of being high if taken in large amounts.

How is cough medicine abused nowadays?

Because a person has to drink/consume large amounts of cough medicine in order to achieve a high, methods of separating the dextromethorphan have been developed. It is possible to buy dextromethorphan in pure powder or tablet form online. One common way to get a fix is by taking “Triple-C” (Coricidin HBP Cough and Cold) which contains 30 mg of dextromethorphan in small red tablets. These contain antihistamines as well, which if taken in large amounts can pose additional health risks.

How does cough medicine addiction work?

Both codeine and promethazine (common ingredients in cough medicine) slow down activities in the central nervous system (brain and spinal cord), which produces calming effects. These ingredients actually change the way the brain works by interrupting the normal communications between nerve cells (known as neurons). The brain is made up of billions of these cells, which are organized into circuits and networks that allow the brain to send signals. These neurons communicate by sending signals to each other by “firing” off information through the network to different parts of the brain, as well as the spinal cord, nerves, and peripheral nervous system. When sending a message, a neuron releases what is called a neurotransmitter into the synapse (AKA the gap between the original neuron and the next cell). The neurotransmitter crosses the synapse and connects to receptors on the next neuron which stimulates the receiving cell. Transporters then recycle the neurotransmitters by returning them to the neuron that originally released them, and this closes the signal between neurons. Addictive substances like the ones found in cough medicine are so pleasurable to us because they flood the brain’s reward system with dopamine in a short amount of time, something that we cannot get via the natural process of the neurons. Meanwhile, the hippocampus stores this information as pleasurable memories and the amygdala creates a conditioned response to certain stimuli. Dextromethorphan acts in a way that is similar to hallucinogenic drugs like ketamine or PCP. A single high dose of dextromethorphan can cause hallucinations. It can also cause a dissociative state, which can make the user feel separated from their body or environment, or affect the processing of your thoughts. Codeine, on the other hand, attaches to the same cell receptors as opioids such as heroin. Codeine and promethazine slow down activities in the central nervous system (brain and spinal cord) to produce calming effects. Large doses of promethazine-codeine cough syrup mimic the effects of other opioids, and like other opioid drugs, the user must continue to increase the amount of the drug they take in order to replicate the feeling of being high. This, as we know, leads to addiction.

Health risks associated with abusing cough medicine

A safe yet still effective dose of dextromethorphan is 15–30 milligrams. However, abusers may consume over 360 milligrams. This leads to not only negative physical effects, but is detrimental to a person’s mental health as well. Possible side effects of dextromethorphan are:
  • Confusion
  • Impaired judgment
  • Blurred vision
  • Dizziness
  • Paranoia
  • Excessive sweating
  • Slurred speech
  • Nausea
  • Vomiting
  • Abdominal pain
  • Irregular heartbeat
  • High blood pressure
  • Headache
  • Lethargy
  • Fever
  • Numbness of fingers and toes
  • Flushed face
  • Dry/itchy skin
  • Loss of consciousness
  • Seizures
  • Brain damage
  • Death
Side effects of promethazine-codeine are:
  • Urinary hesitancy
  • Inability to urinate
  • Rapid heartbeat
  • Low blood pressure
  • Drowsiness
  • Agitation/nervousness
  • Confusion
  • Hallucinations
  • Depression
  • Fever
  • Unsteadiness
  • Restlessness
  • Seizures
  • Tremors
  • Dry mouth
  • Flushed skin
  • Involuntary tongue movement
  • Dilated pupils
  • Blurred vision
  • Muscle stiffness
  • Muscle spasms

Alternatives to cough medicine

If you or your child are experiencing uncomfortable symptoms from an illness such as the cold or flu, but you are concerned about using cough medicine, there are a few things to consider. Firstly, remember that OTC cough medicine is perfectly harmless when following the recommended dose and instructions outlined on the bottle. This article may have made these medicines seem scary, but put this into perspective: TONS of legal, safe substances can become dangerous when taken in excess, even water! So don’t stress if your doctor prescribes cough medicine or recommends an OTC brand — as long as you follow the instructions, the medicine will do its job with little to no negative side effects. One has to actively try to overdose, so the extremely damaging or life-threatening symptoms will not be a risk for those who use the medicine responsibly. However, if the symptoms you are experiencing are mild, or perhaps you’ve struggled with addiction in the past and would prefer to stay away from these substances, here are some things you can do to help abate cold and flu symptoms naturally:
  • Tea with honey and lemon. Brewing tea with honey and lemon can help soothe sore throats and ease coughing. Honey has anti-bacterial and anti-inflammatory properties, and can coat the throat, making swallowing and coughing less painful. This study even showed that children saw greater relief from nighttime coughing with honey than they did with dextromethorphan!
  • Ginger tea. Ginger also has anti-inflammatory properties and can help ease coughing, nausea, and pain.
  • Drinking plenty of fluids and staying hydrated. Staying hydrated is crucial for recovery. Aside from water, clear broths, herbal teas, and low-sugar fruit juices and vitamin drinks are all good options.
  • Steam. Steam can help moisturize your throat and nasal passages, relieving any burning sensations from dryness. It can also help open the lungs and airways.
  •  Saltwater gargle. Gargling with warm salt water is one of the simplest yet most effective remedies for a sore throat.
  • Rest! Rest and sleep allow your body to slow down and focus on fighting the infection or virus within your body, so never feel bad about taking time to relax!

Content for Arizona Addiction Recovery Centers created by Cohn Media, LLC. Passionate and creative writing and broadcasting, covering the following industries: addiction rehab, health care, entertainment, technology and advocate of clear communication, positivity and humanity at its best. www.cohn.media


If you or someone you know needs help with addiction, contact 602-737-1619 or email info@arizonaaddiction.com to get the help you need. Our acclaimed recovery environment merges upscale, luxury accommodations with affordability, clinical expertise and an unwavering commitment to patient care and aftercare.

Recent Posts