Triple C, Skittles, Candy, Red Devils–what do all of these seemingly innocuous things have in common? They sound like treats but in truth represent a much more dangerous and nefarious type of over-the-counter drug. These various names refer to dextromethorphan, known more commonly under the brand names Coricidin HBP Cough & Cold (“Triple C”) and Robitussin. Teens have learned to enjoy the high from cough medicine so much that it’s become known as skittling, robotripping, and more. To make it worse, Triple C is completely legal for minors to purchase in 30 states. The 20 states which have put age restrictions on buying dextromethorphan products points to an ongoing problem. Teenagers routinely abuse this over-the-counter (OTC) product to get a cheap and legal high.
What is Dextromethorphan (DXM)?
Although the proliferation of fentanyl among youth has overtaken popular discourse in media, opioids do not represent the only common drug of abuse for young people. Dextromethorphan has been a popular choice for recreational drug use among teens for decades. Its availability and lack of pharmaceutical restriction in many states puts it as an easy target for teens to procure legally in most states.
So what is dextromethorphan, chemically speaking?
Although structurally similar to other narcotics, DXM does not act as a mureceptor opioid (e.g. morphine, heroin). DXM and its metabolite, dextrorphan, act as potent blockers of the Nmethyl-d-aspartate (NMDA) receptor. At high doses, the pharmacology of DXM is similar to the controlled substances phencyclidine (PCP) and ketamine that also antagonize the NMDA receptor. High doses of DXM produce PCP-like behavioral effects.
This “high” intrigues enough teenagers and young adults enough to create drug-seeking behavior and potentially lead to more serious addictions. It’s important to recognize the symptoms of triple C abuse in minors as it may be a red flag. At the same time, triple C remains unregulated by the federal Controlled Substances Act. Its abuse potential is rated moderate as a hallucinogen.
Triple C Abuse Examples: Common Cough & Cold Medications
Many legal OTC products contain dextromethorphan, the active ingredient in triple C. The most common include Coricidin products such as:
- Cough Cold Medicine Coricidin HBP
- Maximum Strength Flu Coricidin HBP
- Chest Congestion & Cough Coricidin HBP
This medication is one of the most popular because it contains some of the highest doses of dextromethorphan. Coricidin HBP contains 30mg of DXM whereas other leading brands have half that amount. Other common brands that contain DXM include Mucinex, Robitussin, Nyquil, and Delsym. The medication comes in several forms including pills, liquid gel capsules, and powder. Furthermore this means they can be swallowed, snorted, or injected.
Side Effects of Triple C Robotripping Abuse
Cough medications present side effects when used at moderate to high doses. Side effects of abuse include:
- Hallucinations
- Poor muscle control
- Dizziness
- Paranoia
- Slurred Speech
- Vision changes
- Brain damage
Repeatedly abusing Coricidin products may eventually result in adverse reactions or overdose. Symptoms of a DXM overdose include breathing problems, seizures, heightened body temperature, and coma. Also, prolonged exposure to high doses of DXM can cause toxic psychosis. Case reports include individuals presenting in ER with DXM toxicity, hallucinations, and serotonin syndrome from repeated triple C abuse.
Legitimate Uses of Dextromethorphan
Dextromethorphan generally acts as a cough suppressant. This serves a very useful purpose in itself and represents most of the legitimate usage of the product. But beyond cough suppression and the abuse of DXM by adolescents, dextromethorphan also goes toward other pharmaceutical uses. One example of this is the prescription drug Auvelity. Auvelity’s active ingredients include dextromethorphan and bupropion. The drug acts as an antidepressant which acts on the NMDA receptors. Due to the presence of bupropion (the active ingredient in Wellbutrin), Auvelity requires a prescription to obtain.
Help for Triple C Abuse
The first step to handling triple C abuse is prevention. Parents of at-risk teens should closely monitor both medicine cabinets at home and their child’s internet use (as DXM can be sold online). Triple C can act as a gateway to more dangerous drugs of abuse as well. Many adolescents and adults in recovery for substance abuse began their struggle with addiction by using legal OTC meds such as DXM.
If you or a loved one is seeking help for a substance abuse problem, our counselors at Blue Coast Behavioral Health are available 24/7 by phone: 714-203-2708
