Abuse of cough and cold medicines
Some over-the-counter and prescription cough and cold medicines contain active ingredients that are psychoactive (mind-altering) at higher-thanrecommended dosages, which results in them frequently being abused for this purpose. These products may also contain other drugs, such as expectorants and antihistamines, which are dangerous at high doses and compound the dangers of abuse.
Two commonly abused cough and cold medicines are:
Dextromethorphan (DXM), a cough suppressant and expectorant found in many OTC cold medicines. It may produce euphoria and dissociative effects or even hallucinations when taken in quantities greater than the recommended therapeutic dose.
Promethazine-codeine cough syrup, a medication that contains codeine, an opioid that acts as a cough suppressant and can also make the user feel relaxed and euphoric when consumed at a higher-than-prescribed dose. It also contains promethazine HCl (hydrochloride), an antihistamine that additionally acts as a sedative. Although only available by prescription, promethazine-codeine cough syrup is sometimes diverted for abuse by users.
Cough and cold medicines are usually consumed orally in tablet, capsule, or syrup form. They may be mixed with soda for flavor and are often abused in combination with other drugs, such as alcohol or marijuana.
Because they are easily purchased in drugstores without a prescription, cough syrups, pills and gel capsules containing DXM — especially the “extra strength” forms — are frequently abused by young people (who refer to the practice as “robo-tripping” or “skittling”). To avoid nausea produced by high doses of the expectorant guaifenesin, which is commonly found in syrups containing DXM, young people may instead abuse Coricidin HBP Cough & Cold capsules (street name: C-C-C or triple-C), which contain DXM but lack guaifenesin.
Drinking promethazine-codeine cough syrup mixed with soda (a combination called syrup, sizzurp, purple drank, barre, or lean) was referenced frequently in some popular music beginning in the late 1990s and has become increasingly popular among youth in several areas of the country. A variation of purple drank is a promethazinecodeine cough syrup mixed with alcohol.
It was the excruciating six-year rehabilitation process that propelled me to search for ways to save my own son as well as other teenagers who are addicted to new psychoactive substances.
In February 2004, I received a phone call asking me to go to the hospital because my 13-year-old son had collapsed at school and a positive result in a urine test suggested he was using drugs.
When he regained consciousness, my son assured me that he didn’t do drugs, but he admitted to drinking a preparation he called “cough syrup” before he collapsed.
Because it was the first time he had taken the drink and recovered quickly I didn’t take the matter seriously.
Three years later, my son panicked one day when he found a large amount of blood in his urine. He called me for help and repeatedly asked: “Am I going to die?”
He confessed that he had continued to drink the preparation in the three years since his collapse.
I immediately gave up my job as a senior marketing manager at a large life insurance company, and became determined to protect my son from new psychoactive substances, such as codeine in the “cough syrup”.
Codeine is a legally prescribed substance in medications used to reduce and control coughing. When it is used over a long period or in large doses, it can be addictive.
It wasn’t until May 1 last year that codeine was listed as a controlled substance, meaning that only licensed entities are allowed to use it. Prescriptions of medicines containing codeine should not exceed seven days’ dosage.
I regret that I knew too little about the substance when my son had his first drink of “cough syrup” in 2004.
In December 2011, my son proposed setting up an organization to promote awareness of drug prevention and how to break dependence on psychoactive substances that aren’t categorized as illegal drugs.
In the past five years, the organization — The Diandian Care Center for Adolescent Drug Addiction — has organized more than 300 activities and handed out 600,000 brochures to help teenagers and their parents.
Zhou Lihui spoke with Zhang Yi