Teen Cough Medicine Abuse Treatment

Cough medicine abuse can cause a medical emergency, even though the product was sold over the counter.

If you think your teen took too much, seek medical help right away. Treatment for an ongoing pattern of cough medicine misuse begins after any urgent medical needs are addressed.

At Artemis Adolescent Healing Center, we assess teens ages 12 to 17 for substance use and mental health needs, and offer teen cough medicine abuse treatment programs that are licensed and accredited.

Our Tucson program offers residential treatment, partial hospitalization, intensive outpatient care, and outpatient services that can help your child overcome struggles with cough medicine abuse, whether over-the-counter or with prescribed narcotic cough medicines.

The right level of care depends on safety, medical stability, the pattern of use, home support, and a clinical assessment, so please keep reading to learn more and reach out to us at any time for immediate assistance.

Essential Takeaways for Parents

• Over-the-counter does not mean harmless. High doses of dextromethorphan, or DXM, can cause dangerous changes in thinking, movement, heart rate, blood pressure, breathing, and consciousness.
• The label matters. Many cough and cold products contain several active ingredients. A teen who takes a large amount may be exposed to DXM plus acetaminophen, an antihistamine, or a decongestant.
• One sign is not a diagnosis. Missing medicine, sudden behavior changes, poor coordination, or secretive purchases should lead to a calm talk and a professional evaluation when the pattern continues.
• Treatment should fit the teen. Effective care can include individual, group, and family therapy, help for co-occurring mental health concerns, and a level of care matched to current risk.
• Family safety steps help. Lock medicines, track what is in the home, follow the Drug Facts label, and use a take-back option for products that are no longer needed.

What Is Cough Syrup and Cough Medicine Abuse?

Cough medicine abuse means taking a cough or cold product in a way that is not directed on the label or by a health professional. A teen may take a large amount, use it for intoxication, combine it with alcohol or other drugs, or use a concentrated product not meant for medical care.

Some teens may call this robo-tripping, dexing, skittling, or taking triple Cs. Slang changes over time, so behavior and product access matter more than any one term.

DXM is a cough suppressant found in more than 120 over-the-counter cough and cold medicines, and it was approved by the FDA in 1958. In high doses, dextromethorphan misuse can cause euphoria, hallucinations, loss of coordination, slurred speech, sweating, nausea, vomiting, and high blood pressure (Drug Enforcement Administration [DEA], 2025).

Over 1 in 30 teens had misused DXM in a 2018 survey. A product can be a syrup, tablet, capsule, lozenge, or powder. Parents should not assume that only liquid cough syrup is involved.

Why Cough Medicine Products Can Be Dangerous for Adolescents

Effects of a high dose

At very high doses, DXM can distort awareness and a person’s sense of time. Some teens may take 240 mg to 1,500 mg of dextromethorphan (DXM) at a time to get intoxicated. A teen may seem drunk, confused, frightened, agitated, or disconnected from what is happening, with impaired judgment that can alter time perception.

Symptoms of DXM intoxication or overdose can also include dizziness, blurred vision, vomiting, rapid heartbeat, high or low blood pressure, raised body temperature, muscle twitching, seizures, hallucinations, difficulty breathing, coma, or death (National Library of Medicine, 2025). Effects may begin within 30 minutes and last up to 6 hours, depending on the product and dose.

Some symptoms may be stronger when DXM is taken with medicines that affect serotonin, a chemical messenger in the nervous system. Alcohol and other drugs can add risks and increase side effects.

Risks from other active ingredients

Many OTC medicines and cough and cold remedies contain more than DXM. In small doses used as directed, DXM is typically much lower, with a common safe dose around 15 to 30 mg in 24 hours. But many medications for coughs and colds also contain Tylenol (acetaminophen). Too much acetaminophen can injure the liver.

Some antihistamines that are present in cold and cough medications can cause severe drowsiness, agitation, heart problems, seizures, or coma.

Decongestants in these medicines can also affect heart rate and blood pressure in uncomfortable or dangerous ways.

Signs That a Teen May Be Misusing Cough Medicine or Engaging in Drug Abuse

Many warning signs have other possible causes. Look for a pattern, not a single mood change or bad day. One in ten teens report abusing cough medicines, so these warning signs deserve attention.

Ask direct questions without shaming your teen. Remember: the goal is to find out what happened and protect health, not to win an argument.

Possible signs include:

• Product packages: Cough or cold medicines disappear, empty packages appear, or a teen repeatedly buys these products without a clear reason.
• Physical changes: Slurred speech, poor balance, red or glassy eyes, vomiting, unusual sweating, rapid eye movements, or extreme sleepiness appear.
• Thinking or mood changes: The teen seems confused, agitated, fearful, unusually excited, detached, or reports seeing or hearing things that are not there.
• Behavior changes: There are secret online orders, hidden packages, new slang terms, sudden isolation, or a drop in school attendance or performance.
• Loss of control: The teen keeps using despite consequences, cannot cut back, spends a great deal of time getting or recovering from the medicine, or returns to use after trying to stop.

What to Do if Your Teen is Abusing Cough Medicine

Arrange an evaluation with our caring adolescent substance use professionals at Artemis. It may be true that many states have banned DXM sales to minors, but families still need an evaluation when misuse is suspected.

A useful assessment includes a private conversation with the teen, input from caregivers, substance use history, medical and mental health symptoms, current medicines, school and family functioning, and immediate safety risks.

How Teen Cough Medicine Abuse Is Treated at Artemis

There is no one treatment plan for every teen who misuses DXM. Treatment should match the teen’s medical status, use pattern, mental health, family needs, and daily environment.

NIDA describes substance use disorders as treatable conditions and notes that care may occur in outpatient, intensive outpatient, inpatient, or residential settings (NIDA, 2025).

At Artemis, a teen’s treatment plan will likely include the following:

• Individual therapy: A therapist can help the teen understand triggers, build coping skills, and make a plan for high-risk situations.
• Group therapy: Age-appropriate groups can help teens practice communication, problem-solving, and refusal skills with clinical guidance.
• Family therapy and caregiver education: Family work can address communication, boundaries, access to medicine, and the home routines that support recovery. Individual, group, and family counseling are common parts of substance use treatment (NIDA, 2025).
• Co-occurring care: Depression, anxiety, trauma, attention problems, sleep concerns, and other substance use should be assessed and treated alongside the DXM problem when present.
• Continuing care: A discharge plan can include follow-up therapy, school support, recovery activities, medication-safety rules, and a clear response if use returns.

Reach Out for Teen Cough Medicine Abuse Treatment Options

At Artemis, we begin with an assessment and match each teen to the level of care that fits their needs. Our Arizona programs serve youth ages 12 to 17 and include residential treatment, partial hospitalization, intensive outpatient care, and outpatient services. A teen may move between levels as safety, symptoms, and progress change.

Our treatment plans can include individual counseling, group therapy, family therapy, help for co-occurring mental health concerns, and aftercare planning. We involve caregivers in ways that fit the teen’s treatment plan and safety needs. Our team also helps families understand how to reduce access to cough and cold medicines at home.

If cough medicine abuse has become an issue for your teen, please reach out confidentially today for our support and assistance.

How Families Can Support Recovery at Home

Frequently Asked Questions

Can a teen become dependent on cough medicine?

Repeated high-dose use can become hard to control and may meet the criteria for a substance use disorder. A clinician should review frequent use and any physical or mental symptoms after stopping rather than assuming that home withdrawal is safe.

Does every teen who experiments need residential care?

No. Some teens may need brief intervention or outpatient care. Others need more structure because use continues, home support is limited, mental health symptoms are serious, or safety is at risk. A full assessment should guide the decision.

Will cough medicine misuse show on a routine drug test?

Routine test panels may not be designed to identify DXM. Testing methods also vary. A negative result does not rule out misuse. Clinicians use the teen’s history, symptoms, product information, exam, and tests chosen for a specific medical reason.

How long does treatment take?

Length depends on the level of care, health needs, progress, home setting, and co-occurring concerns. Recovery support often continues after a structured program ends. Artemis uses the assessment and ongoing review to help plan each teen’s course of care.

How can I talk with my teen about cough medicine abuse?

Choose a calm time and describe what you noticed. Cough medicine abuse has decreased by nearly half in the last decade, but parent conversations still matter. Ask open questions and listen, including any other suggestions from the teen’s doctor or therapist, before setting limits. Avoid labels such as bad or addict. If you believe an overdose happened, skip the conversation for the moment and call Poison Control or 911.

Talk With Artemis About the Next Level of Care

If cough medicine misuse is affecting your teen’s health, behavior, school, or family life, our admissions team can explain our assessment process and levels of care. Call our admissions team or review our teen substance abuse treatment options. If you suspect an overdose, call Poison Control or 911 before contacting a treatment program.

References

1. Drug Enforcement Administration. (2025, January 21). DXM.
2. Levy, S., Weiss, R., Sherritt, L., Ziemnik, R., Spalding, A., Van Hook, S., & Shrier, L. A. (2014). An electronic screen for triaging adolescent substance use by risk levels. JAMA Pediatrics, 168(9), 822-828.
3. National Capital Poison Center. (n.d.). Dextromethorphan abuse.
4. National Institute on Drug Abuse. (2025, June 9). Treatment.
5. National Library of Medicine. (2025, October 14). Dextromethorphan overdose. MedlinePlus.
6. U.S. Food and Drug Administration. (2024, October 31). Disposal of unused medicines: What you should know.