For some teenagers, getting high is simple. Opening the medicine cabinet at home gives them ready access to an over-the-counter medication that seems relatively harmless — but in high doses, it’s not. What is it? Cough medicine featuring the ingredient dextromethorphan (DXM for short). This medication is used in robotripping, which refers to ingesting products like Robitussin to experience psychological and physical effects.
So while you may not know it, your teen could be getting high on cough medicine at home. Here’s what you need to know about the potential harm of robotripping and what you can do to help your teen.
What Is Robotripping?
Robotripping is a form of substance abuse that allows teens to experience effects such as euphoria and auditory and visual hallucinations by recreationally using products containing dextromethorphan in doses higher than recommended.
DXM is an opioid substance found in OTC medications such as those for coughs or colds, available in liquid, lozenge, or extended release (ER) tablet formats. With over 125 OTC medicines sold that contain this ingredient, according to WebMD, these medications are readily available and easily purchased, although some states require the purchaser be at least 18. Additionally, DXM can be purchased in illicitly manufactured powders or tablets from sources found on the Internet.
Derek Barney, a licensed associate clinical mental health counselor with Sunrise, a residential treatment center for teen girls, has worked with clients as young as 11 years old who’ve become addicted to dextromethorphan.
“Cough syrup is something that stays off an adult’s radar,” Barney said. “It’s common in most homes. And you don’t hear ads out there saying to lock it up.”
Misuse of DXM started gaining ground in the late ’90s, according to Barney. More recently, he said, “It’s common for kids to hear about DXM in music, mostly in rap songs.”
It’s also talked about a lot on social media, with some posts by teens even showing recommended dosing or ways to combine dextromethorphan with other substances to robotrip.
What Happens During Robotripping?
According to Healthline, the amount of dextromethorphan ingested causes different stages of intoxication (known as DXM plateaus):
- First plateau (100 to 200 milligrams): Users feel mild effects and an uplift in mood, becoming more talkative and energetic. Some say the effects are similar to using ecstasy.
- Second plateau (200 to 400 milligrams): This stage is compared with alcohol intoxication, except with a more noticeable decrease in cognitive function and motor skills. Feeling euphoric as well as visual and auditory hallucinations are likely.
- Third plateau (400 to 600 mg): Users will experience sensations similar to if they use ketamine. Effects include dissociation, which refers to feeling disconnected from reality, loss of motor coordination, and intense hallucinations.
- Fourth plateau (500 or more mg): Effects are likened to taking a hallucinogenic like PCP. Hallucinations, delirium, a trance-like state, sensations similar to out-of-body experiences, and reduced pain perception can occur. Hallucinations and delirium from DXM highs can lead to aggression and violence.
In Barney’s experience, teens who robotrip most commonly experience euphoria, hallucinations, sweating, dizziness, and feeling out of it and zombielike.
“Most kids go in looking for euphoria but end up basically out of it with slurred speech, sweating, and lethargy,” he said.
It’s important to note that DXM can become addictive, and overdoses and death can occur.
What Amount of DXM Is Safe?
According to the Mayo Clinic, the average recommended daily dosage of over-the-counter cough medication with DXM as the active ingredient for children 12 and older depends on the form taken:
- Lozenges: 180 milligrams total per 24-hour period.
- Syrup: 120 milligrams total per 24-hour period.
- Extended-release oral suspension: 120 milligrams per 24-hour period.
When compared with the large doses in the four DXM plateau descriptions, teens can be taking upward of three times the recommended daily dosage, with twice the recommended dosage as early as the second plateau.
How Are Teens Getting DXM?
Unfortunately, obtaining cough suppressant substances containing DXM can be easy.
The U.S. Drug Enforcement Administration (DEA) published a dextromethorphan fact sheet in 2019 showing that the most commonly abused products related to robotripping were Robitussin and Coricidin, both OTC cough and cold medicines.
However, the DEA further reported that DXM abuse is fueled not only by its OTC availability but also by extensive “how to” abuse information on various websites. A simple online search for “robotripping” readily shows social media sites with discussions on buying dextromethorphan, mixing it with other substances for added effects, dosing aimed at achieving a DXM high, and much more.
In addition, these sites feature discussions revealing the ever-changing street names for DXM you should be aware of. The DEA recognizes several such names for DXM, including CCC, triple C, robo, poor man’s PCP, and skittles. In fact, skittling is another name for robotripping.
As new street products become available, new slang names develop, and acquisition methods change, social media sites are the source teenagers use to keep up. Common Sense Media has published a guide to the most popular social media apps among teens, and you can check the ones that feature forums or message boards to keep up with the lingo surrounding acquiring and misusing cough medicines to robotrip.
How Do You Know if Your Teen Is Abusing DXM?
Barney said parents should look for physical signs of a DXM high like those described previously, such as loss of motor control, dizziness, slurred speech, and hallucinations. He said to also watch out for other signs like a decline in schoolwork, a loss of interest in favorite activities, or problems at home, such as more intense mood swings, apathy, loss of interest in relationships, stealing, or sneaking around.
Additional signs that DXM abuse is happening in your house include:
- Use of slang words like triple C, a street name for Coricidin HBP Cough & Cold, which has DXM.
- Cough medicine bottles and packets (e.g., Coricidin HBP) in your teen’s room.
- Running out of cough medicine faster than usual.
How Can You Help a Teen Who’s Robotripping?
Treatment options for substance use disorders like robotripping vary widely and include self-management and recovery training, which teaches teens how to control addictive, high-risk behavior. You should work with your son or daughter to find a therapist and a recovery program you all feel comfortable with. You can use the Substance Abuse and Mental Health Services Administration search tool to locate a treatment program near you.
Support toward recovery needs to be applied in the home as well.
“Be more open with communication about substance abuse, and be more a part of their life,” Barney said. “Know who they hang out with, ask questions, monitor their social media, and teach them that DXM can be just as harmful and addictive as harder drugs or those that are illegal.”
Embark is the most trusted name in teen and young adult mental health treatment. We’re driven to find the help your family needs. If you’re looking for support, contact us today!
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