When illegal drugs aren’t an option, adults and teens may turn to medications that are right in their kitchen cabinets. But even when a medication is available over the counter, it can still be dangerous if it is misused. One common type of over-the-counter drug that is frequently abused is cold and cough medications.

Over-the-counter cold and cough medicines may contain several therapeutic substances, but one that is regularly abused is dextromethorphan, also known as DXM. DXM falls into the morphinan classification, a group of medications known for their dissociative, sedative, and stimulant characteristics.

Dextromethorphan works by suppressing the cough reflex in the brain, which helps to alleviate coughing. At higher doses, dextromethorphan can produce dissociative and hallucinogenic effects similar to those of ketamine or PCP.

“Triple C” is a popular slang term used to describe a specific type of medication containing dextromethorphan–Coricidin HBP Cough & Cold. People who get high on Triple Cs may refer to the high as “robotripping.”

What are Triple Cs? HBP Coricidin Cough & Cold

Triple Cs refer to Coricidin HBP Cough & Cold tablets. This popular brand of cough and cold medicine is widely available and can be purchased at nearly any drugstore or grocery store.

Other slang terms used for Triple Cs are:

  • CCC
  • DXM
  • Skittles
  • Candy
  • Red Devils
  • Poor man’s PCP

In high doses, DXM can produce hallucinogenic effects and feelings of dissociation. DXM products are commonly abused by teens and young adults who are trying to achieve a cheap and legal high.

DXM is found in over 120 over-the-counter cold medications and cough syrups, and is sometimes mixed with acetaminophen, chlorpheniramine, pseudoephedrine, or guaifenesin). Since it is not a controlled substance, most people can access DXM products very easily, which is helpful in cases of the cold or flu. However, 15 states have prohibited the sale of these products to minors due to rampant abuse of them among young people.

What Do Triple C’s Look Like?

Coricidin HBP is available in various formulations, including with intended use for cough and cold, chest congestion, and the flu. Coricidin HBP Cough & Cold comes in the form of red round tablets containing 30mg of DXM. Coricidian HBP Chest Congestion & Cough comes in the form of red soft gel capsules and contains 10mg of DXM. Lastly, Coricidin HBP Maximum Strength Flu comes in the form of red tablets containing 15 mg of DXM.

Due to the bright red appearance of these pills, they are sometimes called “Skittles.” People who abuse Triple Cs may swallow high doses of the pills. Others may obtain DXM in powder form illicitly, and the powder may be ingested, snorted, or injected intravenously.

Side Effects

When used as directed, Coricidin HBP Cough & Cold can suppress cough and alleviate cold and flu symptoms. However, when it is abused, it can have hallucinogenic effects. The act of getting high Triple Cs is known as “robotripping” and may produce side effects including:

  • Nausea and vomiting
  • Slurred speech
  • Abdominal pain
  • Loss of muscle control
  • Stomach cramps
  • Increased blood pressure
  • Irregular heartbeat
  • Blurred vision
  • Difficulty walking straight
  • Brain damage
  • Visual, auditory, and tactile hallucinations
  • Euphoria
  • Confusion
  • Paranoia
  • Mood swings

The effects of robotripping can vary based on the dose taken. These effects can be divided up into four phases or plateaus. The plateaus are as follows:

  • 100-200 mg dose – This dose produces mild stimulation. People may experience euphoria, a sensation that they are floating, and auditory hallucinations.
  • 200-400 mg dose – This plateau is similar to alcohol intoxication. People experience decreased cognitive and motor functioning as well as euphoria and hallucinations.
  • 400-600 mg dose – At this dose, DXM may produce effects similar to ketamine. People may be nearly incapacitated and experience strong dissociation, intense hallucinations, and loss of motor control.
  • 500-1,500 mg dose – This is an extremely high dose during which the effects may be similar to PCP. Taking this much DXM can cause a trance-like state and out-of-body experiences. It can also cause delirium, psychosis, and overdose.

It’s important to note that these plateaus and dosages can vary based on a person’s body weight and physiology. Never take more DXM than you are directed to by the label on the bottle or your healthcare provider.

Dangers of Dextromethorphan (DXM) Abuse

The recommended dose for dextromethorphan is between 10-30 mg every six hours. Taking more than this amount can result in “robotripping” as well as a range of negative side effects. People often report becoming scared, confused, and paranoid, sometimes to the point of having panic attacks or harming themselves.

Aside from just DXM, Coricidin also contains a combination of acetaminophen and chlorpheniramine. Acetaminophen is a painkiller that can cause liver damage when taken in high doses. Triple C abuse can increase this risk.

In extremely large doses, DXM abuse can result in an overdose. Symptoms of a DXM overdose are:

  • Slow breathing
  • Labored breathing
  • Blurry vision
  • Bluish lips or fingernails
  • A sudden increase in body temperature
  • Rapid heartbeat
  • Heart palpitations
  • Seizures
  • Psychosis
  • Serotonin syndrome (a potentially life-threatening condition caused by excess serotonin in the brain)
  • Coma
  • Death

If you suspect someone is overdosing on Triple Cs, it’s important to recognize that an overdose is a medical emergency. Call 911 and seek professional assistance immediately.

Repeatedly abusing Triple C’s long-term can result in health problems such as respiratory issues, poor cognitive development, psychosis, liver damage, kidney failure, and mental health issues.

Heavy DXM users may experience withdrawal symptoms for up to a week after they quit using the drug. DXM withdrawal symptoms include:

  • Cravings
  • Depression
  • Anxiety
  • Irritability
  • Insomnia
  • Sleep disturbances
  • Muscle aches and pains
  • Nausea, vomiting, and diarrhea
  • Sweating
  • Difficulty concentrating
  • Increased heart rate
  • Elevated blood pressure

Withdrawal should always be managed under the guidance of a healthcare professional.

Signs of Teen Triple C Abuse

Teens who abuse Triple Cs may exhibit or all of the following symptoms:

  • A decline in grades or academic performance
  • Increased absenteeism at school
  • Changes in friend groups
  • Increased secrecy
  • Hiding empty cough medicine packages in the trash, under the bed, or in their backpack
  • Poor cooperation with parents, teachers, or authority figures
  • Hostility when confronted with substance abuse

Treatment for Triple C Abuse and Addiction

People who can’t control their DXM abuse may have a substance use disorder. In this case, professional treatment is required. Detox and treatment centers can monitor withdrawal symptoms while individuals detox, and then provide them with the care and support they need to achieve lasting sobriety.

Substance abuse treatment typically involves:

  • Assessment
  • Medical detox
  • Behavioral therapy–cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and others
  • Holistic therapy–art, yoga, massage, meditation, exercise, nutrition, and more
  • Relapse prevention planning
  • Individual therapy
  • Group therapy
  • Family therapy
  • Case management
  • Aftercare planning

Find Help Now

First Step Behavioral Health offers various addiction treatment programs that can help individuals overcome Triple C abuse. With residential and outpatient options available, there is a program that is right for everyone. To learn more about our programs or to get started with a confidential, risk-free assessment, please contact us today.

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