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Most parents are aware of the different types of illegal drugs that their children may at some point be exposed to, however, many may not know that there is a growing trend among teenagers use a common household medication for similar purposes – cough medication.

In the 1970s, many cough syrups contained the narcotic, codeine, a pain-relieving drug, similar to morphine, as their main ingredient. Codeine, because it, like all opiates, is highly addictive, was replaced with dextromethorphan (DM), which is a semi-synthetic narcotic, and is found in more than 125 over-the-counter medications.

DM is a cough suppressant, but can be deadly if taken in large doses. It is contained in any medication whose name includes “DM” and comes in liquid, tablet, and caplet forms, over-the-counter. Often DM is combined with other medications, such as acetaminophen, decongestants and antihistamines, which makes taking large doses of cold formulations even more dangerous.

Common slang terms associated with DM include Robo, Dex, DXM, Skittles (several medications that include stronger doses of DM look like the candy), Syrup, Candy, Red devils, and Triple-C. Terms for DM abuse include Robo-tripping, skittling, or robo-dosing.

Because it is relatively easy to get (anyone, including minors, can buy products containing DM), legal, and inexpensive. The normal effective dosage of DM, used as a cough suppressant is 15 to 30 milligrams. People that use DM often take more than 360 milligrams. Poison control centers in Texas reported that the number of calls relating to DM abuse and misuse rose from 99 cases in 1998 to 432 cases in 2002 and then dropped to 365 in 2003. The average age of the person abusing or misusing the drug in 2003 was 16.3 years.

Massive doses of DM cause hallucinations, loss of motor control and involuntary muscle movement, and ‘out-of-body’ sensations. Other adverse effects of taking more than the recommended dosage include confusion, nausea, impaired judgment, blurred vision, dizziness, loss of coordination, paranoia, excessive sweating, slurred speech, vomiting, abdominal pain, reduced sweating due to increased body temperature, irregular heartbeat, high blood pressure, headache, lethargy, high fever, numbness of fingers and toes, redness of face, dry itchy skin, loss of consciousness, seizures, brain damage, and death.

If you think your child may be abusing over-the-counter medications:

Consider locking your medicine cabinet, or keep medications containing DM in a less accessible place.

Avoid stockpiling over-the-counter medications.

Keep track of how much is in each bottle in your medicine cabinet.

Because DM is often sold online in a pure form, monitor your child’s internet usage.

Talk to your child about drug abuse, including both illegal and over-the-counter or prescription drug abuse. Explain that it may seem harmless to take a lot of cough medication, but it is not and can cause serious health problems and even death.