Triple C, a slang term for the over-the-counter (OTC) medication Coricidin Cough & Cold, is abused by young people due to its active ingredient dextromethorphan (DXM), a common ingredient in many OTC cough and cold medications. Triple C is abused because of the psychoactive effects that DXM causes when taken in high doses.
Coricidin Cough & Cold is considered safe when taken as directed. However, at high doses, it can cause hallucinations, mania, psychosis, and other effects similar to ketamine and phencyclidine (PCP). Abusing DXM can also lead to an addiction, which greatly increases the risk of overdose.
What Is Triple C?
Triple C is one of many street names given to Coricidin Cough & Cold, sold OTC in pharmacies and some supermarkets. DXM is one of the active ingredients, along with acetaminophen and guaifenesin.
Coricidin Cough & Cold can provide temporary relief from symptoms of colds and upper-respiratory allergies, such as runny nose, sneezing, and coughing. Some Coricidin Cough & Cold products are specially for people with high blood pressure.
Coricidin products that pose the highest risk of abuse include:
- Coricidin HBP Cough Cold Medicine
- Coricidin HBP Chest Congestion & Cough
- Coricidin HBP Maximum Strength Flu
When taken as intended, the medication can achieve what it’s meant to, and side effects are rare.
Street Names For Triple C
People may use different names when referring to Triple C.
Triple C may also be referred to as:
- CCC
- Dex
- DXM
- orange crush
- poor man’s PCP
- red devils
- robo
- rojo
- skittles
- tussin
- velvet
What Is Dextromethorphan (DXM)?
DXM is an antitussive medication, also known as a cough suppressant. Antitussive medications reduce activity in the area of the brain that controls the urge to cough.
DXM is found in more than 120 OTC cold medications including:
- Alka-Seltzer Plus Cold and Cough
- Benylin DM
- DayQuil
- Dimetapp DM
- Drixoral
- NyQuil
- Robitussin DM
- Rondec DM
- St. Joseph Cough Suppressant
- TheraFlu
- Triaminic DM
- Tylenol Cold
DXM medication has been around since 1958, when it was created as a non-addictive substitute for codeine, and comes in the form of pills, powder, capsules, and cough syrup. People abuse Triple C by drinking an excess of cough syrup, ingesting the pills, and/or crushing and snorting the pills.
When taken as intended, the effects of DXM last five to six hours. The average dose for an adult is 15 to 30 milligrams (mg), taken three to four times a day. It is not considered a controlled substance in the United States under the Controlled Substances Act. However, in Russia, DXM is classified as a Schedule III controlled substance and placed in the same category as benzodiazepines, like Xanax and Klonopin.
The Three Plateaus
Depending on the dose, DXM can produce effects similar to marijuana, ecstasy, ketamine, or PCP.
According to the Drug Enforcement Administration (DEA), the effects of DXM are categorized into three plateaus:
- the first plateau, 100 to 200 mg, involves changes in perception of gravity and auditory sensation, as well as euphoria
- the second plateau, 200 to 400 mg, involves hallucinations and euphoria
- the third plateau, 300 to 1,500 mg, involves loss of motor coordination and profound changes in consciousness, such as that of an out-of-body experience and/or psychosis, and affects the speed of sensory input
Short-Term Effects Of DXM Abuse
When used as directed, DXM is generally considered safe for adults. However, when DXM is abused, side effects can be uncomfortable, dangerous, and possibly fatal.
People who abuse DXM may refer to the experience as “robo-tripping.” The most common way to abuse DXM is to consume large amounts of cough syrup, though it’s becoming more common to ingest capsules or take DXM in powder form. When purchased illegally in powder form, DXM may be combined with methamphetamine or other drugs, which increases serious risks such as fatal overdose.
DXM abuse may cause:
- confusion
- euphoria
- hallucinations
- high blood pressure
- outbursts of laughter
- involuntary eye movements
- lethargy
- loss of coordination
- mania
- nausea and/or vomiting
- overdose
- over-excitability
- paranoia
- sensory changes, such as the feeling of floating
- slurred speech
- sweating
When DXM is taken with alcohol and/or other drugs, it exacerbates the risks. Abuse of DXM when taking an antidepressant can be fatal.
Long-Term Effects Of DXM Abuse
People who abuse Triple C over a longer period of time are at an increased risk of serious health complications.
These include:
- addiction
- coma
- declined learning ability
- heart health concerns
- memory loss
- movement problems
- overdose
- problems with abstract language comprehension
- rhabdomyolysis (a breakdown of muscle tissue that can progress to kidney failure)
- visual processing issues
Coricidin Cough & Cold also contains acetaminophen, which can cause liver damage when taken in excess.
People who abuse Triple C for a prolonged period of time are also at risk of developing a mental health disorder or worsening an existing disorder, like depression or an anxiety disorder.
Why Do People Abuse Triple C?
Most people who abuse DXM are teenagers and young adults. Because Coricidin Cough & Cold and other DXM-containing medications are available OTC, they may be cheaper and easier to access than other drugs. These medications are often shoplifted, causing some stores to place them behind the counter.
Parents and other loved ones should also be aware that young people may also be able to access a product that contains DXM, like Triple C, from a medicine cabinet, at home or elsewhere.
There is also a misconception that, because Triple C is sold for purchase in a sealed package and in stores, it is safer than drugs sold on the street.
Illegal Triple C that is sold on the street can pose even more concerns, as it can be produced in a contaminated facility or combined with other drugs and dangerous additives.
Signs Of Triple C Addiction
People can become addicted to Triple C and other DXM-containing medications. Two of the main symptoms to look out for when it comes to drug addiction are needing a higher dose to achieve the same initial effects and experiencing symptoms of withdrawal when you stop using the drug, which can last up to a week.
Certain signs may be indicative of Triple C abuse in a loved one, including:
- sudden changes in physical appearance and behavior
- complaining about not having enough money and/or borrowing money
- changes in their friend group
- problems at home, school, or work
- empty cough syrup or pill bottles
Signs Of A DXM Overdose
Most DXM overdoses can be treated in a hospital setting. The risk of fatality is heightened when Triple C is used in combination with other drugs, when accidents occur due to the lack of coordination abuse of the drug causes, and for people who have abused the drug for prolonged periods.
Signs of a DXM overdose include:
- bluish hue on fingernails and lips
- blurred vision
- dizziness
- elevated body temperature
- hallucinations
- heart palpitations
- high or low blood pressure
- labored breathing
- muscle spasms
- numbness of the fingers and toes
- seizures
- spasms in the stomach and intestines
- vomiting
According to Poison Control, DXM abuse causes about 6,000 emergency room visits nationwide each year for people ages 12 to 25.
Although fatalities due to DXM overdoses are uncommon, they have occurred. Some people metabolize DXM poorly and are at a greater risk. According to the DEA, 5% to 10% of Caucasians have this susceptibility.
Treatment For Triple C Addiction Is Available At BRC
If you or a loved one is dealing with an addiction to Triple C and is interested in evidence-based treatment, call us today to learn about our recovery programs.
