Facts about Cold and Cough Medications:  cough_syrup

  • Several of the cough and cold medications that can be purchased over the counter (OTC), as well as prescription cough/cold medications, have active ingredients that can cause mind altering effects, when taken in amounts that are above the recommend dosages.
  • Because the medications have the ability to produce psychoactive/mind altering effects, these medications are often abused.  When taken in large doses the medications can produce mild euphoric effects, a feeling of detachment from the environment, distorted sensory perceptions, and even hallucinations.
  • Over the counter cough and cold medications, with the active ingredient Dextromethorphan (DXM), are the most commonly abused (NIH, 2014).
  • These drugs are frequently abused by young people because they are so easy to obtain.  When the drug is taken in large amounts to obtain a high it is sometimes referred to as “robo-tripping”.
  • Another medication that is often abused is Promethazine-codeine cough syrup.  This medication is available by prescription only, but as with any other prescription drug of abuse, people find a way to obtain it.  It is a popular choice for abuse because it contains the opioid codeine. It also contains promethazine HCl, an antihistamine that can cause sedation.
  • Opioid medications work very well as a cough suppressant.  However, they can also produce relaxation and euphoria when consumed at a higher-than-prescribed dose. So the relaxing, euphoric, and sedating effects of  promethazine-codeine cough syrup, make it a popular choice to be diverted for abuse.
  • Abuse of promethazine-codeine cough syrup increased in popularity during the late 1990s.  This trend was attributed to frequent references to the drug in some popular music during that time. Some song titles included: “Sippin’ on Some Syrup”, “Sippin’ and Spinnin”, and “Talkin’ Sizzurp”, just to name a few (Mann, 2011).  The drug trend became the new “thing to do” among youth that were looking to “get high”.
  • The cough syrup was often mixed with soda, alcohol, or candy, and given street names such as sizzurp, purple drank, barre, or lean.

How abuse of cough/cold medication’s affect the brain:

  • When used as directed, these medications safely treat the symptoms and discomfort caused by colds, cough, flu, and respiratory congestion. But when taken in higher quantities, or used frequently when such symptoms aren’t present, they can affect the brain in ways very similar to illegal drugs.
  • When taken in high doses, Dextromethorphan (DXM) acts on the same cell receptors as dissociative hallucinogenic drugs, such as PCP or ketamine. Users have describe feeling sensations of physical distortion and hallucinations.
  • Codeine works on the same nerve cells in the brain as all other opioids, including illegal opioids like heroin. Opioid drugs produce a feeling of euphoria, especially when not taken as prescribed. This can contribute to addiction.  People who are addicted to these drugs often take several times the recommended, safe amount.
  • In addition, both codeine and promethazine HCl cause depression of the central nervous system, producing sedating or calming effects.
  • Many of the cough and cold medications contain an expectorant, called guaifenesin, which can cause nausea if taken in large amounts.

This page is a work in progress, more information will be added shortly.  In the meantime, thank you for your patience.


Mann, L. (2011). Top ten songs about ingesting cough syrup for leisure.  Retrieved from http://www.dallasobserver.com/music/listomania-top-ten-songs-about-ingesting-cough-syrup-for-leisure-7050435

National Institute of Health [NIH]. (2014).