Other medications

Are cough and cold medicines addictive?

Misusing cold medicines is physically dangerous and can potentially lead to addiction. Understand the risks of cold medicine abuse.

Ophelia team
Cough and cold medicine bottle
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Fact checked by
Arthur Robin Williams, MD

Over-the-counter (OTC) medicines are crucial tools that many people use to treat various illnesses without a prescription, and they are perfectly safe when taken as directed. However, some contain active ingredients with a higher potential for misuse. Cold medicine abuse is one of the most common forms of this phenomenon, and this has been a problem for decades. Misusing cold medicines in this way is physically dangerous and can lead to addiction. Here is some helpful info about these substances and their risks.

Active ingredients in cold medicine and cough syrup

Today, there are a wide variety of cold medicines with different active ingredients, but one active ingredient sticks out as having a high potential for misuse. This substance is known as dextromethorphan, or DXM. Cough medicines with DXM come in many forms and brands, including certain formulations of Robitussin®, NyQuil™, Dimetapp®, and their generic or off-brand counterparts. 

When used according to the instructions on the bottle, cough medicines with DXM are safe and effective at treating the symptoms of a cold and suppressing a cough. However, in larger doses, the DXM in the product can produce a high that can last between 30 minutes and six hours. It can cause feelings of euphoria as well as dissociative hallucinations, and many compare its effects to drugs like ketamine, PCP, and ecstasy.

Why cold medicine abuse is so common

Recreational cold medicine abuse is so prevalent because cough medicines with DXM are not nationally regulated or controlled. The ingredient can be included in OTC medicines that get sold in stores and pharmacies everywhere. In many cases, there are no age restrictions to purchase these medications, and they don’t require a prescription. By contrast, cough medicines containing codeine are subject to at least some regulations as codeine is a controlled substance by the DEA.

Because of open availability, cold medicine abuse has become common among teens and young adults, who might find other mind-altering substances hard to come by. 

These problems have led to some stores choosing to restrict access to cough medicines with DXM, but this is not universal. They may require someone to be over 18 or have a prescription or doctor’s recommendation to purchase the medicine. But no laws have yet been established to regulate the drug nationwide. 

Is it possible to get addicted to cough medicine with DXM?

While DXM is not as highly addictive as drugs like nicotine and opioids, it can still be habit-forming. The feelings of euphoria that DXM produces are highly appealing to many people, encouraging them to make a habit of seeking out the high. Once this habit has formed, it’s possible to become physically dependent on the drug. DXM addiction and withdrawal have not yet been thoroughly studied, but they can still represent a serious problem and come with risks of physical and psychological harm.

Once an individual has developed a substance use disorder through cold medicine abuse, they are more likely to become dependent on other drugs, such as opioids. This often happens after the person develops a higher tolerance for the DXM and seeks a more powerful drug to get high on. 

The risks of cold medicine abuse

The recommended dosage of DXM for medicinal effects is 10 to 15 milligrams in a 24-hour period, and it takes nearly 10 times that dose to produce mind-altering effects. The high leads to increased body temperatures, and individuals run the risk of high fevers and even heat stroke. This is especially common when accompanied by physical activity, such as prolonged dancing.

Individuals may also experience liver damage, high blood pressure, loss of consciousness, and seizures, among other side effects. If not treated properly and promptly, these effects can cause permanent injury and even death.


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