SMA_Icon-and-ingredientBy Peggy McKibbin of Five Moms

As parents, when we think of drug abuse, we tend to immediately think about illicit drugs that are most often associated with misuse and abuse. However, there is another drug that tends to slip under the radar because of its more common and safe use.

Dextromethorphan (DXM) is the active ingredient in most over-the-counter (OTC) cough medicines. DXM is safe and effective when used according to the Drug Facts label, but it can cause potentially life-threatening side-effects when taken in excess.

Alarming statistics show that approximately one in 25 teens report abusing DXM—aka skittles, robo, triple C’s and red hots—to get high. Furthermore, one in three teens knows someone who has intentionally taken more than the recommended dose—sometimes more than 25 times the recommended dose—of DXM to get high.

Protecting our teens from negative influences and bad decisions is easier when we know they are making smart, healthy decisions and doing the right thing. But when we suspect that they might be participating in risky activities like cough medicine abuse, it can be tough to walk the line between being aware of the fact that there might be a problem and actively surveilling their behavior. We may be wary of making our teens feel like they are being watched, but it is important to be able to recognize the warning signs:

  • Empty cough medicine boxes or bottles in your teen’s backpack or the trash;
  • Missing boxes or bottles of medicine from home medicine cabinets;
  • Your teen’s purchase of large amounts of cough medicine when nobody in the family is sick;
  • Changes in friends, physical appearance , or sleeping or eating patterns;
  • Declining grades;
  • Loss of interest in hobbies or favorite activities;
  • Your teen’s visits to pro-drug websites that provide information on how to abuse DXM;
  • Hostile and uncooperative attitude;
  • Unexplained disappearance of household money.

Should you suspect that your teen is abusing DXM, plan your approach with care. Your teen should feel that “the talk” is motivated by your concern for his or her health and safety. Most importantly, make no direct accusations. The last thing you want is for your teen to feel like he or she has come under attack. Have an open discussion and calmly voice your concerns without overreacting.

Find out what’s going on in your teen’s life. Pay attention to any signs of stress, peer pressure or bullying. Talk with your teen about ways to avoid drug or alcohol abuse. This may also be a good time to address any other unhealthy behaviors you may have noticed. Assure your teen that you are always available for support and guidance.

It can also be helpful for you to seek a support network when addressing such a sensitive, scary topic. Reach out to school guidance counselors, nurses, teachers and other parents if you need help having the conversation. After all, we can all play a part in raising awareness and preventing medicine abuse.

Visit to learn more about cough medicine abuse and how to start this difficult conversation with your teen.

About Peggy McKibbin:

Peggy is a mother of two and a high school nurse with a passion for promoting good health among teens. As one of The Five Moms for the Stop Medicine Abuse campaign and through her involvement with the National Association of School Nurses (NASN), Peggy works to educate her students and her community on the dangers of medicine abuse. Join the conversation by following Stop Medicine Abuse on Facebook and Twitter.