Triple C is a street name for Coricidin HBP Cough and Cold, a popular brand of cough and cold medicine that is commonly abused by teens. The drug Coricidin is a brand name decongestant for allergies, and it comes in three types: Cough and Cold, Cold and Flu, as well as Cold and Flu Extra Strength. All three of the medications contain an antihistamine known as chlorpheniramine, which causes dizziness and drowsiness similar to other over-the-counter (OTC) antihistamines.
The Cough and Cold, as well as Cold and Flu Extra Strength, contain a cough suppressant known as dextromethorphan (DXM), which is safe when used as suggested on the box but has become an area of concern when it comes to substance abuse. Unfortunately, its use has become widespread among teenagers because large doses of DXM are easy to purchase. In high enough doses, DXM can cause an intense body high and hallucinations.
Dextromethorphan has been used safely for years as a cough suppressant, and it was first recognized as early as the 1960s when it was marketed as the sole active ingredient in Romilar, an OTC product that was voluntarily removed from the market because of abuse. Since the late 1990s, adolescents have been abusing dextromethorphan products because of their easy accessibility and false perception of safety.
During a six-year study conducted by the U.S. National Library of Medicine National Institute of Health, 1,382 cases of dextromethorphan abuse were reported to poison control, and 74.5 percent of all reported cases involved adolescents. The median age was 16. Of the 1,382 cases in the study, the most commonly abused product was triple C. In times of youth, our bodies are still developing, and abusing unsafe amounts of the drug can cause adverse short-term and long-term effects in which will we cover below.
What is Dextromethorphan?
Dextromethorphan, which is also known as DXM, is a cough suppressant found in over-the-counter cough, cold, and flu medicines. It can be found in both gel capsules and cough syrups. It is considered a dissociative anesthetic at very high doses and produces psychedelic effects. At low doses, however, it suppresses cough and creates some sedation, which helps those plagued by illness relax, rest, and experience fewer coughing fits. The chemical is available in over 120 over-the-counter medications.
The antitussive was developed as a replacement for codeine as an alternative to the addictive opioid drug. Unfortunately, DXM has also become a drug of abuse. Although it is legal across the country, several states have taken precautions and enacted legislation that limits how much DXM a person can buy at one time. In addition, they have also included that proof of age with an ID card is required when purchasing these medications to determine legal status.
How Much Coricidin is Intoxicating?
When triple C is used recreationally, an unsafe dose is consumed where the goal is to get high. Those who abuse Coricidin will experience euphoria and hallucinations, usually both visual and auditory. The amount needed to experience intoxication, however, will vary based on the person’s body weight and what kind of high they want. Recreational doses can range from 250 milligrams to 1,500 milligrams, which can cause poisoning and death.
There are specific effects someone can expect from recreational doses, and they include:
- 100-200 milligrams – Mild stimulation that is comparable to marijuana.
- 200-400 milligrams – Euphoria and hallucinations similar to a high from ecstasy.
- 300-600 milligrams – Distorted visuals along with loss of physical coordination and balance.
- 500-1500 milligrams – Intense out of body situations that make the users feel detached from reality.
For a long time, abusing triple C was something that involved drinking a lot of liquid cough syrup. By administering DXM in this fashion, it was challenging to drink a lot of the substance in a short period. Unfortunately, there are now gel capsule forms of many OTC cough suppressants, which makes it much easier to consume a hefty dose of DXM very quickly. While many DXM products are inexpensive and easy to access, it makes them a prime target for young adults to abuse. The drug is not currently regulated under the Controlled Substances Act (CSA) like prescription medications and even some OTC drugs.
Some studies have indicated that one in 10 teenagers in the United States abused DXM products to get high, making this substance more prevalent among those who are ages 12-17 than ecstasy, cocaine, crystal meth, and LSD. The drug works on the same brain cells as PCP or ketamine, which are also dissociative drugs, meaning someone who consumes extreme doses will feel disconnected or separated from their environment and body.
While some effects of DXM can be disturbing and disorienting, they also release small amounts of dopamine through the brain’s reward pathway. It reinforces good feelings and wanting to take more of the drug, potentially leading to a cycle of abuse.
Short-Term Effects of Triple C
Dissociative drugs can produce visual and auditory distortions and a sense of floating disassociations. Use of triple c, however, can cause anxiety, memory loss, and impaired motor function, including body tremors and numbness. The effects will be determined by the dosage of the drug, and are unpredictable. They can occur within minutes of ingestion and last several hours, although some users have mentioned feeling effects for days.
Other Common Short-Term Effects of Triple C Include:
- Loss of coordination
- Changes in sensory perceptions
- Memory loss
- Physical distress
- Increased blood pressure
- Extreme panic
- Increased heart rate
- Increased body temperature
- Respiratory distress
Long-Term Effects of Triple C
Long-term effects of triple c have not been investigated to the extent they need, but research shows that repeated use can lead to tolerance and the development of a substance use disorder that includes withdrawal syndrome. It’s possible to experience headaches, cravings for the drug, and sweating when abstaining without the proper medical channels. Some other forms of long-term harm include:
- Muscle contortions
- Chronic high blood pressure
- Mental illness, including psychosis
- Nystagmus, or rapid back-and-forth eye movements
The most severe issues that have been studied about triple C, however, is that severe psychiatric symptoms leading to a psychotic break can become permanent. If you or someone you know is abusing the drug, it’s imperative to seek treatment immediately. Continuous psychotic episodes can have life-changing consequences in someone’s life, and seeking help will be the only way to avoid this possibility.
Treating Triple C Abuse
Abusing over-the-counter drugs can be dangerous, despite their relative safety compared to prescription and illicit drugs. Since Triple C contains dextromethorphan, it can cause a euphoric dissociative high that encourages repeated use in some people. Both Triple C and dextromethorphan are considered to have low dependence liabilities, which means that it’s unlikely for you to develop a chemical dependence on the drug. However, it may cause psychological dependence or encourage the use of other substances. In some cases, OTC users will move on to abusing prescription or illicit drugs. In other cases, recreational drug users will combine OTCs with illicit drugs. Plus, early exposure to drug use and abuse can increase a person’s risk of struggling with a substance use disorder later in life.
Catching a substance use disorder early can help to avoid some of the most severe consequences of addiction like illicit drug dependence, overdose, and health problems. Addiction treatment can help address substance use disorders and the underlying issues that might be contributing to them like mental health problems. Addiction treatment is tailored to your needs. If you have been abusing OTC drugs, but you don’t have a moderate or severe substance use disorder, you may only attend outpatient therapy sessions. If you have higher level needs, you might go through medical detox, inpatient services, or intensive outpatient treatment.