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:

  • Numbness
  • Disorientation
  • Confusion
  • Loss of coordination
  • Dizziness
  • Nausea
  • Changes in sensory perceptions
  • Hallucinations
  • Memory loss
  • Physical distress
  • Increased blood pressure
  • Extreme panic
  • Fear
  • Increased heart rate
  • Increased body temperature
  • Aggression
  • Respiratory distress
  • Seizures

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.

Triple C Abuse

Dextromethorphan is found in more than 120 over-the-counter cold medications. In many cases, it’s by itself, but in others, it’s used in conjunction with another medicine to enhance the therapeutic effects, such as an antihistamine or acetaminophen. A standard dose of DXM is around 15 mg to 30 mg and would be taken four times a day. The cough-suppressant effects from a typical amount will work between five and six hours after it’s ingested, but when you abuse Coricidin, this all changes. Coricidin abuse is dangerous, and the long-term effect of triple C’s can have a detrimental impact on your health. 

Depending on the dose, you might wonder how long does Coricidin last? Well, when a recreational or unsafe dose of the drug is taken, the primary objective is to get high and can last for several hours. Those who abuse the drug will experience euphoria and hallucinations. In most cases, these will be auditory and visual. The amount to reach that level of intoxication is dependent on the person’s body weight and what experience they’re looking to have. Recreational doses can range from 250 mg to 1,500 mg, which can soon spiral out of control and lead to an overdose. At this point, the Coricidin side effects like hallucinations will be severe. Even worse, Coricidin HBP side effects may also occur.

Below are some of the effects that you can expect when abusing Coricidin.

  • First level of abuse: At this stage, a person will take anywhere from 100 mg to 200 mg and achieve mild stimulation. It has been compared to a high you could expect with marijuana. 
  • Second level of abuse: At this level of abuse, the individual will be ingesting anywhere from 200 mg to 400 mg. They will experience hallucinations and euphoria, which can be compared to a high like MDMA.
  • Third level of abuse: At this point, it’s starting to get dangerous. The user will be ingesting anywhere from 300 mg to 600 mg. They’ll experience a loss of physical coordination and balance, as well as having distorted visuals.
  • Fourth level of abuse: The most dangerous level of abuse, the user will be ingesting anywhere from 500 mg to 1,500 mg. They will encounter out-of-body sensations and question if what’s happening around them is real. 

If you’re wondering what are the long-term effects of DXM, it can be catastrophic on your body and even lead to addiction—for many years, abusing the drug required drinking a lot of syrup. However, once the formula was made into capsules, abuse exploded. Creating Coricidin pills helped abuse explode because you could easily ingest high doses of DXM. Despite the relatively low cost and how easy it is to find, it’s not regulated under the Controlled Substances Act (CSA) like other OTC drugs and prescription medications. 

One of the primary issues attached to DXM abuse is when it’s used in conjunction with other decongestants. Too much of the OTC drug can lead to passing out and short breaths, leading to oxygen deprivation. Although this is a risk of any large dose of DXM, coupling it with other decongestants increases this risk, so the person is more likely to encounter brain damage or even death. Coricidin has become prevalent in the abuse community because it does not contain decongestants. However, abusing DXM and other substances in Coricidin is extremely dangerous. 

One of the more dangerous issues associated with Coricidin is that because it contains DXM, the odds of developing severe psychiatric symptoms. It can lead to a psychotic break that doesn’t go away. Abusing this drug is extremely dangerous, and if you’re having problems stopping, it might be time to seek treatment.

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.

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