Abuse of over-the-counter dextromethorphan by teenagers

South Med J. 1993 Oct;86(10):1151-3. doi: 10.1097/00007611-199310000-00014.


Dextromethorphan, the d-isomer of the opiate agonist levorphanol, has none of the analgesic or sedative effects associated with the opiates and is approved for over-the-counter use as an antitussive. It is available, in various combinations with other medications, in nonprescription cough suppressant and common cold formulations, and its availability in the United States is not controlled. In this paper we have reported two cases of recreational use of dextromethorphan-containing cough syrup by two unrelated teenage boys. Despite the safety of this medication when used at the recommended dosage, there have been cases of "recreational" use of dextromethorphan as well as death by overdose. Although usually thought to be nonaddictive, dextromethorphan produces a substance dependence syndrome, and physicians should be aware of its abuse potential, particularly by youths.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Alcohol Drinking / epidemiology
  • Comorbidity
  • Dextromethorphan* / adverse effects
  • Dextromethorphan* / supply & distribution
  • Drug Combinations
  • Drug Overdose
  • Drug and Narcotic Control
  • Humans
  • Male
  • Marijuana Abuse / epidemiology
  • Nonprescription Drugs* / adverse effects
  • Nonprescription Drugs* / supply & distribution
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / etiology*
  • Substance-Related Disorders / prevention & control
  • Substance-Related Disorders / therapy


  • Drug Combinations
  • Nonprescription Drugs
  • Dextromethorphan