Cough Syrup: Everything You Need to Know

Coughing can be frustrating, whether it’s caused by a cold, allergies, or an underlying condition. Cough syrup is one of the most common remedies used to manage and soothe coughs. But how does it work? What should you know about its side effects and safety? While cough syrups are effective for treating coughs when used as directed, some types—especially those containing codeine or dextromethorphan (DXM)—are often abused for their psychoactive effects.

Cough Syrup Abuse: A Growing Concern

When consumed in large quantities, these ingredients can cause euphoria, hallucinations, or a sense of detachment, leading to their misuse as recreational drugs. This practice, commonly referred to as “cough syrup abuse”, poses serious health risks, including addiction, respiratory depression, liver damage (when combined with acetaminophen), and even fatal overdoses. It’s important to use cough syrup only as prescribed and to store it securely, especially in households with young children and teenagers, to prevent accidental use or misuse.

Potential Dangers and Effects

Cough syrup abuse, particularly with products containing dextromethorphan (DXM) or codeine, can have severe short-term and long-term consequences. These substances, when taken in excessive amounts, affect the central nervous system, leading to both physical and psychological effects. Here’s a breakdown of the potential dangers:

Short-Term Effects of Cough Syrup Abuse

Euphoria and Hallucinations: High doses of DXM can cause dissociative effects, including hallucinations and a feeling of detachment from reality.

Drowsiness and Confusion: Codeine and DXM can impair cognitive function, leading to confusion, poor coordination, and sedation.

Nausea and Vomiting: Overdosing on cough syrups can irritate the stomach and cause digestive issues.

Dizziness and Impaired Motor Skills: These effects can increase the risk of accidents or injuries, especially while driving or performing tasks that require focus.
Respiratory Depression: Codeine, as an opioid, can slow breathing, which may lead to life-threatening complications such as respiratory arrest and coma, especially when combined with other depressants like alcohol.

Long-Term Effects of Cough Syrup Abuse

Addiction and Dependency: Prolonged misuse of codeine-based syrups can lead to opioid addiction, requiring medical intervention and rehabilitation.

Mental Health Issues: Chronic abuse of DXM may cause depression, anxiety, or psychosis.

Liver and Organ Damage: Many cough syrups contain acetaminophen, which, when consumed in large quantities, can cause severe liver damage or failure.

Memory and Cognitive Impairment: Long-term abuse can impair memory, judgment, and reasoning skills.
Seizures: Extremely high doses of cough syrup, especially DXM, can cause seizures or convulsions.

Life-Threatening Risks

Overdose: Taking excessive amounts of cough syrup can lead to overdose, with symptoms such as slowed breathing, unconsciousness, and even coma or death.

Interaction with Other Substances: Combining cough syrup with alcohol, sedatives, or other drugs exponentially increases the risk of severe side effects like respiratory failure, coma, or cardiovascular collapse.

Proper Use of Cough Syrup

Cough syrups are liquid medications designed to alleviate coughing. They work by targeting the cause of the cough, which can be due to irritation, mucus buildup, or an overactive cough reflex. Here’s how cough syrups are typically used:

To Suppress Dry Coughs:

Dry coughs, also known as non-productive coughs, don’t produce mucus.

For these, antitussive cough syrups (e.g., those containing dextromethorphan) are used to suppress the cough reflex.

To Relieve Wet Coughs:

Wet coughs involve mucus or phlegm buildup.

Expectorant cough syrups (e.g., those containing guaifenesin) help thin and loosen mucus, making it easier to expel.

For Allergies or Post-Nasal Drip:

Some cough syrups contain antihistamines (e.g., diphenhydramine) and decongestants (e.g. phenylephrine) to reduce nasal congestion and coughing caused by allergies.

Cough Syrup Use for Drug Abuse:

Unfortunately, some cough syrup containing dextromethorphan or codeine are misused or abused for their psychoactive effects. Known as “cough syrup abuse,” this can lead to serious health risks, addiction, and legal consequences.

When using cough syrup, it’s essential to choose the right type based on the type of cough and underlying cause.

Cough Syrup Side Effects

While cough syrups can be effective, they may cause side effects, especially when misused or taken in large doses. Common side effects include:

Drowsiness: Many cough syrups, especially those with antihistamines, can cause sleepiness.

Dizziness: Some users may feel lightheaded after taking cough medication.

Upset Stomach: Ingredients like guaifenesin may irritate the stomach lining.

Allergic Reactions: Symptoms like rash, itching, or swelling may occur in rare cases.

Dependence and Abuse: Syrups containing codeine or dextromethorphan can be addictive when consumed recreationally.

Serious Risks When Abused:

Misusing cough syrups for their psychoactive effects can result in:

Seizures

Hallucinations

Heart rhythm problems

Respiratory depression (in severe cases)

Coma (in severe cases)

Death (in severe cases)

If you experience unusual or severe side effects, it’s important to stop use and consult a healthcare professional immediately.

Exploring Different Types of Cough Syrup

Not all cough syrups are the same. They’re formulated to address specific types of coughs and symptoms. Here’s a breakdown of the most common types:

1. Antitussive Cough Syrups

Purpose: Suppress the cough reflex.

Best For: Dry, persistent coughs that disrupt sleep or daily activities.

Examples: Syrups containing dextromethorphan, benzonatate or codeine.

2. Expectorant Cough Syrups

Purpose: Loosen mucus in the airways, making it easier to cough up.

Best For: Wet coughs with mucus buildup.

Examples: Syrups containing guaifenesin.

3. Antihistamine Cough Syrups

Purpose: Alleviate coughing caused by allergies, post-nasal drip, or sinus irritation.

Best For: Coughs associated with allergies or colds.

Examples: Syrups with diphenhydramine or chlorpheniramine.

4. Combination Cough Syrups

Purpose: Treat multiple symptoms, including cough, fever, nasal congestion, or sore throat.

Best For: General cold and flu symptoms.

Examples: Syrups that mix antitussives, expectorants, and decongestants. Codaewon syrup brand is an example.

Always read the label to ensure the cough syrup matches your symptoms and consult a healthcare provider if you’re unsure which type to use.

Essential Tips on Taking Cough Syrup

To ensure cough syrup is effective and safe, follow these essential tips:

Measure Accurately: Use the provided measuring cup or spoon to avoid overdosing. Never use a kitchen spoon, as it may not be accurate.
Follow the Dosage Instructions: Stick to the recommended dose and frequency. Taking too much can increase the risk of side effects or complications.
Check for Drug Interactions: Cough syrups can interact with other medications, especially sedatives or alcohol. Discuss with your doctor if you’re taking other drugs.
Know When to Avoid: Avoid cough syrups with codeine or sedatives if you need to stay alert (e.g., while driving, operating heavy machinery).
Don’t Use for Extended Periods: If your cough persists for more than 7-10 days, consult a doctor. Prolonged use of cough syrup without improvement may signal a more serious underlying condition.

Ensuring Safety: Best Practices with Cough Syrup

Cough syrups are generally safe when used correctly, but misuse or overuse can lead to serious problems. Here are some best practices to ensure safety:

1. Keep Out of Reach of Children

Many cough syrups have appealing flavors, which can tempt children. Store them securely to prevent accidental ingestion.

2. Avoid Mixing with Alcohol

Combining cough syrup with alcohol can amplify sedative effects, leading to drowsiness or impaired coordination.

3. Be Cautious with Recreational Use

Recreational use of cough syrup for its psychoactive effects can cause serious health consequences, including addiction/dependence and organ damage.

4. Choose the Right Product for Your Symptoms

Using the wrong type of cough syrup (e.g., taking an antitussive for a wet cough) won’t address your symptoms and may prolong recovery.

5. Consult a Doctor for Underlying Conditions

If your cough is persistent, severe, or accompanied by other symptoms like fever, fatigue, or chest pain, seek medical advice instead of self-medicating.

Cough syrup is a common and effective remedy for managing coughs at home, but it’s important to use it responsibly. If you’re unsure about which cough syrup is right for you or if your symptoms persist, consult a healthcare professional for guidance.