Cough Syrup Treatment and Rehab

Millions of people around the world take cold and cough medication to help reduce symptoms. Over-the-counter medication and stronger prescriptions like codeine are effective when taken as instructed. Cough syrups contain ingredients, such as DXM (Dextromethorphan), that are problematic when abused. These can induce psychedelic effects, whereby you hallucinate, have an altered perception of time and space, as well as an out-of-body experience.

Compared to illicit drugs like heroin and cocaine, DXM is cheap and legal. There are no risks to buying cough syrup and it can be carried on your person wherever you go. However, it is dangerous to take pure DXM, where raw ingredients are used to make cough syrup.

This is why it’s important to seek rehab and treatment as soon as you notice even the slightest symptoms of abuse. Therapies will help you treat the root causes of your syrup abuse while detox will aid you to cleanse your body from the substance.

What Is Cough Syrup Addiction?

You abuse cough syrup when you take it in large doses and snort or inject DXM to enhance the associated ‘high’. With increased usage, you’ll quickly build tolerance and within a few months, you may even switch to tablets that are more potent. After a while, dependence sets in and at this stage you’ll experience withdrawal symptoms when you suddenly stop using.

With dependence comes constant craving to keep using cough syrup to sustain the euphoric ‘high’ that also includes feelings of relaxation and calm. Mixing dextromethorphan with alcohol and other addictive substances makes it more dangerous and only accelerates the addiction timeline.

Taken at regular doses, DXM is safe and effective, targeting areas of the brain that suppress coughing. When you abuse cough syrup (taking as much as 10 to 50 times the prescribed dose) it causes dissociative and hallucinatory effects, similar to ketamine and PCP. Teenagers abuse DXM because it’s easy to get hold of and you don’t need a prescription to buy it. Any individual could feasibly access someone else’s prescription cabinet and find DXM products.

Effects of DXM addiction include respiratory depression, liver failure, rapid heart rate, hyperthermia, seizures, psychosis and coma. High doses of DXM can lead to overdose. In 2014, the American Association of Poison Control Centres reported 45,748 overdose cases related to DXM abuse, with six deaths involved. Addiction affects your personal relationships with friends and family; it prevents you from putting in 100% at work, destroys your physical health and worsens any mental health issues you may have.

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Warning Signs of Cough Syrup Abuse and Addiction

Since DXM is legal and easily available, many don’t believe that it’s wrong to take large quantities of DXM. The mind-altering properties in cough syrup make it very dangerous.

Warning signs of cough syrup addiction include:

  • Dilated pupils
  • Red and glassy eyes
  • Rapid weight loss
  • Mood swings
  • Anxiety
  • Depression
  • Irritability
  • Disorientation and confusion
  • Skin rashes
  • Paranoia

Why Should You Seek Rehab for Cough Syrup Abuse and Addiction and Do You Need It?

There are several problems that arise from abusing cough syrup, with overdose, coma and death being the most serious issues. The ingredients in DXM (such as acetaminophen, pseudoephedrine and chlorpheniramine) are active compounds that cause liver failure, seizures and others.

If you or your teenager are struggling with DXM addiction, you’ll need professional treatment at a drug rehabilitation centre where you would receive a unique treatment plan to ensure all facets of the addiction are covered. Medical professionals at a rehab centre monitor the detox process, use the tapering method to reduce uncomfortable withdrawal symptoms and ensure you remain safe throughout the process.

You’ll need addiction treatment to properly address all aspects of addiction and reverse the physical and psychological effects, including broken relationships, financial problems and medical conditions.

Cough Syrup Addiction Treatment

Treatment includes detox to remove all DXM from your body; rehab to help you understand why you abuse DXM and teach you coping skills for dealing with triggers in a healthy manner; and aftercare for continued support after treatment.

Detox is not complete treatment on its own because it only looks at the physical aspect of cleansing your body of the substance you are addicted to. After detox, as mentioned, you will need to go to rehab if you wish to have a way of managing the root causes of your problem and learn relapse prevention techniques.

Psychotherapists will use a range of therapy techniques to help you understand your addiction, change negative behaviours and thought patterns that fuel addiction, improve communication and build a social network to stay sober.

Your teenager will benefit more from a specialised teen rehab facility, where doctors and drug counsellors are licensed to work with young people. Treatment options include individualised programmes, tailored to your teen’s personality, emotional state and any other recovery needs they might have.

What Is Cough Syrup Rehab Like?

It’s difficult to imagine what treatment is like if you’ve never attended rehab. Knowing what to expect will ease any frayed nerves. The first part of treatment comprises intake and assessment. An intake coordinator (looks for a licensed drug counsellor) will welcome you to the rehab centre and gather your insurance details and other legal paperwork. They’ll also collect forms relating to your medical history.

A clinical associate or detox nurse will collect blood for EKG and TB tests. After all paperwork and testing are complete, you’ll say goodbye to friends and family before being admitted to the detox clinic, where you’ll rid your system of drugs. In detox, you’ll attend group therapy and individual therapy sessions to address psychological withdrawal symptoms.

After detox, you’ll transition to rehab, where the real work begins. The structure is an integral part of treatment. You’ll wake up at the same time every day, participate in therapy sessions, eat meals, take your medication and attend classes at the same time. There’s the opportunity to build communication skills by interacting with counsellors, doctors, nurses and other patients in the rehab centre. Family members will be able to visit after a set period, during which they’ll attend family therapy and some group therapy sessions with you.

Treatment and Therapy Options

Inpatient rehab centres are structured, live-in, therapeutic communities, where you focus on addiction recovery journey without any temptations or distractions. It is more expensive than outpatient rehab but offers many benefits that help to maximise your recovery goals.

Outpatient programmes are not as structured or disciplined as inpatient ones, but are just as effective. It’s a good option if you’re a high functioning addict who is motivated to quit drug use. Treatment is scheduled in the evenings, weekends or several hours during the week. It is designed to integrate with your work or school schedule, so you can meet with both without reneging on certain commitments.

12-step recovery: support groups are a part of every drug-free journey. The goal of any support group is to help you remain abstinent from drugs and encourage positive behaviour for an abstinent living. Therefore, you’ll start attending meetings whilst in treatment and continue post-rehab. Narcotics Anonymous (NA) is the ideal group if you’re a cough syrup addict or you could attend self-management and recovery training (SMART) if you don’t ascribe to the theory of a higher being.

When to Choose: Inpatient vs. Outpatient

Not every case of addiction requires inpatient care. If you’ve recently started abusing cough syrup at small doses, you could receive substance abuse treatment as an outpatient. If you’re a high functioning addict who can attend work or school without drugs impacting on your performance, you can attend rehab as an outpatient. It also applies if you have a mild addiction without any co-occurring disorders or polydrug use problems.

Inpatient rehab or residential treatment is a type of addiction programme that requires you to live in a treatment facility fulltime for a fixed period. This type of treatment is recommended if you have a history of substance abuse; are a long-term codeine or DXM user; have a dual diagnosis of mental health disorder and drug addiction; or medical conditions that might affect treatment.

Benefits of inpatient and outpatient treatment

Inpatient therapy

  • It offers structure that isn’t as prevalent in outpatient treatment. This ensures there are no distractions or temptations to use drugs.
  • You enjoy 24/7 care & support from professional staff.
  • There is zero access to drugs in inpatient rehab, as you’re under constant supervision.
  • Medical supervision is provided during detox to manage any severe withdrawal symptoms (even after detox).
  • Total focus on your recovery journey.
  • Unique opportunity to make lasting friendships with other recovering addicts, who have the same goals as you.
  • Alternative therapy options that complement conventional programmes. They include meditation, yoga, Pilates, exercise routines and massage.
  • Practical nutritional therapies that help you imbibe healthy and balanced diet.

Outpatient rehab

  • A unique opportunity to receive addiction treatment and continue with school or work.
  • You’ll enjoy support from your loved ones.
  • It is cheaper than inpatient care while providing a high quality of treatment. You’ll recover more effectively when you have the loving support of close relatives and friends. If you’re an outpatient, you can start to build an abstinent community by going to meetings with other recovering addicts.

Choosing the Best Cough Syrup Rehab Centre

With hundreds of rehab centres scattered across the UK, it’s difficult to choose the right one that adequately caters to your addiction needs. A few things to look for when choosing a rehab centre include:

Location: If you have a support circle of family and friends, you’ll benefit more from staying close to home so that your loved ones can attend family therapy sessions and visit you during treatment. If you need to get away from your immediate environment, a luxury rehab centre in an isolated location might help you better focus on recovery.

Accreditation: the rehab facility of your choice must be fully accredited with certified and licensed addiction specialists. You can search online for the guidelines for accreditation in your local jurisdiction, as well as research individual licensed psychotherapists.

A number of therapy techniques: the best substance abuse treatment utilises multiple therapies to enhance results. Therapies will include treatment for dual diagnosis and alternative therapies that complement traditional techniques. Treatment should also be customised to your addiction needs and incorporate the core principles of effective care.

Cost of treatment: a major factor affecting the rehab facility you choose is the cost of treatment.  What is your budget and can you find a rehab centre within that price range? There are options such as government grants, financial aid and insurance that can help you pay for addiction treatment.

Specialised Treatment and Therapy Options

The goal of substance abuse treatment is to help you live a drug-free life. Treatment starts with the intake phase, where an individualised treatment plan will be created for you, based on answers you provide and results from the physical and psychiatric examinations. The best treatment combines pharmacology and psychotherapy to ensure both physical and psychological aspects of addiction are properly treated.


Methadone: some cough syrups (such as codeine) contain opiates. Therefore, opiate withdrawal medication is used in treatment, with methadone being the primary remedy. It works as an opiate agonist to relieve uncomfortable withdrawal symptoms and makes detox less painful. It is also a long-term maintenance medication to reduce cravings after you’ve completed treatment.

Buprenorphine: buprenorphine reduces the length of detox and works as a partial opioid agonist. It is less addictive than methadone and possesses similar properties to opioids without producing the euphoric effect associated with the medication.

Clonidine: this withdrawal medication is a centrally acting alpha-agonist hypotensive agent. It is prescribed if you have a mild addiction to cough syrups like codeine (or other prescription cough syrups).

Antidepressants: if you’re experiencing sleep disturbances during withdrawal, you’ll be prescribed antidepressants to reduce irritability, anxiety and insomnia.

Therapy options

Introduced in the 1970s, Cognitive behavioural therapy is the leading therapy approach used in treating mental health disorders and substance addiction. It’s most successful when combined with medication management and helps you learn the reasons why you abused drugs initially, as well as maintaining long-term abstinence. Working with a therapist, you’ll learn the skillset required to cope with triggers and stressful situations. Your treatment is personalized, based on your addiction or dual diagnosis and is altered or customised to maximise results.

Cough syrup addiction mostly affects young people aged 12 to 18. Multidimensional family therapy(MDFT) was created especially for adolescents and includes family sessions with parents, siblings and therapists. Sessions can be held at home or in the workplace. The goal is to explore parental style; identify how parents can trigger drug use, and helps both parents and family members change parenting styles in a way that encourages abstinence.

Withdrawal from Cough Syrup

The timeline of DXM detox is hard to define, as there isn’t sufficient research on the study. For one individual who was using 1800mg a day for five years, early withdrawal symptoms set in within 24 hours after their last drug use and peaked the next day. Common withdrawal symptoms associated with dextromethorphan abuse include:

  • Restlessness
  • Insomnia
  • Muscle pain
  • Diarrhoea
  • Nausea and vomiting
  • Cold flashes
  • Depression
  • Cravings
  • Anxiety
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Most of the symptoms are not deadly if well-managed, but are uncomfortable. The detox process takes three days for most people but extends to a few weeks in some long-term users with co-occurring disorders. Long-term treatment starts whilst you’re receiving detox treatment. You’ll attend individual and group counselling sessions to discuss your history of drug use, understand reasons for initial drug use and address psychological issues that might cause you to relapse.

Continuing Care That Comes Next

Also referred to as ‘aftercare’, continuing care is a plan that helps you stay drug-free after a period of addiction treatment. You’ll implement your plan whilst in treatment with the help of therapists and the addiction treatment team. This details all the activities you are to partake in after treatment has been completed.

Occasionally, the plan will be adjusted to fit recovery needs or based on your progress, especially when the risk of relapse is imminent. Returning home presents certain challenges, such as facing friends who previously encouraged drug use. You’ll need to live healthily, find interests and activities that encourage abstinence and surround yourself with people who are also on the recovery journey.

Your continuing care plan usually includes:

  • Continuing education classes
  • Finding a sponsor
  • Attending community-based support meetings
  • Staying at a halfway house
  • Scheduling group and individual therapy sessions with your therapist
  • Receiving maintenance medication from your prescribing doctor
  • Family/couples counselling

Relapse Prevention

Relapse is within the realm of possibilities for every recovering addict, no matter how long you’ve been abstinent. It’s essential that you have a relapse prevention plan that helps you avoid relapse for the rest of your life.

Relapse can include:

Emotional relapse: this is the first stage of the relapse process, during which you will have started thinking about consuming cough syrup. Your behaviour and emotions will prepare you for future relapse. Warning signs include isolation, anxiety, defensiveness and anger. If you’ve stopped following your aftercare plan or attending support group meetings, this is also a cause for concern.

Mental relapse: there is a crisis in your mind, where some parts of you want to consume cough syrup, but the other part is holding back. Signs include constantly thinking about relapse, lying, fantasising about relapsing and thinking of places and times you enjoyed under the influence of cough syrup.

Physical relapse: if you don’t recognise the warning signs, you will relapse during the physical stage, as it is difficult to curtail the process at this point in time.

A few tips to help include:

Practice self-care: take care of yourself. Eat healthy meals, sleep on time, create time for relaxation and ensure you remove yourself from stressful situations or trigger environments that might lead to relapse.

When you fantasise about taking cough syrup, play the scene in your head through to the end. Imagining the consequences of drug use might help keep you on the right track. You know from experience that using just once isn’t possible as an addict.

Talk to your sponsor about your urges and attend a meeting.

Take your recovery journey one day at a time.

Treatment Payment Options

For many years, people struggling with substance abuse didn’t have the means to pay for rehab,as the full cost was beyond their means. What they could afford were short-term hospital stays and 12-step programmes that didn’t adequately get to the root cause of addiction. Halfway houses and residential treatment were also expensive and insurance didn’t cover the cost.

Thankfully, the law has been amended and people now have options when considering paying for rehab. The first option for rehab payment is insurance. Most insurance companies will cover the full or partial cost of rehab, though this is dependent on your policy. Some insurance policies only cover basic therapies such as CBT, but won’t cover recent innovations targeted towards specific addictions.

Alternative options include:

Personal finance: if insurance doesn’t cover the cost of rehab, you can pay via your personal funds. Eliminating the biggest problem in your life is the best investment you’ll ever make.

Seek support from friends and family: if you can’t pay for rehab on your own, ask your loved ones to send money directly to the rehab centre on your behalf. It might make you uncomfortable, but it’s the right step in taking the path to freedom from addiction.

Personal bank loan: find the bank with the lowest interest rate and manageable payback terms to reduce the burden of paying out of your personal finances.

Insurance: You may be able to get into rehab on the NHS. Talk to your GP and maybe call your insurance group itself for advice.

Live a Sober Life: Call Now for Treatment Options

When you abuse DXM,this induces psychedelic effects that lead to hallucination and psychosis, which could last days before wearing off. An alarming number of teenagers and young adults are being hospitalised for cough syrup overdose because they don’t know the dangers of abusing over-the-counter medications or the risk of addiction. Effects include mild simulation, hallucinations, dissociative state and complete unresponsiveness.

You’ll need addiction treatment to help you address the underlying issues that led to drug use and learn coping skills for dealing with the pressure and triggers, without using drugs. Addiction is a serious problem. You don’t have to walk the lonely road alone. Call a drug addiction helpline and a consultant will help you start the process of getting treatment for your addiction.

Cough Syrup Addiction: Fast Facts

  • One in ten people aged 12 to 17 has abused cough medicine to feel ‘high’.
  • 55% of teenagers don’t agree that it’s dangerous to get ‘high’ on cough syrup.
  • 75% of parents who talk to their kids about the dangers of drug abuse don’t include over-the-counter medicine like DXM.
  • DAWN estimates that 16,858 hospital visits in 2004 were directly related to cough syrup, with 51% of patients aged 12 to 20 years old.
  • In the 12 to 17age group, more females abused OTC cough medicine than males. Meanwhile, in the 18 to 25 age group, men abused more than females.
  • In 2006, young adults and adolescents aged 12 to 25 were the maingroups to abuse cough syrup. The figure was 3.1 million users.
  • In the age group 12 to 25, the most abused cough medicineswere Robitussin, NyQuil and Coricidin.
  • In 2014, 5,500 hospital visits were as a result of dextromethorphan abuse.

Cough Syrup: True Stories of Addiction

A young man recounted the story about his addiction to Robitussin on an addiction blog. At first, he didn’t believe it was possible to get ‘high’ on cough syrup until his first hallucinogenic trip that lasted three days. During that time, he had diarrhoea, looked physically pale, vomited and was in and out of a realistic state for almost a week.

After recovering, he went back to Robitussin and continued using the drug every day, because of the ‘trip’ the cough medicine induced. To hide his druguse, he consumed bottles of syrup and sprayed perfume to hide the smell. Soon, eight ounces wasn’t enough and he switched to the capsule version.

After a few months, he looked sick, frail, had lost weight and was taking 38 pills without a chaser. Luckily, he asked for help before his health suffered any further. There were several relapses on the recovery journey, but he’s now been clean for 18 years.

Frequently Asked Questions

What recovery programme is right for me?

The right recovery programme is one that caters to all your unique addiction needs and equips you with skills and techniques for lifelong abstinence. If you’re a long-term addict, mental health diagnosis patient, polydrug user or have a medical condition that might complicate treatment, you should enrol as an inpatient. Where your job is demanding and you can’t take time off to fully commit to treatment, attend as an outpatient if you have a support network that motivates you to get better. However, it may be best for you to heal without the stress.

Should recovering people use cough syrup?

Doctors might use cough syrup during the tapering process. They gradually lower your regular doses of cough syrup until all traces of it have left your system. After detox, you should not use cough syrup, as the aim of treatment is to help you live a drug-free life.

What are Purple drank, Sizzurp, Syrup and Lean?

These are a slang name for different combinations of cough syrup. Lean and Purple Drankare a mixture of fruit-flavoured candy, soda and codeine. The fruit candy and soda make it sweet and amenable to the palate.

When is treatment necessary?

Treatment is necessary when you realise you have no control over your cough syrup use or experience withdrawal symptoms when you try to quit. You should never attempt to quit drug use on your own, without the help of a medical professional.

What is Robitussin abuse?

Robitussin is a type of cough syrup and a brand name for DXM. You would be abusing Robitussin when consuming it for non-medical purposes or recreational use.

What are the effects of DXM use?

Side effects of DXM usage include fatigue, feeling faint, dizziness, nausea, restlessness, stomach pain and increased heart rate.

What is dextromethorphan?

Dextromethorphan is one of the most commonly prescribed cough suppressants. It is the major ingredient in most cough syrups sold over-the-counter. Taken at lower doses, it reduces coughs and helps you relax, but at higher doses has psychedelic effects. It is currently found in more than 120 different over-the-counter medications.

What support is available after you leave the programme?

After you leave rehab, you’ll continue receiving treatment as an outpatient. This includes attending community-based support group meetings, scheduled appointments with your psychiatrist and prescribing doctor, as well as education classes.

Which recovery centre is right for your teen?

Teenagers benefit more from specialised rehab programmes, where doctors and counsellors are accredited with the relevant qualifications that enable them to work with and help teenagers struggling with substance abuse.

How long does inpatient rehabilitation last?

Short-term inpatient rehab lasts 28 to 30 days and is usually recommended if you have a mild addiction to drugs. Long-term rehab stays last between 60 to 90 days and sometimes longer.

What happens during treatment?

During treatment, you’ll undergo detox to remove cough syrup from your system. After that, you’ll transition to rehab, where psychotherapists help you understand why you started abusing cough syrup and teach you coping skills for dealing with triggers and stressful situations, without resorting to drug use. Then you will move on to aftercare.

Should I travel or stay near home?

This all depends on your situation. If there are too many triggers at home or you don’t have close family that can motivate you during treatment, you might be better served by travelling.

Can I access an executive or luxury rehab centre?

Exclusive or luxury rehab facilities are ideal for business executives and affluent people who want to enjoy the same standard of living in rehab that they’re used to at home. There are many luxury treatment centres in the UK that provide amenities such as fine dining, luxurious rooms, spa treatment, massage therapy, animal therapy, gym, swimming pool, phone and wi-fi access.

How long does a withdrawal from codeine last?

The detox process takes three days for most users and withdrawal lasts between eight and 30 thirty days, depending on the severity of your addiction.

Are there any home remedies to get clean safely?

Withdrawal from cough syrup isn’t as dangerous as other addictions. To stay safe and avoid overdosing, attend rehab as an inpatient. For some people, taking laxatives or drinking copious amounts of water helps to relieve withdrawal symptoms. Sadly, this does not ease the pain and can cause liver damage.

Is there a list of popular slang or street names for codeine?

Captain Cody, Schoolboy, Lean, Purple Drank, Sizzurp, Loads, Pancakes and Syrup, Cody, Doors and Fours.

Can abuse and addiction to cough syrup be treated?

Yes. Abuse and addiction will be treated during drug rehabilitation, using innovative therapy techniques such as Cognitive Behavioural Therapy and Motivational Interviewing.

Do I need addiction treatment?

You need treatment if the cough syrup is having a negative impact on your life or you’ve lost control over your drug use. Addiction is a complicated mental health issue that should be properly treated by specialists. You need to understand and address all underlying issues that led to an addiction to ensure you know your triggers and can handle them without using drugs.

How much does the programme cost?

The cost of treatment depends on several factors, such as the type of rehab facility, length of rehab, the location of the rehab centre, the expertise of staff, any co-occurring conditions that need to be treated alongside your addiction, as well as the staff-to-patient ratio. In the UK, standard rehab programmes cost around £2,000 a week and £5,000 a month. Luxury rehab programmes cost up to £10,000 a week.

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