What is Triple C?

Triple C is a slang term for the over-the-counter medication Coricidin HBP Cough & Cold, which contains dextromethorphan, or DXM. The medication is abused because it contains dextromethorphan which, when taken in doses that dramatically exceed those recommended by physicians and pharmacists, produces hallucinations and a sense of dissociation. The medication is used legitimately to treat the symptoms that typically result from colds or upper respiratory allergies.

What does Triple C look like?

Triple C (Coricidin HBP Cough & Cold) is available as red tablets containing 30 milligrams of dextromethorphan. It is likely that individuals abuse similar products, which may include Coricidin HBP Chest Congestion & Cough (available as softgels containing 10 milligrams of dextromethorphan) and Coricidin HBP Maximum Strength Flu (available as tablets containing 15 milligrams of dextromethorphan).

How is Triple C abused?

Triple C tablets generally are taken orally. Powdered extractions of dextromethorphan, which are either inhaled or repackaged in capsules and swallowed, are reportedly available, but it is unclear whether the drug has been extracted from Triple C or from other medications containing dextromethorphan. (See DXM Fast Facts.)

Who abuses Triple C?   

It is difficult to gauge the extent to which Triple C and other medications containing dextromethorphan are abused in the United States because most data sources that provide estimates of drug abuse do not report data regarding these drugs. Law enforcement sources indicate that teenagers and young adults are the principal abusers of dextromethorphan and Triple C. Usually stocked on open shelves, Triple C is susceptible to shoplifting, which has caused some stores to place it behind the counter. Its accessibility and relatively low price make it particularly attractive to young people, especially compared to illicit drugs.

What are the risks?

Coricidin HBP products have proven to be safe and effective when users adhere to recommended doses (containing 10 to 30 milligrams of dextromethorphan taken every 6 hours). However, abusers typically consume many times the recommended dose, which produces hallucinations and dissociative effects similar to those experienced with PCP (phencyclidine) or ketamine. While under the influence of the drug, which can last for as long as 6 hours, abusers risk injuring themselves and others because of the drug's effects on visual perception and cognitive processes.

High doses of dextromethorphan result in an increased body temperature, which poses a particularly acute health threat if the drug is used in an environment--such as a rave or dance club--where users are dancing among crowds of people. Other risks associated with dextromethorphan abuse include nausea, abdominal pain, vomiting, irregular heartbeat, high blood pressure, headache, numbness of fingers and toes, loss of consciousness, seizure, brain damage, and possibly death.

The risks to Triple C abusers are heightened because the medications that are abused contain additional ingredients such as expectorants, pain relievers, and antihistamines that produce additional side effects and compound the risks associated with dextromethorphan.

What is it called?

Most commonly called Triple C (CCC), the drug also may be called DXM or dex (for dextromethorphan), candy, skittles, and red devils.

Is Triple C illegal?

No, Triple C is not illegal. The medication is available without a prescription because, when used properly, it has proven to be safe and effective. Reports of dextromethorphan abuse, however, have resulted in monitoring by the Drug Enforcement Administration (DEA).