Drug abuse has been a national social problem in the United States for decades and is often complicated by the emergence of new types of abused drugs or new forms of abuse. The forms of abuse, particularly by young persons, include the search for substitutes for better-known substances. It is unclear what factors determine the choice of drug or substance for experimentation, considering the wide range of choices. However, the appeal of Dextromethorphan-based cough syrup as a substitute for other drugs or substances may lie in one or more of the following factors: (1) Availability: no prescription required, available over the counter in drug stores and food markets, in the medicine cabinets of many American households; (2) Approval: does not bear the same social negative connotations as, e.g., glue or butane sniffing; (3) Ignorance: little known about the negative effects of its abuse; and (4) Fear: does not have the intimidating qualities to the abuser of a pill such as aspirin, powders, or needles. References