Although it's been all over the news lately,
chugging cough medicine for an instant high certainly isn't a new practice for
teens. They've been raiding the medicine cabinet for a quick, cheap, and - more
importantly - legal high for decades. But recent coverage of the dangerous,
potentially deadly practice of intentionally overdosing on cough and cold
medicine has put parents, educators, and emergency departments on the
alert.
Why Are Kids Abusing Cough and
Cold Remedies? Before the
Food and Drug Administration (FDA) replaced the narcotic codeine with
dextromethorphan as an over-the-counter (OTC) cough suppressant in the 1970s,
teens were simply guzzling down cough syrup for a quick buzz. Over the years,
teens have made the unsettling discovery that they could get high by taking mass
quantities of any of the multitude of over-the-counter medicines containing
dextromethorphan (also called DXM). Found in tablets, capsules, gel caps, and
lozenges, as well as syrups, dextromethorphan-containing products are labeled
DM, cough, cough suppressant, or Tuss (or contain "tuss" in the
title).
Medicines containing dextromethorphan are easy to
find, affordable for cash-strapped teens, and perfectly legal. Getting access to
the dangerous drug is often as easy as walking into the local drugstore with a
few dollars or raiding the family medicine cabinet. And because it's found in
over-the-counter medicines, many teens are naively assuming that DXM can't be
that dangerous.
Then and
Now Despite the recent
media coverage, there's been "no significant change" in the number of emergency
department visits from DXM abuse since 1994, according to the U.S. Department of
Health and Human Services' Substance Abuse and Mental Health Services
Administration (SAMHSA), which monitors trends in drug-related emergency
department visits and deaths nationwide.
The major difference between abuse of cough and
cold medicines from past years is that teens are using the Internet to not only
buy DXM in pure powder form, but to learn how to abuse it. Because drinking
large volumes of cough syrup causes vomiting, the drug is being extracted from
cough syrups and sold on the Internet in a tablet that can be swallowed or a
powder that can be snorted. Online dosing calculators even teach abusers how
much they'll need to take for their weight to get high.
One major way teens are getting their DXM fixes is
by taking "triple C" - Coricidin HBP Cough and Cold, which contains 30 mg of DXM
in little red tablets. Users taking large volumes of triple C run additional
health risks because triple C contains an antihistamine as well. The list of
other ingredients - decongestants, expectorants, and pain relievers - contained
in other Coricidin products and OTC cough and cold preparations compound the
risks associated with DXM and could lead to a serious drug overdose.
In addition to Triple C, other street names for DXM
include: Candy, C-C-C, Dex, DM, Drex, Red Devils, Robo, Rojo, Skittles, Tussin,
Velvet, and Vitamin D. Users are sometimes called "syrup heads," and the act of
abusing DXM is often called "dexing," "robotripping," or "robodosing" (because
users chug Robitussin or another cough syrup to achieve their desired
high).
What Happens When Teens Abuse
DXM? Although DXM can be
safely taken in 15- to 30-milligram doses to effectively suppress a cough, users
tend to consume as much as 360 milligrams or more. Taking mass quantities of
products containing DXM can cause hallucinations, loss of motor control, and
"out-of-body" (disassociative) sensations.
Other possible side effects of DXM abuse include:
confusion, impaired judgment, blurred vision, dizziness, paranoia, excessive
sweating, slurred speech, nausea, vomiting, abdominal pain, irregular
heartbeat, high blood pressure, headache, lethargy, numbness of fingers and
toes, redness of face, dry and itchy skin, loss of consciousness, seizures, brain damage,
and even death.
When consumed in large quantities, DXM can also
cause hyperthermia, or high fever. This is a real concern for teens who take DXM
while in a hot environment or while exerting themselves at a rave or dance club,
where DXM is often sold and passed off as similar-looking drugs like
PCP.
Being on the
Lookout If you suspect
that your child may be abusing over-the-counter medicines
or if your teen often attends raves or dance clubs where DXM can likely be found
in abundance, it might be a good idea to:
- Lock your medicine cabinet, or keep those OTC
medicines that could potentially be abused in a less accessible place.
- Avoid stockpiling OTC medicines. Having too many
OTC medications at your teen's disposal could make abusing them more
tempting.
- Keep track of how much is in each bottle or
container in your medicine cabinet.
- Keep an eye out for not only traditional-looking
cough and cold remedies in your teen's room, but also strange-looking tablets
(DXM is often sold on the Internet and at raves in its pure form in various
shapes and colors).
- Look for possible warning signs of DXM abuse
listed above.
- Monitor your child's Internet usage. Be on the
lookout for suspicious websites and emails that seem to be promoting the abuse
of DXM or other drugs, both legal and illegal.
Above all, talk to your kids about drug abuse
and explain that even though taking lots of a cough or cold medicine seems
harmless, it's not. Whether it comes from inside the family medicine cabinet or
the corner drugstore, when taken in large amounts dextromethorphan is still a
drug that can be just as deadly as those sold by drug dealers on a seedy street
corner. And even if you don't think your teen is doing it, chances are they know
someone who is.
Reviewed by: Mary L.
Gavin, MD Date reviewed: February 2004
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