Information About OTC Cough Medicine Abuse (page 4)

Cough Medicine

OTC cough medicines containing the active ingredient dextromethorphan (DXM) have been providing families with safe and effective relief from coughing for generations. Dextromethorphan was approved by the U.S. Food and Drug Administration (FDA) in the 1950s and, when used according to label directions, helps relieve cough symptoms.

There are well over 100 OTC medicines that contain DXM, either as the only active ingredient or in combination with other active ingredients. Examples include Alka-Seltzer Plus Cold & Cough Formula, Coricidin HBP Cough and Cold, Dimetapp® DM, Mucinex® DM tablets, PediaCare cough medicines, certain Robitussin® cough products, Sudafed cough products, TheraFlu Cough products, Triaminic cough products, Tylenol Cough and Tylenol Cold products, Vicks 44 Cough Relief products, and certain Vicks DayQuil and NyQuil LiquiCaps. There also are a number of store brands that contain dextromethorphan, as well.

While recognized as safe and effective by FDA when used according to the Drug Facts label, dextromethorphan’s effects can be dangerous when abused in extreme doses. Reports indicate that teens looking to get high take anywhere from 25 to 50 times the recommended amount on the label, which can often translate to multiple bottles or packages of medicine at one time.

Good Medicines, Bad Behaviors

Cough medicine abuse is a situation of 'good medicines, bad behavior.' The fact of the matter is that teen cough medicine abuse does not happen by accident; it involves intentionally taking huge amounts—sometimes 25-50 times the recommended dose—of medication to get high. The ingredient in over-the-counter (OTC) cough medicines that teens are abusing is dextromethorphan, or DXM. While DXM-containing medicines are safe and effective when used as directed, they can be dangerous when abused in extreme amounts.

Educational Icon Helps You Understand the Issue

The makers of OTC cough medicines containing DXM have introduced an educational icon on their medicines’ packages. The icon helps raise awareness about the teen abuse of cough medicines and provides the StopMedicineAbuse.org web site as a resource for more information. It also provides a great conversation starter with your teens about cough medicine abuse. 

Side Effects

At recommended doses, OTC cough medicines give you cough relief and have little or no physical or psychological side effects. When abused—sometimes at 25–50 times the recommended dose—dextromethorphan-containing cough medicines can cause strong visual hallucinations, mild distortions of color and sound, out-of-body sensations, confusion, slurred speech, or the loss of motor control. Other serious side effects can include:

• Delusions
• Panic attacks
• Memory problems
• Blurred vision
• Stomach pain, nausea, and vomiting
• High blood pressure and rapid heartbeat
• Numbness of fingers and toes
• Drowsiness and dizziness
• Fever and headaches
• Rashes and itchy skin
• Loss of consciousness

The effects can be worsened if the DXM-containing cough medicine being abused also contains other ingredients to treat more than just coughs or if it is being abused in combination with other medications, or taken with alcohol and illegal drugs.

Size of the Problem

Recent research shows that while parents are aware of the dangers of illicit street drugs, both prescription medicine and over-the-counter (OTC) cough medicines are often overlooked as potential threats. The lack of awareness about this type of substance abuse is a barrier to preventing it.

According to data from the Partnership for a Drug-Free America, while an estimated one in five teens has abused prescription drugs, an estimated one in 10 youths—or 2.4 million young people—has intentionally abused cough medicines to get high. Data collected in 2008 by the National Institute on Drug Abuse for its Monitoring the Future study estimates the intentional abuse of cough medicine among eighth, tenth, and twelfth graders is at 3.6 percent, 5.3 percent, and 5.5 percent, respectively.

DXM abuse is becoming more common in teen culture, especially on the Internet. There are hundreds of web sites and online communities promoting the abuse of DXM-containing medicines. Some of these sites provide guides on how to achieve a high based on a user’s height and weight, how to combine DXM-containing medicines with other drugs, and what effects are to be expected at specific dosage levels. Some web sites serve as dangerous Internet drug dealers, allowing teens to buy large amounts of pure, unfinished DXM online.

Web sites promoting DXM abuse information are not the only online sources providing dangerous content to kids. Social networking sites such as MySpace, YouTube, LiveJournal, and Facebook are filled with detailed instructions, user conversations, and videos of DXM abuse. Users blog and post videos about specific plans to take DXM, how and when they will take it, and even experiences while abusing. Through these outlets, users actively compare notes, exchange approaches, and further promote this dangerous type of abuse.

Warning Signs

You likely already know some of the warning signs of alcohol or illegal drug abuse. But do you know the signs of medicine abuse?

Signs that abuse may be taking place:

• Empty cough medicine boxes or bottles in the trash of your child’s room or in your child’s backpack or school locker
• Purchase or use of large amounts of cough medicine when not ill
• Missing boxes or bottles of medication from the medicine cabinet
• Visiting pro-drug web sites that provide information on how to abuse dextromethorphan
• Internet orders (for example, note the arrival of unexpected packages, or payments by credit card or PayPal account)
• Changes in friends, physical appearance, or sleeping or eating patterns
• Declining grades
• Loss of interest in hobbies or favorite activities
• Hostile and uncooperative attitude
• Unexplained disappearance of household money
• Unusual chemical or medicinal smells on your child or in his or her room
• Hearing your child use certain slang terms for DXM abuse, such as Skittling, Tussing, Robo-Tripping, Triple Cs, Robo-tripping, and Dex

Cough Medicine Abuse Can Touch Any Family

We hear it from parents all the time – "not my kid." Our answer: Even if your teens don't have an issue with over-the-counter cough medicine abuse, they live in a world where they are confronted with it daily. Roughly 33 percent of American high school teens know someone who has abused cough medicine containing dextromethorphan, or DXM.

The Issue is Increasingly Prevalent in Teen Culture

DXM abuse is becoming increasingly present in teen culture. There are hundreds of web sites and online communities promoting DXM abuse with instructions on how much medicine it takes for different types of highs.

Don't Wait to Address the Issue

So, even if you think your teens don't have an issue, don't wait to talk to them about the real risks. In order for teens to take cough medicine abuse seriously, they need to know that their parents do not approve of any sort of substance abuse behavior.