Tuesday, January 06, 2004

Tussin! Its not just for Teens.

Teens Still Getting High on Cough Remedy - By Daniel DeNoon (WebMd)

Jan. 5, 2004 -- It's not new. It's not illegal. And when abused as a recreational drug, it's not safe.

Generations of teens have used the cough suppressant dextromethorphan to get high. And every year, according to the U.S. government statistics, thousands of users end up in emergency rooms.

Users call it DXM or dex. It's an ingredient in more than 125 over-the-counter cough and cold remedies. Some of the more popular ones have their own drug-culture nicknames: "C-C-C" (Coricidin HBP Cough & Cold tablets), for example, or "robo" (Robitussin). Other nicknames include "candy," "skittles," and "red devils."

What does it do? The intoxicating effect is similar, but much less intense, to the effects of PCP and LSD, says Ronald Strong, supervisor of the national drug threat assessment unit at the U.S. National Drug Intelligence Center (NDIC).

"PCP and LSD as hallucinogens are far more potent than DXM," Strong tells WebMD. "But the effects you would get from what these kids are taking is similar."

The side effects are much less fun, notes Ilene B. Anderson, PharmD, associate clinical professor at the University of California, San Francisco, School of Pharmacy and senior toxicology management specialist for California's poison control system.

"The primary effects are nausea, vomiting, feeling dizzy and lightheaded -- kids taking DXM can become drowsy and can look like they are drunk," Anderson tells WebMD. "They have dilated pupils, increased heart rate and blood pressure, and they can have hallucinations. Many patients also are agitated. And the potential is there for seizures, although these are uncommon."

Here, There, and Everywhere

When used as directed, DXM is good medicine, says Deborah Mitchell, an intelligence analyst at the NDIC. It acts on the brain's cough center to relieve the misery of nagging, unproductive coughing. That's why it's included in so many cough and cold products.

And those products are everywhere. You can buy them at your local drug store. You can get them over the Internet. Many pharmacies make no effort to keep children from buying these products.

Normal doses of the drug range up to 30 mg, which is the highest potency available on the market. That's the amount in Coricidin HBP Cough & Cold tablets, and also the dose in DexAlone Maximum Strength Cough Suppressant liquid gelcaps.

Anderson notes that the dose needed for a hallucinatory effect is about 400 to 500 mg. That's about 15 doses of the high-strength DXM products. These huge doses of DXM are bad enough. But as most DXM products contain other medicines, abusers risk overdoses of other serious medicines. These include the antihistamine chlorpheniramine and/or pain reliever acetaminophen. Overdoses of these drugs can be extremely dangerous and cause lasting damage.