What & Why Parents of Teenagers Should Know About Cough & Cold Remedies Like Coricidin What is Dextromethorphan? DXM,?

As a parent, you try from the moment your children are born to keep them safe, but as any parent of a teenager can tell you, the older that they get, the harder it is to do. Still, if you are like me, there are a few things that you have been talking to your teenager about for most of their lives, things like; stranger danger, safe sex, and of course, the dangers and pitfalls of drug and alcohol abuse. As the parent of two teenagers, a son who is seventeen, and a daughter who is nearly sixteen, I have always tried to be conscientious about not only talking to them about drugs and alcohol, but I've also tried set a good example at home, (children learn by example), and I've done my best to stay informed about whatever new illicit, or designer drug dangers might be swirling around in my children's ever expanding universe. So, imagine my surprise, shock, and horror, when, through the prayer request of a Facebook friend, I found out that besides worrying about the usual host of illicit drugs, marijuana, methamphetamines, cocaine, PCP, LSD, or prescription drugs like Ritalin, Ativan, and Xanax, I should now be concerned about what over-the-counter cold medications are in my medicine cabinet!

In her Facebook post of July 7, 2011, my friend said;

"Please say a prayer for my daughter's friend who is in ICU! And, parents....BE AWARE!! This girl is in ICU of taking Coricidin, aka, Triple C's or Skittles. It's an otc cold med that teenagers are stealing/using to get high. Google it! In this girls case, she is in ICU....and she is only 12!!!! Talk to your kids, you will be surprised at what they already know. Very sad....please please pray for her."

"Coricidin?!" I said out loud, as I shook my head in disbelief, "is what I give my father when he is congested. Why in the world would she take Coricidin? It's a cold medicine." I am wondering, and because I don't know the answers, I spend the rest of the afternoon finding out.

What I Already Knew

I began my search knowing a very little bit about the over-the-counter cold and flu medication that, even as write this, inhabits my family's medicine cabinet. What I did know is that Coricidin, which is also known by the generic name Chlorpheniramine Maleate Dextromethorphan, is for the treatment of cold and flu symptoms, which also works as a cough suppressant. I also knew that it is a small round brightly colored red pill that (after measuring it), is about ten millimeters in diameter, and that because it does not interfere with my father's blood pressure medication, Coricidin is his doctor's choice of treatment for any cold or flu symptoms that my dad might have. Further investigation of the box, reminded me that the recommended dosage is one (1) thirty milligram pill every six (6) hours, and the usual warnings about not exceeding the recommended dosage etc. Once I had done a thorough investigation of the box, it was time to do some real research; and I was shocked by what I learned.

What I Learned

Over the period of about the last decade, Coricidin, and other drugs containing the cough suppressant dextromethorphan, have become among the top favorite party drugs for teenagers between the ages of thirteen and sixteen, who are looking for a high that mimics that of other psychotropic drugs; producing hallucinations, loss of motor control, and out-of-body or dis- associative sensations, and who in order to achieve that high, are taking the over-the-counter medications in dosages that are the equivalent of three times or more the recommended dosage.

So what is it that makes this drug so popular? Why are suburban tweens and teens choosing this drug, which mimics the effects of the more widely known street and designer drugs? The answer is two fold, and as old as time; Cost and availability. The average teenager between the ages of thirteen and sixteen, doesn't have an endless supply of cash; but for around ten dollars they can walk into almost any grocery or drug store and purchase enough Coricidin or Robitussin DM, or Vicks 44-D, or one of many other over-the-counter cough and cold medications, that contain the cough suppressant dextromethorphan, to get themselves and maybe a friend or two, through a Friday or Saturday night; and in households, just like mine, where the unsuspecting parent has no idea what potential dangers may be present in the over-the-counter cough and cold medicines that are in their family medicine cabinet, awaiting the inevitable next bout of cold or flu, access is both free and easy.

Although reports of it's abuse were not widely known until the last decade or so, dextromethorphan (DXM) is not a new drug.

Dextromethorphan is a synthetic drug that was developed in part as a replacement for cough treatments that contained the narcotic codeine, and was approved by the FDA, (Federal Food and Drug Administration), as a cough suppressant in 1958. It was originally introduced as an over-the-counter medication called Romilar and was available in both tablet and liquid form. News of Romilar's popularity among the drug counter-culture was well known as early as the beginning of the 1970's, and as a result, the tablet form of Romilar was removed from the otc market in 1973. Though it had been banned as an otc treatment, and subsequently been removed from drug store shelves, DXM had been specifically excluded from the Controlled Substance Act of 1970, which meant that it was still legal to produce and use the potentially dangerous drug. This exclusion, allowed the big drug manufacturers to reformulate the original recipe for DXM, and shortly after it was removed from the over-the-counter market, they began to reintroduce it in a refined liquid form that left a bad aftertaste when taken in large quantities. The belief that the unpleasant aftertaste would work as a determent to abuse, allowed the new improved formula to remain on the shelves. A short time later, those same drug companies began to introduce their products in new and appealing flavors, and the abuse did not stop.

In the 1980's the popularity of DXM began again to surge, which prompted the FDA to convene a committee in 1990 to determine just exactly what DXM's abuse potential was. The committee recommended that additional toxicity data and more epidemiological data be gathered. In 1992, with the new data in hand, the committee reconvened, and concluded that the abuse was contained to small communities and that additional studies should be conducted. It was during the 1990's that the use of dextromethorphan containing syrups among teens as a recreational drug became a well-known phenomenon.

In a study of the Cincinnati Poison Control Center's call records for the period of January 1, 2000 - October 1, 2000, regarding the ingestion of Coricidin, a whopping 71% were classified as abuse, (a probable attempt to gain a euphoric or other psychotropic effect.)

In 2004, an article by the New York Times, reports that of the *2,523 calls placed to poison control centers nationwide, regarding the improper ingestion of Coricidin or other DXM containing over-the-counter drugs, 60% of those were teenagers between the ages of thirteen and seventeen. Three years later, in 2007 the calls have increased to 4,382, and the number of those relating to teenage involvement has risen to 75%.

^{(*statistics provided by the American Association of Poison Control Centers Toxic Exposure Surveillance System)}

As of 2011, there is still no law that makes it illegal to produce or to use dextromethorphan, and even though there is overwhelming proof of wide spread abuse, the FDA, has yet to take steps toward the scheduling of this potentially dangerous drug as a narcotic, and so it remains readily available to countless numbers of teens and tweens, many of whom believe that because it is available over-the-counter, and it isn't illegal, that it isn't really dangerous either.

But rest assured, it is dangerous, very dangerous, and with its already easy accessibility being enhanced by on-line sites, where not only can it be purchased in it's pure powder form, dosing information, and instructions on how to extract DXM from cough and cold products are also provided, it's prevalence is growing.

So how can this epidemic be stopped? Although not required by law, some drugstore chains, such as Rite-Aid, have taken steps to help by placing all medicines containing detromethorphan behind the counter, requiring identification for those under the age of eighteen, and by limiting the amount of the medication which can be bought by one person. Until enough pressure is put on lawmakers, and the FDA, to take action, parents can help by being aware of what is in their medicine cabinet, educating their children, and just good old fashioned parent awareness.

_{Kristen Burns-Darling ©2011}