drdĒv
03-07-2005, 06:23 AM
Back Article published Mar 6, 2005
Common household items become drugs
By Kim Mitchell
Daily Times Staff Writer
While on a mission to delve into heroin use in the area, Cpl. Matt Brown of the Fruitland Police Department said he discovered that area teenagers were going a different route to get "high."
Drug abusers are looking past traditional ways, trading the bong for the bottle -- as in cough syrup.
Since 1978, Monitoring the Future has provided the nation with a window to see the prevalence of teenage drug use. Through an annual study, analysts discover the behaviors and trends of teenage drug use often hidden from the public.
The MTF study surveys about 50,000 students across the country on the use of any drugs throughout the prior 12 months, said Lloyd Johnston, director of MTF.
The survey asks general questions, focusing on illicit drugs, and even though it asks students their frequency of over-the-counter drug use, it fails to inquire about the reasons for the use, whether to get high or for intended proper uses, he said.
About 140 over-the-counter medicines, including Dimetapp DM and Sudafed, contain the cough-suppressing ingredient dextromethorphan (DXM). Those medications containing DXM usually have "DM," "Tuss" or "Maximum Strength" on the label.
Under recommended doses, DXM triggers no adverse effects. However, those seeking a high from DXM don't follow the recommended doses.
Instead, they may consume an entire bottle of Robitussin cough syrup or ingest a box of CoricidinHBP gel capsules, the two most commonly products abused, according to the U.S. Department of Justice.
Shannon Miller, an addiction services psychiatrist from the Dayton, Ohio, Veterans Administrative Medical Center, said that instead of facing the taste of cough medicine, users are gravitating toward pills and, increasingly, the powder form found on the Internet.
Even though DXM is considered a powerful psychedelic, it is sold legally in the form of over-the-counter medications throughout the United States and in many foreign countries, Miller said.
With increased use for unintended purposes, retailers across the country have placed limitations on the number of cough and cold products purchased at any time. The same retailers restrict underage persons from products classified as inhalants.
Other substances that are alternatives for cough suppression are opiates or opioids, but they have a greater potential of being abused.
Theft, bulk-buying
As Brown inquired about needle thefts by suspected heroin users, a Wal-Mart associate told him something that surprised him. The associate said the Fruitland store is seeing an increasing number of thefts of over-the-counter products containing DXM. Those thefts led Brown to investigate the drug's rise in popularity, he said.
Teenagers across the country target stores selling OTC medicines for thefts, especially pills and gel caps, Miller said. Abusers will remove a sheet of pills from the box, hide it under their clothes and simply walk out of the store, he said.
"It's harder to steal a bottle than a box," he said. "They're easier to take, easier to steal and easier to hide in schools. It makes for a more portable addiction."
Abusers are also buying multiple packs at a time, Miller added.
"DXM is becoming pretty popular," Brown said. "It's easy access and no one bats an eye at someone buying cough medicine."
Inhalant use
While overall teen drug use continues to decline, the use of inhalants in the hopes of achieving temporary euphoria continues to rise across the country, said Johnston.
On the Lower Shore, the use of inhalants isn't presently a major concern, but it has been and will be again, said Linda McClung, director of Warwick Manor Outpatient Services on East Main Street in Salisbury.
"It comes in cycles," she said.
Johnston said these drugs are attractive to younger audiences who don't have access to illicit drugs. Inhalants are less expensive, legal and easy to obtain, she said.
"It's easy to get ahold of and it's in everyone's homes," said Cindy Shifler, drug prevention coordinator for the Wicomico County Health Department.
Johnston said the MTF results accurately reflect students' drug use. Although the anonymous survey is administered in classrooms, Johnston said that each student gets a different survey, teachers do not circulate the room and the tests are immediately taken out of the school.
The 2004 study indicated that the peak year of interest is in the eighth grade and by the 10th grade use begins to taper off with students seeking illicit drugs.
MTF also tracks the students' perception of the risks involved with drug use.
"The proportion of young people who believe it is dangerous to use inhalants has declined among both eighth- and 10th-graders over the past three years, which quite possibly explains the rebound in use," Johnston said. "They need to see that they are dangerous and deadly."
No child, despite age, sex, race or socioeconomic status, is immune to the attraction of inhalants, but the survey found that those most at risk for dangerous side effects are not bound for college. Males are more at risk than females and the frequency of use is evenly spread across the country in both rural and urban areas.
Because of the range of substances and products, Johnston said it may be hard to know what a user is abusing.
Children find products, including solvents, aerosols and nitrates, to inhale in the household. Common solvents teens "huff" to get high include gasoline, lighter fluid and paint thinners, while any aerosol, from hair spray to spray paint, also do the trick, Johnston said.
Favorites among users include nitrates, more particularly whippets. Adolescents seek a "laughing gas" effect, which dentists use to help patients relax. They find the sensation in canned dairy products, such as whipped cream.
Effects of use
Because of their availability with no regulations, many teenagers believe OTC drugs and inhalants aren't dangerous.
"Kids aren't aware of the damage they can do," Shifler said. "They can actually die."
Even though inhalants and DXM are in every household, they have the potential to cause adverse long-term effects, Shifler said.
Adolescents turn to OTCs containing DXM, seeking dissociation or a sense of disconnection from the body and their environment. The drug is also know to heighten senses and trigger hallucinations, said Miller. The user can have heightened perceptual awareness and feelings of lethargy and euphoria.
DXM's effects vary, depending on the dose, Miller said. Users reach several plateaus during use, pushing them to try higher doses.
In the first plateau, users experience a sensation similar to feeling a little drunk and high on marijuana, according to the Beginner's Guide to DXM.
The guide states that the most recreational uses occur in the second plateau, where users begin to experience visual hallucinations. Abusers also experience lack of coordination and double vision.
Logic breaks down in the third plateau, where the "unusual can make perfect sense." At this level of dosage, the possibility of users harming themselves increases.
As the person takes enough DXM to reach the fourth plateau, complete dissociation occurs where the user loses connection with most senses and is limited in movement.
DXM also causes confusion, blurred vision, slurred speech, loss of coordination, dizziness and paranoia, among others, Miller said.
OTC drugs containing DXM can create irregular heartbeats, high blood pressure, numbness in limbs, redness, dry mouth and dry, itchy skin.
Recreational use of DXM has killed people since its FDA approval in 1958, according to the Beginner's Guide.
While working with DXM, Miller said he's come across at least four deaths linked to the drug. The side effects associated with DXM and overdoses contributed to the deaths.
With impaired judgment, bad ideas seem good. For example, Miller said taking a dip in the ocean while under the influence of the drug can be deadly. When dissociation sets in, a person can end up drowning.
Bad side effects also happen when users mix DXM with other drugs, including Ecstasy, and supplements, especially magnesium.
As abuse of DXM continues or becomes regular, panic attacks, psychotic episodes and depression may occur. There have been cases reporting abusers spending time in mental hospitals because of a psychotic meltdown.
For a different high, adolescents turn to inhaling products around the house, McClung said.
Nearly all products children use to inhale produce similar effects to those of anesthetics, which slow down body function, reaction time and cloud thinking, she said.
Highs through inhalants empower its users, but the effect only lasts a few minutes, McClung said.
When the feeling begins to fade, the user's transition is typically into an irritable and depressed state.
Inhalants can cause double vision, dizziness, weakness, nausea, numbness and severe headaches.
Even during the first use, the National Inhalant Prevention Coalition says inhalants can kill -- Sudden Sniffing Death Syndrome. Inhalants may slow down body function enough to prevent the lungs from properly working or the chemical could coat the lungs preventing oxygen from reaching vital organs, the Web site stated.
Warning signs
Because inhalants and OTC drugs are found everywhere, it's often hard for parents to know if a child is abusing these common household products.
McClung and Miller said there are some warning signs to alert parents.
When family differences turn to the child isolating himself from the family, McClung said it's a sign they are abusing drugs.
"If you notice there's a change, something's going on," McClung said. "Parents need to bring children in on little things. Don't wait until there is a full-blown problem."
A major indicator is if children have their own supply of OTC medicine or the family stock begins to dwindle, Miller said. Parents may have a hard time determining if a child is abusing OTC medicines and the average drug test does not look for abusive levels of DXM. Special drug tests are required and very few labs specifically search for DXM.
The signs a child is abusing OTCs can include tiredness, slurred speech, lack of coordination and psychotic behavior.
Miller recommends parents monitor their child's Internet activity, especially with powder DXM now more readily available.
Parents can look for rings around mouths and noses, maybe developing into sores if they suspect their child is inhaling. McClung said the user's face may appear splotchy and discolored.
Teens who use for an extended period often change behaviors, exhibiting psychotic tendencies. McClung suggested parents look for:
# paint or stains on body or clothing;
# red or runny eyes or nose;
# chemical breath odor;
# drunken, dazed or dizzy appearance;
# nausea, loss of appetite;
# anxiety, excitability, irritability.
Miller said the best thing a parent can do to determine if a child is abusing drugs is to ask.
Treatment options
"If doesn't matter if you're 15 or 50, the earlier you get treatment the better your chances to be successful," McClung said. "They need to learn as quickly as possible what they're in store for," she said.
Very few facilities specialize on treating inhalants, but help is available. Because of the possible life-altering side effects, McClung said children abusing inhalants should get into treatment as early as possible for as long as possible.
At Warwick Manor Outpatient Services, treatment for adolescents comes in three levels -- early intervention, intensive outpatient treatment and partial hospital treatment.
Those just starting or experimenting with drugs and alcohol come to the center two times each week for six weeks. McClung said if the counselors do not pick up signs of a major problem, the child is released.
In the next level, which sees the most patients, the users go beyond experimenting, but are using alcohol or drugs more than once.
"Most don't come in addicted, but abusing," she said. "We want to interrupt that process before it becomes an addiction."
These children spend three hours, three days a week in counseling.
If behaviors change for the better, McClung said the child progresses through the program. If not, the user goes through the partial hospitalization program.
Treatment replaces school as the children attend the facility each day from 9 a.m. to 3 p.m. Education isn't ignored, McClung said, but treatment is stressed.
The counselors work with the children on behavior issues, following rules and takes them through the 12-step program to fight their addiction.
It's not just education at Warwick Manor. Counselors show children fun activities, including trips to the beach or mall, going bowling or playing pool.
"We're trying to show them that they can have fun without drugs and alcohol," McClung said. "That they can have friends that don't use."
Parents are a crucial part of the treatment. Through weekly family sessions, the parents and children learn to communicate in a positive way and how to negotiate and compromise.
"Change must take place with both the parents and the child if the child is going to be successful," she said.
http://www.delmarvanow.com/apps/pbcs.dll/a.../503060322/1002 (http://www.delmarvanow.com/apps/pbcs.dll/article?AID=/20050306/NEWS01/503060322/1002)
Common household items become drugs
By Kim Mitchell
Daily Times Staff Writer
While on a mission to delve into heroin use in the area, Cpl. Matt Brown of the Fruitland Police Department said he discovered that area teenagers were going a different route to get "high."
Drug abusers are looking past traditional ways, trading the bong for the bottle -- as in cough syrup.
Since 1978, Monitoring the Future has provided the nation with a window to see the prevalence of teenage drug use. Through an annual study, analysts discover the behaviors and trends of teenage drug use often hidden from the public.
The MTF study surveys about 50,000 students across the country on the use of any drugs throughout the prior 12 months, said Lloyd Johnston, director of MTF.
The survey asks general questions, focusing on illicit drugs, and even though it asks students their frequency of over-the-counter drug use, it fails to inquire about the reasons for the use, whether to get high or for intended proper uses, he said.
About 140 over-the-counter medicines, including Dimetapp DM and Sudafed, contain the cough-suppressing ingredient dextromethorphan (DXM). Those medications containing DXM usually have "DM," "Tuss" or "Maximum Strength" on the label.
Under recommended doses, DXM triggers no adverse effects. However, those seeking a high from DXM don't follow the recommended doses.
Instead, they may consume an entire bottle of Robitussin cough syrup or ingest a box of CoricidinHBP gel capsules, the two most commonly products abused, according to the U.S. Department of Justice.
Shannon Miller, an addiction services psychiatrist from the Dayton, Ohio, Veterans Administrative Medical Center, said that instead of facing the taste of cough medicine, users are gravitating toward pills and, increasingly, the powder form found on the Internet.
Even though DXM is considered a powerful psychedelic, it is sold legally in the form of over-the-counter medications throughout the United States and in many foreign countries, Miller said.
With increased use for unintended purposes, retailers across the country have placed limitations on the number of cough and cold products purchased at any time. The same retailers restrict underage persons from products classified as inhalants.
Other substances that are alternatives for cough suppression are opiates or opioids, but they have a greater potential of being abused.
Theft, bulk-buying
As Brown inquired about needle thefts by suspected heroin users, a Wal-Mart associate told him something that surprised him. The associate said the Fruitland store is seeing an increasing number of thefts of over-the-counter products containing DXM. Those thefts led Brown to investigate the drug's rise in popularity, he said.
Teenagers across the country target stores selling OTC medicines for thefts, especially pills and gel caps, Miller said. Abusers will remove a sheet of pills from the box, hide it under their clothes and simply walk out of the store, he said.
"It's harder to steal a bottle than a box," he said. "They're easier to take, easier to steal and easier to hide in schools. It makes for a more portable addiction."
Abusers are also buying multiple packs at a time, Miller added.
"DXM is becoming pretty popular," Brown said. "It's easy access and no one bats an eye at someone buying cough medicine."
Inhalant use
While overall teen drug use continues to decline, the use of inhalants in the hopes of achieving temporary euphoria continues to rise across the country, said Johnston.
On the Lower Shore, the use of inhalants isn't presently a major concern, but it has been and will be again, said Linda McClung, director of Warwick Manor Outpatient Services on East Main Street in Salisbury.
"It comes in cycles," she said.
Johnston said these drugs are attractive to younger audiences who don't have access to illicit drugs. Inhalants are less expensive, legal and easy to obtain, she said.
"It's easy to get ahold of and it's in everyone's homes," said Cindy Shifler, drug prevention coordinator for the Wicomico County Health Department.
Johnston said the MTF results accurately reflect students' drug use. Although the anonymous survey is administered in classrooms, Johnston said that each student gets a different survey, teachers do not circulate the room and the tests are immediately taken out of the school.
The 2004 study indicated that the peak year of interest is in the eighth grade and by the 10th grade use begins to taper off with students seeking illicit drugs.
MTF also tracks the students' perception of the risks involved with drug use.
"The proportion of young people who believe it is dangerous to use inhalants has declined among both eighth- and 10th-graders over the past three years, which quite possibly explains the rebound in use," Johnston said. "They need to see that they are dangerous and deadly."
No child, despite age, sex, race or socioeconomic status, is immune to the attraction of inhalants, but the survey found that those most at risk for dangerous side effects are not bound for college. Males are more at risk than females and the frequency of use is evenly spread across the country in both rural and urban areas.
Because of the range of substances and products, Johnston said it may be hard to know what a user is abusing.
Children find products, including solvents, aerosols and nitrates, to inhale in the household. Common solvents teens "huff" to get high include gasoline, lighter fluid and paint thinners, while any aerosol, from hair spray to spray paint, also do the trick, Johnston said.
Favorites among users include nitrates, more particularly whippets. Adolescents seek a "laughing gas" effect, which dentists use to help patients relax. They find the sensation in canned dairy products, such as whipped cream.
Effects of use
Because of their availability with no regulations, many teenagers believe OTC drugs and inhalants aren't dangerous.
"Kids aren't aware of the damage they can do," Shifler said. "They can actually die."
Even though inhalants and DXM are in every household, they have the potential to cause adverse long-term effects, Shifler said.
Adolescents turn to OTCs containing DXM, seeking dissociation or a sense of disconnection from the body and their environment. The drug is also know to heighten senses and trigger hallucinations, said Miller. The user can have heightened perceptual awareness and feelings of lethargy and euphoria.
DXM's effects vary, depending on the dose, Miller said. Users reach several plateaus during use, pushing them to try higher doses.
In the first plateau, users experience a sensation similar to feeling a little drunk and high on marijuana, according to the Beginner's Guide to DXM.
The guide states that the most recreational uses occur in the second plateau, where users begin to experience visual hallucinations. Abusers also experience lack of coordination and double vision.
Logic breaks down in the third plateau, where the "unusual can make perfect sense." At this level of dosage, the possibility of users harming themselves increases.
As the person takes enough DXM to reach the fourth plateau, complete dissociation occurs where the user loses connection with most senses and is limited in movement.
DXM also causes confusion, blurred vision, slurred speech, loss of coordination, dizziness and paranoia, among others, Miller said.
OTC drugs containing DXM can create irregular heartbeats, high blood pressure, numbness in limbs, redness, dry mouth and dry, itchy skin.
Recreational use of DXM has killed people since its FDA approval in 1958, according to the Beginner's Guide.
While working with DXM, Miller said he's come across at least four deaths linked to the drug. The side effects associated with DXM and overdoses contributed to the deaths.
With impaired judgment, bad ideas seem good. For example, Miller said taking a dip in the ocean while under the influence of the drug can be deadly. When dissociation sets in, a person can end up drowning.
Bad side effects also happen when users mix DXM with other drugs, including Ecstasy, and supplements, especially magnesium.
As abuse of DXM continues or becomes regular, panic attacks, psychotic episodes and depression may occur. There have been cases reporting abusers spending time in mental hospitals because of a psychotic meltdown.
For a different high, adolescents turn to inhaling products around the house, McClung said.
Nearly all products children use to inhale produce similar effects to those of anesthetics, which slow down body function, reaction time and cloud thinking, she said.
Highs through inhalants empower its users, but the effect only lasts a few minutes, McClung said.
When the feeling begins to fade, the user's transition is typically into an irritable and depressed state.
Inhalants can cause double vision, dizziness, weakness, nausea, numbness and severe headaches.
Even during the first use, the National Inhalant Prevention Coalition says inhalants can kill -- Sudden Sniffing Death Syndrome. Inhalants may slow down body function enough to prevent the lungs from properly working or the chemical could coat the lungs preventing oxygen from reaching vital organs, the Web site stated.
Warning signs
Because inhalants and OTC drugs are found everywhere, it's often hard for parents to know if a child is abusing these common household products.
McClung and Miller said there are some warning signs to alert parents.
When family differences turn to the child isolating himself from the family, McClung said it's a sign they are abusing drugs.
"If you notice there's a change, something's going on," McClung said. "Parents need to bring children in on little things. Don't wait until there is a full-blown problem."
A major indicator is if children have their own supply of OTC medicine or the family stock begins to dwindle, Miller said. Parents may have a hard time determining if a child is abusing OTC medicines and the average drug test does not look for abusive levels of DXM. Special drug tests are required and very few labs specifically search for DXM.
The signs a child is abusing OTCs can include tiredness, slurred speech, lack of coordination and psychotic behavior.
Miller recommends parents monitor their child's Internet activity, especially with powder DXM now more readily available.
Parents can look for rings around mouths and noses, maybe developing into sores if they suspect their child is inhaling. McClung said the user's face may appear splotchy and discolored.
Teens who use for an extended period often change behaviors, exhibiting psychotic tendencies. McClung suggested parents look for:
# paint or stains on body or clothing;
# red or runny eyes or nose;
# chemical breath odor;
# drunken, dazed or dizzy appearance;
# nausea, loss of appetite;
# anxiety, excitability, irritability.
Miller said the best thing a parent can do to determine if a child is abusing drugs is to ask.
Treatment options
"If doesn't matter if you're 15 or 50, the earlier you get treatment the better your chances to be successful," McClung said. "They need to learn as quickly as possible what they're in store for," she said.
Very few facilities specialize on treating inhalants, but help is available. Because of the possible life-altering side effects, McClung said children abusing inhalants should get into treatment as early as possible for as long as possible.
At Warwick Manor Outpatient Services, treatment for adolescents comes in three levels -- early intervention, intensive outpatient treatment and partial hospital treatment.
Those just starting or experimenting with drugs and alcohol come to the center two times each week for six weeks. McClung said if the counselors do not pick up signs of a major problem, the child is released.
In the next level, which sees the most patients, the users go beyond experimenting, but are using alcohol or drugs more than once.
"Most don't come in addicted, but abusing," she said. "We want to interrupt that process before it becomes an addiction."
These children spend three hours, three days a week in counseling.
If behaviors change for the better, McClung said the child progresses through the program. If not, the user goes through the partial hospitalization program.
Treatment replaces school as the children attend the facility each day from 9 a.m. to 3 p.m. Education isn't ignored, McClung said, but treatment is stressed.
The counselors work with the children on behavior issues, following rules and takes them through the 12-step program to fight their addiction.
It's not just education at Warwick Manor. Counselors show children fun activities, including trips to the beach or mall, going bowling or playing pool.
"We're trying to show them that they can have fun without drugs and alcohol," McClung said. "That they can have friends that don't use."
Parents are a crucial part of the treatment. Through weekly family sessions, the parents and children learn to communicate in a positive way and how to negotiate and compromise.
"Change must take place with both the parents and the child if the child is going to be successful," she said.
http://www.delmarvanow.com/apps/pbcs.dll/a.../503060322/1002 (http://www.delmarvanow.com/apps/pbcs.dll/article?AID=/20050306/NEWS01/503060322/1002)