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03-21-2005, 12:28 PM
http://www.post-gazette.com/pg/05080/474772.stm
Kids' abuse of over-the-counter cold medicine on the rise
Monday, March 21, 2005
By Alana Semuels, Pittsburgh Post-Gazette
Sharon Smith found the empty packets of cold medicine and bottles of cough syrup in her son's room, but he told her the medications made him feel intelligent and invincible, just as he had learned from the Internet.
It's just cold medicine, he rationalized. How much harm could it do?
But it did not take long for Smith's son to turn from a shy, easygoing teenager into what she calls "a raving lunatic." He would drink four bottles of cough syrup at a time, or swallow tablets of Coricidin Cough and Cold, and become furiously angry and violent, breaking things in his house and punching the wall.
Since then, he's been in and out of the hospital, incarcerated twice, and plagued with mental health problems that doctors say might affect him for the rest of the life.
"You can take a sweet loving child and they become something that you are afraid of -- you can't even believe it's your child," said Smith, of Mechanicsburg, about the dangers of over-the-counter cold medicine. "It's an awful, awful roller coaster for parents."
Cold medicine and cough syrup have been around for decades, and kids have experimented with them for just as long, but a string of recent incidents suggest the problem is becoming more widespread.
In the past six months, teenagers from Seattle to Ohio to Florida have either died or been hospitalized because of cold-tablet overdoses. The number of calls to poison control centers about teens abusing DXM -- the active ingredient in these cold medicines -- has more than doubled from 2000 to 2003.
Locally, three men were caught stealing Coricidin tablets from a Wal-Mart in Ebensburg last week. The same day, a convenience store owner in Westmont was charged with child endangerment for selling boxes of cold medicine and cigarettes to a 14-year-old. And in the last month, three teens have overdosed on Coricidin in one school district, according to the Allegheny County District Attorney's office.
By surfing the Internet, teens can readily learn how to abuse cold medicine and read about its potent effects. They can head over to their local drugstore and buy packets of the medicine without doing anything illegal. And they can slip right under the radar of even the most vigilant parents who are looking for kids reeking of cigarette smoke or alcohol.
The dangers of DXM
These cold medicines contain dextromethorphan, or DXM, a substance that can cause feelings of detachment, distorted perceptions, and a dreamlike or euphoric state. High dosages can also cause blurred vision, shallow breathing, fever, coma, an increase in heart rate, and in some users, acute anger.
The parents of today's teens might have abused cold medicine by "robotripping," or drinking cough syrup. But new cold tablets make it easier to feel the same effects by just popping a couple of pills, commonly called "skittling" because the red pills resemble Skittles candy.
The pills are easy to hide from parents and extremely dangerous.
Many teens assume that experimenting with cold medicine is not risky because they can buy it legally, unlike heroin or marijuana, said Ed Krenzelok, director of the Pittsburgh Poison Control center.
"The overwhelming feeling is that nonprescription means nontoxic, but nothing could be farther from the truth," he said.
Most cold medicines contain ingredients that are toxic when ingested in large doses, and can cause massive liver damage, increased heart rate, a lack of coordination, seizures and a coma. Teens must ingest a significant amount of DXM to feel these effects, but procuring the medicines is easy enough.
"Kids are very astute," Krenzelok said. "They can buy that stuff at a 7-Eleven or anywhere. It's a non-controlled, nonprescription cough and cold medication." It's especially difficult to limit because teens can buy small amounts from different stores, or steal from the home medicine cabinet, or pilfer the drugs from a smattering of supermarkets and drugstores.
Making legal drugs illegal
Even so, drugstores across the country are changing their policies to stop kids from abusing these medicines. At Rite Aid, customers can only buy three packages of any product containing DXM at a time. Since the spring of 2004, CVS has restricted the sale of a number of products containing DXM to people 18 and older. And Giant Eagle will only sell Coricidin HBP, a more potent form of the cough medicine, to people 18 and older.
But the availability of these over-the-counter drugs is one of the reasons they're so popular with teens, and restricting access to them is an uphill battle. The 2003 National Survey on Drug Use and Health found that while fewer teens are abusing marijuana and ecstasy, more are using pain relievers for nonmedical reasons. A survey of more than 7,000 teens by the Partnership for a Drug-Free America found that one in five had used a prescription painkiller without a prescription.
"There's a general trend of kids moving away from 'farming' marijuana to 'pharming' ---- abusing prescription and over-the-counter medication," said Tom Hedrick, founding member and director of the Partnership for Drug-Free America.
Teens often learn about these alternative medications over the Internet, where they can find sites that glamorize the drugs and downplay their side effects, Hedrick said. Some of these sites explain how to extract DXM from cough syrup, while others wax poetic about writers' euphoric experiences with Coricidin.
Teens will probably surf the Web and keep taking Coricidin until they and their parents realize the dangers of ingesting too much, said Oscar Bukstein, an associate professor of psychiatry at Western Psychiatric Institute and Clinic. He says that once kids see others having adverse effects from any drug, they shy away from these substances.
And while it usually isn't an addictive drug, Bukstein says it is commonly used. Even trying these substances once can be potentially dangerous, and many kids don't hesitate to experiment.
"You name it, these kids will try it if they think they can get a buzz out of it," said George Musulin, detective sergeant of the West Hills regional police, who investigated the candy store incident near Johnstown.
It could happen to anyone
National experts emphasize that parents are the most effective gatekeepers against abuse, and recommend that parents be on the lookout for teens who experience dramatic changes in behavior. Parents should watch out for an outgoing child who suddenly starts spending excessive time in his or her room, becomes secretive or uncommunicative or changes their friends abruptly.
Unfortunately, these also are classic teen behaviors.
In the past several months, local organizations have stepped up prevention efforts. The Allegheny County district attorney's office is working with district attorneys throughout the state to introduce legislation that would restrict the sale of certain cold medications and make it illegal for teens to have more than a few boxes of the medicine on their person. Similar legislation has been introduced in California and Minnesota.
"You may think your child would never do this, but there's always a chance," said James Manley, superintendent of the Pine-Richland School District, which has partnered with 11 other districts to form the Northern Area Alliance Against Highly Addictive Drugs.
The alliance was formed after a local teen died of a heroin overdose, but the member schools have seen a smattering of kids abusing cold medicine as well.
One student was rushed to the hospital after taking a combination of rum and Coricidin in a bathroom at Deer Lakes High School last year.
But it shouldn't take an overdose or a hospitalization to make parents spring into action, said Sharon Smith, who is still reeling from the effects of her son's problems with DXM. Her son, who is now 22, was recently released from the hospital, but Smith says that doctors have said that he will have long-term psychological problems because of the cold medicine.
She's now the president of Momstell, a Harrisburg-based organization that advocates for changes regarding drug and alcohol issues, which she founded after her daughter died of a heroin overdose in 2000. Smith says that her son knew of the dangers of drug abuse after seeing his sister suffer, and she never thought he would even dream of abusing drugs. But for him, cold medicine didn't seem as dangerous.
"Parents need to realize that any child can make a bad decision to pick up and use just once," she said. "And from there they might not get another chance to make a bad decision.
"This could be anybody's kid."
Kids' abuse of over-the-counter cold medicine on the rise
Monday, March 21, 2005
By Alana Semuels, Pittsburgh Post-Gazette
Sharon Smith found the empty packets of cold medicine and bottles of cough syrup in her son's room, but he told her the medications made him feel intelligent and invincible, just as he had learned from the Internet.
It's just cold medicine, he rationalized. How much harm could it do?
But it did not take long for Smith's son to turn from a shy, easygoing teenager into what she calls "a raving lunatic." He would drink four bottles of cough syrup at a time, or swallow tablets of Coricidin Cough and Cold, and become furiously angry and violent, breaking things in his house and punching the wall.
Since then, he's been in and out of the hospital, incarcerated twice, and plagued with mental health problems that doctors say might affect him for the rest of the life.
"You can take a sweet loving child and they become something that you are afraid of -- you can't even believe it's your child," said Smith, of Mechanicsburg, about the dangers of over-the-counter cold medicine. "It's an awful, awful roller coaster for parents."
Cold medicine and cough syrup have been around for decades, and kids have experimented with them for just as long, but a string of recent incidents suggest the problem is becoming more widespread.
In the past six months, teenagers from Seattle to Ohio to Florida have either died or been hospitalized because of cold-tablet overdoses. The number of calls to poison control centers about teens abusing DXM -- the active ingredient in these cold medicines -- has more than doubled from 2000 to 2003.
Locally, three men were caught stealing Coricidin tablets from a Wal-Mart in Ebensburg last week. The same day, a convenience store owner in Westmont was charged with child endangerment for selling boxes of cold medicine and cigarettes to a 14-year-old. And in the last month, three teens have overdosed on Coricidin in one school district, according to the Allegheny County District Attorney's office.
By surfing the Internet, teens can readily learn how to abuse cold medicine and read about its potent effects. They can head over to their local drugstore and buy packets of the medicine without doing anything illegal. And they can slip right under the radar of even the most vigilant parents who are looking for kids reeking of cigarette smoke or alcohol.
The dangers of DXM
These cold medicines contain dextromethorphan, or DXM, a substance that can cause feelings of detachment, distorted perceptions, and a dreamlike or euphoric state. High dosages can also cause blurred vision, shallow breathing, fever, coma, an increase in heart rate, and in some users, acute anger.
The parents of today's teens might have abused cold medicine by "robotripping," or drinking cough syrup. But new cold tablets make it easier to feel the same effects by just popping a couple of pills, commonly called "skittling" because the red pills resemble Skittles candy.
The pills are easy to hide from parents and extremely dangerous.
Many teens assume that experimenting with cold medicine is not risky because they can buy it legally, unlike heroin or marijuana, said Ed Krenzelok, director of the Pittsburgh Poison Control center.
"The overwhelming feeling is that nonprescription means nontoxic, but nothing could be farther from the truth," he said.
Most cold medicines contain ingredients that are toxic when ingested in large doses, and can cause massive liver damage, increased heart rate, a lack of coordination, seizures and a coma. Teens must ingest a significant amount of DXM to feel these effects, but procuring the medicines is easy enough.
"Kids are very astute," Krenzelok said. "They can buy that stuff at a 7-Eleven or anywhere. It's a non-controlled, nonprescription cough and cold medication." It's especially difficult to limit because teens can buy small amounts from different stores, or steal from the home medicine cabinet, or pilfer the drugs from a smattering of supermarkets and drugstores.
Making legal drugs illegal
Even so, drugstores across the country are changing their policies to stop kids from abusing these medicines. At Rite Aid, customers can only buy three packages of any product containing DXM at a time. Since the spring of 2004, CVS has restricted the sale of a number of products containing DXM to people 18 and older. And Giant Eagle will only sell Coricidin HBP, a more potent form of the cough medicine, to people 18 and older.
But the availability of these over-the-counter drugs is one of the reasons they're so popular with teens, and restricting access to them is an uphill battle. The 2003 National Survey on Drug Use and Health found that while fewer teens are abusing marijuana and ecstasy, more are using pain relievers for nonmedical reasons. A survey of more than 7,000 teens by the Partnership for a Drug-Free America found that one in five had used a prescription painkiller without a prescription.
"There's a general trend of kids moving away from 'farming' marijuana to 'pharming' ---- abusing prescription and over-the-counter medication," said Tom Hedrick, founding member and director of the Partnership for Drug-Free America.
Teens often learn about these alternative medications over the Internet, where they can find sites that glamorize the drugs and downplay their side effects, Hedrick said. Some of these sites explain how to extract DXM from cough syrup, while others wax poetic about writers' euphoric experiences with Coricidin.
Teens will probably surf the Web and keep taking Coricidin until they and their parents realize the dangers of ingesting too much, said Oscar Bukstein, an associate professor of psychiatry at Western Psychiatric Institute and Clinic. He says that once kids see others having adverse effects from any drug, they shy away from these substances.
And while it usually isn't an addictive drug, Bukstein says it is commonly used. Even trying these substances once can be potentially dangerous, and many kids don't hesitate to experiment.
"You name it, these kids will try it if they think they can get a buzz out of it," said George Musulin, detective sergeant of the West Hills regional police, who investigated the candy store incident near Johnstown.
It could happen to anyone
National experts emphasize that parents are the most effective gatekeepers against abuse, and recommend that parents be on the lookout for teens who experience dramatic changes in behavior. Parents should watch out for an outgoing child who suddenly starts spending excessive time in his or her room, becomes secretive or uncommunicative or changes their friends abruptly.
Unfortunately, these also are classic teen behaviors.
In the past several months, local organizations have stepped up prevention efforts. The Allegheny County district attorney's office is working with district attorneys throughout the state to introduce legislation that would restrict the sale of certain cold medications and make it illegal for teens to have more than a few boxes of the medicine on their person. Similar legislation has been introduced in California and Minnesota.
"You may think your child would never do this, but there's always a chance," said James Manley, superintendent of the Pine-Richland School District, which has partnered with 11 other districts to form the Northern Area Alliance Against Highly Addictive Drugs.
The alliance was formed after a local teen died of a heroin overdose, but the member schools have seen a smattering of kids abusing cold medicine as well.
One student was rushed to the hospital after taking a combination of rum and Coricidin in a bathroom at Deer Lakes High School last year.
But it shouldn't take an overdose or a hospitalization to make parents spring into action, said Sharon Smith, who is still reeling from the effects of her son's problems with DXM. Her son, who is now 22, was recently released from the hospital, but Smith says that doctors have said that he will have long-term psychological problems because of the cold medicine.
She's now the president of Momstell, a Harrisburg-based organization that advocates for changes regarding drug and alcohol issues, which she founded after her daughter died of a heroin overdose in 2000. Smith says that her son knew of the dangers of drug abuse after seeing his sister suffer, and she never thought he would even dream of abusing drugs. But for him, cold medicine didn't seem as dangerous.
"Parents need to realize that any child can make a bad decision to pick up and use just once," she said. "And from there they might not get another chance to make a bad decision.
"This could be anybody's kid."