A group of young teens huddles around a bottle of liquid cough medication.

They scan the label for a key active ingredient -- dextromethorphan.

The cough suppressant ingredient has a legitimate purpose, but the teens were looking for a quick high. Roboing, robo rolling, robo tripping -- they're all names for the disassociative experience abusing the drug can bring.

"It's a dangerous substance if it's not used as prescribed," said Grand Island police Sgt. Dale Hilderbrand, who is also a drug recognition expert.

Hilderbrand has fielded calls from local pharmacies whose employees want to know why groups of teenagers are reading cough medication labels.

Abusing dextromethorphan, also known as dxm, dex, robo, skittles, and tussein, gives the user an out-of-body feeling or floating sensation, Hilderbrand said.

It can also make a person feel intoxicated, he said.

But the euphoria has a dangerous downside. Abusing medications containing dextromethorphan can lead to psychotic behavior, said Chuck Matson, an Omaha police drug recognition expert.

Dextromethorphan is an opioid type drug somewhat related to codeine, he said. If it is taken in large amounts, it attaches to the same central nervous receptors as phencyclidine, which is also known as PCP or angel dust, Matson said.

As with any hallucinogenic drug, long-term problems include depletion of serotonin levels in the brain, which can result in memory problems, extreme depression and suicidal tendencies, he said.

Hilderbrand said abuse of dextromethorphan can also lead to death. Last year in the United States, 14 people under the age of 18 died from using dextromethorphan.

According to Nebraska Poison Control Center, there were 19 overdoses statewide related to exposure to dextromethorphan in 2003. As of Thursday, there were already 12 for the year.

Grand Island police investigator Jason Urbanski said there have been several overdoses in Grand Island this year, including at least two earlier this month.

There are more than 80 over-the-counter products that contain the substance, Hilderbrand said. It is most commonly found in Robitussin DM, Triaminic DM, Rondec DM, Drixoral and St. Joseph Cough Suppressant, he said.

Dextromethorphan can also be found in Coricidin Cough and Cold pills, also known as Triple C, Matson said. The directions instruct the user to take one pill every six hours and to not exceed four pills in a 24-hour period. Abusers are taking many more than that, with some reports as high as 30 at one time, which can lead to death, he said.

The substance is also available in bulk powder form, he said.

Antihistamines are part of the tablets and, when taken in high amounts, the pills can elevate blood pressure and can cause seizures and cerebral hemorrhage, he said.

Dextromethorphan can slow breathing down and cause the heart to race. The other active ingredients in the medications that contain dextromethorphan can make the user vomit and can act as depressants, which can be a lethal combination, Hilderbrand said.

The drug was originally patented by the Food and Drug Administration in 1958 for use as an anesthetic. It is now commonly used in cough medications to suppress the cough reflex, he said.

Urbanski said the drug is being abused by local teens. He received a call from a mother who said her son was using dextromethorphan. He said she did the right thing by calling law enforcement when she became suspicious of her son's activities.

Parents should watch for changes in behavior and things that appear to be out of the ordinary. For example, the mother who spoke to Urbanski said her son repeatedly took the trash out when his friends were visiting without being asked to do so. He was hiding empty cough medicine bottles from his parents, Urbanski said.

Another parent found large caplets in an ibuprofen bottle that didn't appear to belong there, he said.

Matson also recommends talking to teens about not accepting pills from anyone without parent approval, keeping track of prescription medications, and being aware of over-the-counter medications used and possessed by children. Parents should also be concerned about mood swings, new friends their children are hanging out with, and changes in school performance.

Hilderbrand said he has been picking up information on dextromethorphan from other agencies for the last two years and became aware of the local problem about six months ago.

Signs that someone is abusing dextromethorphan:


Clumsy walking or lack of coordination

Slurred speech

Nausea and vomiting

Heavy sweating

Blank stare

Rigid muscles and involuntary movement

Numbness of fingers or toes

Tremors

Impaired judgment or confusion

Statements suggesting hallucinations

Nonresponsivness

Dilated pupils

Drowsiness and dizziness
Sources: Chuck Matson, Omaha police drug recognition expert, and Grand Island Police Department

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