Knox County Sees Rise in Abuse of Medicine

Friday, December 07, 2007
MOUNT VERNON — A new drug of abuse has found its way into the juvenile drug court program, according to Juvenile Magistrate Jeffrey Williams. Three juveniles are enrolled in the program for abusing over-the-counter cough medication.

“Those are the three [juveniles] that we know of,” said Williams.

Called “Skittling” or “Robo-Tripping,” teens across the country have recently begun ingesting massive doses of Dextromethorphan (DXM), the active ingredient in over 120 over-the-counter cough medications. Safe when taken as directed, when taken in large amounts, DXM can produce hallucinations and a high similar to PCP and ketamine. DXM can act on the body in 20 minutes and the effects can last from 2 to 6 hours.

A juvenile court official said that while most abusers simply ingest the tablets, it’s not uncommon for someone to crush the pills and snort the powder.

According to the Drug Enforcement Agency, DXM abusers report a heightened sense of perceptual awareness, altered time perception and visual hallucinations. Typically, an abuser presents clinical symptoms such as hyperexcitability, lethargy, ataxia (uncoordinated muscle control), slurred speech, sweating, hypertension (high blood pressure), and nystagmus (involuntary eye movement).

The typical recommended dosage of any cough remedy containing DXM is usually 10 to 20 milligrams every four hours or 30 milligrams every 6 to 8 hours. It has been reported that some abusers ingest 250 to 1,500 milligrams in a single dosage. The DEA reports that dosages at that level are known to cause blurred vision, body itching, rash, sweating, fever, shallow respiration, diarrhea, toxic psychosis, body temperature increase and coma.

DEA Special Agent Rich Isaacson, of the Detroit division, said that over-the-counter drug abuse is a “perception of risk” issue.

“They don’t believe there’s any real harm in it,” said Isaacson. “Young people see these medicines that have DXM as the active ingredient and it’s available over the counter. They think ‘If my 6-year-old brother can buy it can’t be dangerous’. The lower the perception of risk, the more likely kids are to mess around with it.”

Though it has not yet been added to the Controlled Substances Act, the DEA has classified DXM as a “drug of concern.”

“It’s definitely a problem across the country and not just a localized issue,” said Isaacson.

One particular version of DXM causing particular concern among health officials is the abuse of Coricidin Cough and Cold tablets, often call “Triple C,” “Skittles,” “Dex” or “red devils.” The small circular red tablets are imprinted with three C’s on one side.

Coricidin contains not only DXM but Chlorpheniaramine Maleate (CPM), a first-generation antihistamine with depressant properties. The drug is designed to treat cold symptoms in patients with high blood pressure. The Drug Abuse Warning Network reports that high doses of CPM can cause seizures, loss of consciousness, bleeding from skin, mouth, eyes, rectum and vagina, and possibly death. It has been advised that no more that 24mg of CPM can safely be taken in a day. When mixed with alcohol or other drugs of abuse the dangers multiply.

According to Mary Samuell of the Knox County Freedom Center, some DXM tablets also contain pseudoephedrine, transforming the high and the risks involved with a massive dose to something similar to methamphetamine.

“It’s not unusual for someone to take 20 pills at a time,” said Samuell. “That’s a whole box. We actually have one 16-year-old client that’s become addicted to it.”

One court official has said that abusers are prone to steal the pills out of the box at local drug stores or retailers. After the first reported DXM overdose in Knox County, juvenile probation officers have asked local stores carrying the drug to place it behind the counter.

“It became pretty popular a year or two ago so we voluntarily moved it behind the counter,” said Denise Conway, a pharmacist for Foster’s Pharmacies. “Unlike Pseudoephedrine, which pharmacies are required to take off the shelves, Coricidin is put behind the counter only on a voluntary effort.”

A pharmacist for CVS/Pharmacy whose name was withheld as she did not have corporate permission to speak to the News said, “[We pulled it from the shelves] about three months after it came out because we noticed it kept walking out the door.”

According to juvenile court officials, after that first reported overdose, representatives of the Mount Vernon Wal-Mart declined to remove the drug from the shelves of their Coshocton Avenue location. Wal-Mart said they would monitor potential theft with video surveillance.

However, court officials say that after the second reported overdose in Knox County they returned to the Wal-Mart only to find 40 boxes of Coricidin on the shelves, each one empty as a result of theft.

Although Wal-Mart has since pulled the “Cough and Cold” brand of Coricidin from the shelves, it continues to stock three other varieties, two containing both DXM and CPM. A representative from the Coshocton Avenue branch declined to comment and referred to the corporate headquarters media relations department.

At press time, Knox Community Hospital officials were unable to determine the total number of DXM-related emergency room visits in Knox County.

The DEA has reported that a powdered form of DXM is now available for purchase over the Internet. One report said that “Internet sites also inform young users to drink enough cough syrup expeditiously in order to absorb enough DXM from the drink prior to the impending incidence of vomiting which will occur as a result of the ingestion of the large volume of syrup required for intoxication.”

According to a study conducted by the Substance Abuse and Mental Health Services Administration, DXM was a contributing factor in an estimated 12,584 visits to hospital emergency rooms nationwide in 2004, and 5,581 of those visits were attributed to nonmedical use. Forty-eight percent involved patients ages 12 to 20. Suicide attempts accounted for 14 percent of DXM-related emergency room visits.

A 2006 study conducted by the University of Michigan revealed that 1 in 14 high school seniors reported using cold or cough medicine to get high in the past year.

More than half of teens (55 percent) don’t strongly agree that using cough medicines to get high is risky, according to a survey conducted by Partnership for a Drug-Free America. “They don’t see it to be real drug abuse,” said DEA Agent Isaacson.

Over-the-counter medications accounted for $20 billion in sales in 2005.

http://www.mountvernonnews.com/local/07/12...drug.abuse.html

[dianne]

Originally posted by drdªv€@Dec 7 2007, 11:49 AM
The typical recommended dosage of any cough remedy containing DXM is usually 10 to 20 milligrams every four hours or 30 milligrams every 6 to 8 hours. It has been reported that some abusers ingest 250 to 1,500 milligrams in a single dosage. The DEA reports that dosages at that level are known to cause blurred vision, body itching, rash, sweating, fever, shallow respiration, diarrhea, toxic psychosis, body temperature increase and coma.

“It’s not unusual for someone to take 20 pills at a time,” said Samuell. “That’s a whole box. We actually have one 16-year-old client that’s become addicted to it.”

Okay. First, that's a rather wide range of doses and side effects.

Secondly, there's fucking 16 pills in a box.

[dianne]

Originally posted by drdªv€@Dec 7 2007, 11:49 AM
The DEA has reported that a powdered form of DXM is now available for purchase over the Internet. One report said that “Internet sites also inform young users to drink enough cough syrup expeditiously in order to absorb enough DXM from the drink prior to the impending incidence of vomiting which will occur as a result of the ingestion of the large volume of syrup required for intoxication.”

and. . . WHAT?

This is just retarded.

[Madison Young St Jamirez]

Originally posted by dianne+Dec 8 2007, 08:53 AM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (dianne @ Dec 8 2007, 08:53 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin--drdªv€@Dec 7 2007, 11:49 AM
The DEA has reported that a powdered form of DXM is now available for purchase over the Internet. One report said that “Internet sites also inform young users to drink enough cough syrup expeditiously in order to absorb enough DXM from the drink prior to the impending incidence of vomiting which will occur as a result of the ingestion of the large volume of syrup required for intoxication.”

and. . . WHAT?

This is just retarded. [/b][/quote]
actually, if you read the DXM Discussion forum, that's exactly what goes down. :chug:

[dianne]

Originally posted by KINGOFTHEFOREST+Dec 8 2007, 12:55 PM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (KINGOFTHEFOREST @ Dec 8 2007, 12:55 PM)</td></tr><tr><td id='QUOTE'>

and. . . WHAT?

This is just retarded.

actually, if you read the DXM Discussion forum, that's exactly what goes down. :chug: [/b][/quote]

prior to the impending incidence of vomiting which will occur as a result of the ingestion of the large volume of syrup required for intoxication.”

I was mostly referring to that part. I don't think most people vomit when they take DXM, unless they've been using for a while. I didn't start tripping until I had tripped many times.

Nervousness and anxiety can contribute though.