Experts Warn Of Cold Medicine Abuse Trend

During the fall and winter months, it is not uncommon to see people carrying around bottles of cough medicines or taking cold pills. It is the time of year for cold and flu, and many people choose to self-medicate to alleviate their symptoms. This includes adolescents, who can easily purchase these products at local pharmacies.

An increasing trend among youth, however, is the abuse of these over-the-counter (OTC) medications. Of particular concern is dextomethorphan or DXM, which is used in a variety of OTC cough and cold medicines, particularly those whose name includes “DM” or “Tuss.” DXM is a narcotic related to opium and is a cough suppressant that suppresses an area in the brain that causes one to cough.

When used according to directions, the drug will alleviate cough and is particularly helpful with nighttime coughing that keeps one awake.

When ingested in higher doses, however, it creates a euphoric and hallucinogenic effect similar to ecstasy and LSD. It alters perception of reality. People report having creative dreamlike experiences and a dissociate experience while using the drug. Increased media coverage of “pharming,” or intentional misuse of OTC medicines, reveal that this practice is becoming increasingly popular and potentially deadly. It is cheap, legal and available — and most parents will not question their children having cold medicine in their bags or rooms.

Experts believe that DXM abuse is rising among adolescents, particularly on the club or rave scene. Reported cases are often sporadic, however, because parents are unaware of DXM abuse, or it is being mixed with other substances that mask the drug’s effects.

In 2002, the Regional Center for Poison Control and Prevention recorded 1,048 cases of DXM abuse, up from the 870 the year before. Street names for DXM include Dex, DM, Drex, Robo, Rojo, Skittles, Triple C, and Velvet.

Symptoms and consequences of DXM misuse include loss of balance, increase pulse, hypothermia, severe high blood pressure, loss of consciousness, mania, loss of muscle control, permanent brain damage, coma, seizure, cerebral hemorrhages, and stroke.

When taken in a dance-club setting accompanied by vigorous physical activity and poor air circulation, the result can be heat stroke. This phenomenon is sometimes called “rave-related heat stroke.”

In addition to problems associated with DXM itself, many DXM products also contain acetaminophen or antihistamines. DXM can also interact with many prescription medicines. The co-ingestions or interactions can result in life-threatening symptoms.

If an overdose is suspected, call your Poison Control Center at 800-222-1222.

Additional Resources: Substance Abuse Treatment Facility Locator, www.findtreatment.samhsa.gov; Partnership of Awareness, www.partnershipforawareness.org/dxm.htm; and US Department of Justice DXM Fast Facts, www.usdoj.gov/ndic/pubs6/6095.