Pubdate: Sun, 11 Feb 2001
Source: Houston Chronicle (TX)
Copyright: 2001 Houston Chronicle
Contact:  Viewpoints Editor, P.O. Box 4260 Houston, Texas 77210-4260
Fax: (713) 220-3575
Website: http://www.chron.com/
Forum: http://www.chron.com/content/hcitalk/index.html
Author: Ruth Rendon

COUGH MEDICINE GAINS POPULARITY WITH TEENS

The Drug May Be Legal, But High Is Still Deadly

They're cheap, legal and easy to get.

For anyone who needs relief from symptoms of colds or flu, that's good.

But officials in the Clear Creek school district say a number of teens have 
been using certain cold medications lately for another purpose - to get high.

While it isn't against the law, drug counselors are warning that the sort 
of abuse they've been seeing can have dire consequences.

"It's kind of one of the new trends," said Kristi Allen, program director 
for youth works for the Bay Area Council on Drugs & Alcohol. "Years and 
years ago, they used to drink the whole bottle of (cough medicine) to get 
high. This is just kind of the new wave."

The problem does not yet appear to be widespread in the Houston area, 
officials say, but similar trends have shown up from time to time in school 
districts nationwide.

The Clear Creek district, which includes parts of north Galveston County 
and southeast Harris County, recently mailed a newsletter to the homes of 
all intermediate-school pupils, warning parents about the problem. The 
letter, titled "Danger," was prepared by Deanne Cooney and Julie Purser, 
the district's drug-prevention and safety coordinators for middle schools.

One of the more popular medications being abused is Coricidin HBP Cough & 
Cold tablets, which pupils call "Triple C," authorities said.

The product, which sells for about $6 for 16 tablets, is especially popular 
because it has a larger dose -- 30 mg -- of the drug dextromethorphan than 
most other medications, said Jane Maxwell, a researcher with the Texas 
Council on Alcohol & Drug Abuse.

Dextromethorphan, also called DXM, is a synthetic drug related to morphine. 
It acts upon the central nervous system to suppress the cough reflex.

Drug counselors say abusers of dextromethorphan experience effects similar 
to those of alcohol, marijuana and PCP. It causes a loss of motor control, 
and users say they lose touch with reality.

MIXTURES CAN BE FATAL

Mixed with other medications, however, the result can be fatal.

The directions on the Coricidin Cough & Cold box suggest taking one tablet 
every six hours, not to exceed four in a 24-hour period. Officials say 
teens looking for a quick high often take double-digit doses at a time.

Alcohol and marijuana use is still more prevalent among teens, but the 
abuse of Coricidin "is becoming more and more popular," said Allen. "They 
are mixing it with alcohol, which is really dangerous."

She said she alerted Clear Creek school officials and parents several 
months ago after noticing an increase in abuse of over-the-counter medicines.

"It's something we tell our parents regularly. We tell them it's something 
they should be on the lookout for," Allen said. "It's not uncommon for the 
parents to be very shocked to find out kids are taking cold medicine."

Three recent cases involved pupils who showed up at Seabrook Intermediate 
School disoriented after overdosing on Coricidin.

Seabrook police officer Berna McMahan, who is assigned to the 970-pupil 
campus for sixth-through eighth-graders, said the problem persists because 
the medicine is cheap and easy to get.

"We were just letting the parents know because a lot of parents are 
clueless about it," McMahan said. "We had one girl who actually called her 
mom and specifically asked her to get Coricidin.

"The nurse heard her and got on the phone and told (the mother) not to 
bring it and explained what was going on. This is the drug of choice for 
the kids."

A week later, McMahan said, that 14-year-old girl suffered an overdose 
after buying the medication at a grocery store. She told authorities she 
had swallowed 24 tablets.

In the other two cases at Seabrook Intermediate, officials said, one pupil 
took 11 pills and the other took eight.

McMahan said pupils who abuse Coricidin are showing up at school "spaced out."

"It's like an LSD high, depending on how many they take," she said. "They 
start hallucinating."

HIGH SCHOOLS AFFECTED

Other recent cases of cold-medicine abuse have been reported at Brookside 
Intermediate and at the district's three high schools, McMahan said.

In addition to products containing dextromethorphan, Cooney and Purser said 
some pupils also have been using Extra Strength Robitussin cough syrup and 
cold medications containing phenylpropanolamine, chlorpheniramine or 
acetaminophen. (Phenylpropanolamine, or PPA, was removed from store shelves 
in November after it was found to increase the risk of stroke in women.)

"The effects of taking excessive amounts of these types of medications can 
not only be harmful but can be deadly," the counselors warned in their 
newsletter. "Given that adolescence is a time associated with 
experimentation and questioning authority, even the best pupils have been 
known to experiment in this manner, especially when they are unaware of the 
consequences."

The Coricidin package is printed with a warning against taking the drug if 
the user is taking -- or has taken in the past two weeks -- a prescription 
monoamine oxidase inhibitor, a drug used to treat depression, psychiatric 
or emotional conditions or Parkinson's disease.

The Coricidin instructions also advise against taking it with sedatives, 
tranquilizers or alcohol.

Officials with Schering-Plough Healthcare Products, the makers of 
Coricidin, said they have heard reports that some teens abuse the 
medication, among others.

"We are actively monitoring claims and stories concerning possible misuse 
of our products that contain dextromethorphan, and we take these reports 
very seriously," company officials said in a prepared statement.

The company reported that it has spoken with school officials, parents and 
retailers about the misuse of dextromethorphan and are working with 
industry organizations, parents and educators on the importance of proper 
use of over-the-counter medications.

"In addition, we are developing a Web site for parents and educators that 
addresses the abuse of over-the-counter products by teen-agers and the 
company is implementing a packaging system that will provide an additional 
product safety seal for Coricidin products," the statement said.

The company said dextromethorphan has served as a safe, effective cough 
suppressant for more than 37 years and is used in more than 135 
over-the-counter products.

INFORMATION ON INTERNET

Some Internet users have created Web sites specifically about abusing 
dextromethorphan. One person said he tried Coricidin because he had 
"chugged syrup" before and was nauseated by the taste, "so pills seemed 
like a great idea."

The writer, who did not give his name or age, said he took eight tablets 
and felt lightheaded in about 15 minutes.

After an hour, he wrote, "it hit me like a freight train."

"When I turned my head, it felt like my physical head would move first and 
my spirit would slowly lag behind in turning," he wrote. "I truly felt much 
more intoxicated than I ever have with syrup."

He added that he had double vision and could not focus.

While saying he enjoyed the experience, he wrote that "it was very strong 
and much too powerful for the average Joe."

Another Web site lists the positive effects of using dextromethorphan as 
mood elevation, dissociation of mind from body and creative, dreamlike 
experiences.

Negative side effects that were mentioned included upset stomach, vomiting, 
body itching, diarrhea, red, blotchy skin, fever and abnormally fast heartbeat.

The mother of the 14-year-old Seabrook Intermediate pupil who overdosed 
said she asked area drugstores to remove Coricidin from their shelves. They 
have not done so.

"Eckerd is not aware of any abuse regarding over-the-counter cough 
medications, and our warehouses do not stock Coricidin," said Tami 
Alderman, a company spokeswoman in Clearwater, Fla.

Carol Hively, spokeswoman for Walgreen's in Deerfield, Ill., said the 
company is monitoring sales of the medicine.

"We have not noticed any unusual problem in our stores," she said. "We have 
not pulled the product, but we are just watching the situation right now."

Kathy Lussier, a spokeswoman for Randalls Food Markets, said that company 
also has not removed the product.

The Clear Creek counselors offered these tips to parents concerned about 
abuse of any medication:

. Talk with your children, and explain the dangers.

. Keep prescription and nonprescription medications locked away. Make sure 
they are taken under parental supervision.

. Make sure that any medication, including cold medicine sent to school for 
your child, is accompanied by a note, is in its original container and goes 
directly to the school nurse.
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