Pubdate: Wed, 07 Jan 2004
Source: Lexington Herald-Leader (KY)
Copyright: 2004 Lexington Herald-Leader
Author: Mary Meehan


Cheap Drug Available Over The Counter

Found over the counter, not on a street corner, the latest troublesome drug 
making inroads with Central Kentucky teens is an easily accessible cough 
remedy: Coricidin.

"It was a surprise for me," said Pat Cardona, director of outpatient 
services at Comprehensive Care Center in Cynthiana. "I thought somebody was 
just telling a story. It was just so goofy."

But, she said, after seeing a rising number of teens abusing the medicine, 
including a 15-year-old who ended up in intensive care during her third 
emergency room visit for an overdose, "it's not a surprise anymore."

Coricidin HBP Cough & Cold and other variations of Coricidin contain 
dextromethorphan, or DXM.

Slang names for Coricidin include Triple C, skittles or red devils. DXM is 
found in any cold remedy with "DM" on the label, said Jon Colvin, senior 
poison control information specialist for the Cincinnati Drug and 
Poison-Information Center.

According to the National Drug Intelligence Center, part of the Department 
of Justice, when any medicine containing DXM is taken in 
higher-than-recommended doses, it produces hallucinations and a sense of 
dissociation similar to those of PCP, known commonly as angel dust. 
Coricidin, largely through word of mouth, has become the brand of choice 
for abusers.

Since Coricidin began appearing in Harrison and Bourbon counties last year, 
Cardona has been hearing from drug counselors across the state about its 
growing misuse.

"We really do need to educate parents more," she said. "They probably don't 
have a clue. It's like a new issue for everybody here."

56 Overdoses Last Year

According to Amy Weber, of the Northkey Regional Prevention Center in 
Florence, Coricidin has been a major problem in her area since appearing 
about three years ago.

During a one-month period in 2000, the Cincinnati Drug and Poison 
Information Center reported 12 overdoses from Coricidin. Those numbers have 
declined, but "it's still certainly a trend we continue to see," said Colvin.

There were 56 overdoses of the drug in Kentucky in 2003, including three in 
Fayette County, said Henry Spiller,-director of the Kentucky-Regional 
Poison Control Center. He said 50 of those cases involved emergency room 
visits, where treatment can include evacuating the stomach through a tube, 
or intubation for assistance with breathing.

The overall number of overdoses is down from last year, Spiller said, but 
it's possible that the drug may just be popping up in some places because 
drug abuse trends generally go from cities into the country.

Deborah Mitchell, senior analyst with the National Drug Intelligence 
Center, said that is the historic pattern with drugs, but "now with the 
Internet we see more things kind of jumping around the country. Proximity 
doesn't really matter."

Underestimating Danger

In the case of Coricidin, there are Web sites dedicated to explaining how 
to abuse it and describing trips induced by taking large doses.

Used as recommended, Mitchell said, it is a good drug for coughs and colds, 
and fatal overdoses are rare.

But because it is available over the counter, users, who can be as young as 
13, underestimate the damage it can do.

"They're thinking, 'It's three or four bucks. It's over the counter. What 
risk can there be?'" said Spiller.

Often, Spiller said, the DXM is not the issue as much as "the other drugs 
that are in there. They are what is going to kill you."

Most forms of Coricidin contain acetaminophen, which can cause liver 
damage. "We are concerned that they (teens) are unaware of this and that 
they can easily dose themselves into the danger zone," he said.

The other danger, Mitchell said, is that hallucinations can cause users to 
do stupid and dangerous things.

Jim Searle, director of law enforcement for Fayette County Schools, said 
his officers have not received any reports of abuse associated with 
Coricidin. But, he said, he can't be aware of everything that goes on in 
school buildings.

Mitchell said the over-the-counter nature of the drug makes it hard to 
police. If "some girl's purse falls open and some Coricidin falls out, all 
she'd have to say is that she has the sniffles," she said. "It's easy to hide."

Plus, she said, "a lot of people aren't aware of it."

Keys To Prevention

One way to combat abuse is to remove the drug from the shelves and keep it 
behind the counter, where it must be requested. Limiting the amount an 
individual can purchase also can cut down on abuse, Colvin said. He said 
those measures seemed to help in Cincinnati because many abusers shoplifted 
their supply. Spiller said most major pharmaceutical companies are leaning 
toward similar measures.

But don't look for full-scale removal of the product. The Bush 
administration is banning the sale of ephedra this year, after several 
deaths were linked to its abuse, but Mitchell said not to expect a similar 
action against Coricidin. "It's too widespread," she said.

Parents should be on the lookout for slurred speech, glassy eyes, and the 
bubble packs that the pills come in, she said.

And Weber, who helps kids in Northern Kentucky deal with substance abuse, 
said parents also should start networking, sharing information with one 
another. But, beyond that, she said, parents need to look at why kids as 
young as 13 are seeking a hallucinogenic high?

"Our culture is saying something," she said. "It is saying something in 
some way that is very scary."

"Everybody has to be part of the solution," she said.
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MAP posted-by: Beth Wehrman