DANGEROUS HIGH SOLD OVER THE COUNTER

Young people are increasingly buying over-the-counter cough syrups and
cold medications to get high from one of its main ingredients,
dextromethorphan, which is found in about 200 products.

At least three Orange County teens have been hospitalized after
overdosing on over-the-counter cold remedies in the past two weeks.

The teens arrived at Mission Hospital hallucinating, with owl-like
eyes and racing heartbeats.

The medicines, when abused, can cause seizures, comas, even
death.

"One kid was grabbing in the air for his math textbook," said Dr. Mike
Ritter, assistant director of the hospital's emergency room. "He was
seeing schoolbooks flying around the room." None of the cases was fatal.

Experts say teens and young adults are increasingly buying
over-the-counter cough syrups and cold medications to get high from
one of their main ingredients -- dextromethorphan, or DXM. The
ingredient is in about 200 products.

"It causes dissociative hallucinations and out-of-body experiences,"
said Dr. Ilene B. Anderson, a clinical professor at UC San Francisco's
School of Pharmacy, who compared the fix to "a PCP-like high."

This week the Consumer Healthcare Products Association, which
represents nonprescription drug makers, launched a national education
campaign through Web sites, TV and radio spots, and brochures about
cough-medication abuse.

Efforts to impose state legislation have failed.

State Sen. Joe Simitian, D-Palo Alto, introduced two bills in the past
three years - one in the Assembly and the second in the Senate - to
ban the sale of products containing DXM to minors without a
prescription. Both bills met strong opposition from drug
manufacturers, retailers and other lawmakers. Those against it worried
it would penalize people making legitimate purchases.

"I may reintroduce it as a way to increase awareness," said Simitian,
who pulled the bills back before they reached a floor vote. "There are
things in the Legislature that take a decade to do. Sometimes you are
ahead of the curve."

But growing concern about DXM has led some drugstores, such as
Walgreens, to voluntarily prohibit teens from buying any product with
the substance. A Walgreens spokeswoman said the restriction came last
year after the company noticed teens buying up to 10 packages at a
time. Rite Aid limits the number of such products on store shelves.
But getting DXM is often as easy as opening the home medicine cabinet.

Danger on the Rise

According to the California Poison Control System, the number of DXM
overdoses reported in patients ages 9 to 17 has increased more than
tenfold - from 23 cases in 1999 to 375 cases in 2004.

High doses of DXM can cause serious medical complications, such as
coma. However, no deaths have been reported to the California Poison
Control System - or Orange County coroner's office since at least 2001
- - in which DXM was the sole cause.

Still, poison-control experts said kids run other health risks from
ingredients mixed with DXM, such as antihistamines and acetaminophen,
the main ingredient in Tylenol.

"It's always contained with something else, which is usually more
toxic," said Dr. Lee Cantrell, interim director of the California
Poison Control System's San Diego Division, which oversees Orange
County. Toxic levels of acetaminophen can destroy a liver.
Antihistamines and pseudoephedrine, for allergies and colds, can cause
increased heart rate, high blood pressure and seizures.

Swapping Stories

The cough suppressant DXM has been around for decades, but experts say
the Internet is fueling its abuse.

"Kids have more access now to what other kids are doing," Ritter said.
"One kid in one city can use a drug, and the next thing you know,
10,000 other kids are aware of it."

In the past year, Ritter estimates Mission doctors have treated three
to five cases a month. This month, they've already seen at least three
cases. Teens ages 14 to 17 have arrived unconscious, with seizures and
with psychosis. Other local hospitals reported cases, too.

Some Web sites the Register reviewed detail teens swapping stories of
"skittling" or "robotripping."

"I got caught in a nasty time loop. That stuff makes pure LSD seem
like ginger beer. There is no comparison," blogged a girl on one site.
Dr. Gary Goodman, director of the pediatric intensive-care unit at
Children's Hospital of Orange County's Mission Viejo campus, where the
teens who recently overdosed stayed overnight, said he had a case in
which one patient took 35 Coricidin pills to get stoned. The teen had
read online it took 36 to die. The hospital requires such patients to
meet with a social worker before being released and also recommends
counseling.

"We look at this as drug abuse," he said.

Cheap and Available

All three recent Orange County overdoses involved Coricidin HBP Cough
& Cold, which contains DXM.

"It's the newest fad out there," said Duane Durst, program director of
Chapman Medical Center's substance- abuse program, called Positive
Action Center, about the over-the-counter drug.

"It's available. It's cheap. No prescription is necessary," Durst
said.

In virtually all cases, patients at the center are abusing cold
remedies with other drugs. Julie Lux, a spokeswoman for the maker of
Coricidin, said the drug maker has begun using anti-theft tags in
packaging to prevent teens from stealing the products.

"We recognize abuse of it is a problem," she said.

The Appeal

"I'd heard about it before from other friends, and they said it was
fun," said Christina Pearce, 17, of Coto de Caza, who experimented
with Coricidin once, when she was a high school freshman. "You buy it
over the counter, so you figure it's not heroin -- like, it can't be
that bad."

But the effects - delusions, racing heart and swollen eyes - lasted
for three days. She vowed never to try it again. "I was scared to death."

Her message to other teens: "There are effects to your actions that
aren't worth it. It's never worth your life."

Later her mother, Beth, became involved in drug education after a
Laguna Niguel girl overdosed on ketamine, a sedative. She read the
story in the newspaper and decided something had to be done. She made
two films warning parents about the dangers of drugs, including DXM.

"The pharmacies have started to put them behind the counter, but kids
can still buy it," Beth Pearce said. "Kids think there is nothing
wrong with it, that it is safe. ... It's not illegal to buy.