OVER-THE-COUNTER HIGH

Teen abuse of ordinary medicine a small but growing problem

Naperville police officers noticed something peculiar about teens hanging
out along the downtown Riverwalk during the summer.

High-schoolers exhibiting symptoms of intoxication were seen more and more,
but police were puzzled when the mixtures making them high featured names
such as Robitussin and Vicks 44 instead of Budweiser and Jack Daniels.

Sgt. Bob Guerrieri, commander of Naperville's Special Enforcement Unit,
encountered a teen who wanted to combine marijuana with a motion-sickness
drug to produce a stronger high.

The police and officials at Naperville's Edward Hospital eventually
compared notes to see how big a problem they had on their hands.

Then, as suddenly as the phenomenon appeared in the summer, it virtually
vanished when the leaves began to fall.

That didn't deter police, who want to cut off the problem before it can
become more prevalent.

Guerrieri said prevention and information are the best medicines for this
ailment. Parents need to understand that there are teens abusing these
drugs, he said, and there could be more consequences from them than just a
buzz.

"I would say it's a growing problem, but I would also say that it is a
small problem," Guerrieri said. "I'd like to think it's because we do such
a good job suppressing the illegal drugs that it makes the kids go for the
over-the-counter drugs, but I don't think I can give our unit that much
credit."

Small-Time Abuse

Area police departments and hospitals say abuse of over-the-counter and
prescription drugs is still rare, but they say the problem does exist, if
only because these drugs are legal and readily available.

In addition to Naperville's reports, Aurora police recently handled two
cases of teens who appeared to be high on caffeine pills and ephedrine.

A graduate of Oswego High School and a student at Aurora University said
it's common for teens in her hometown to buy quantities of caffeine pills
and ephedrine to get high. The young woman, who asked for anonymity, said
one of her friends contemplated obtaining an illegal prescription for
Prozac, an antidepressant, to improve his sexual performance.

Lt. John Dobran, head of Aurora's Special Operations Group, didn't know of
any local cases until he talked to some of his officers stationed at the
public schools.

Aurora police said the incidents are isolated but share Naperville's
concern that it can become a bigger problem if left unattended.

"I really thought we didn't have problems here, but I'll have to say that
this is happening more than we think," Dobran said.

Naperville police have found that cold and cough formulas containing the
ingredient dextromethorphan, or DXM, are the major legal drugs abused by
teens.

DXM is an opium derivative used to suppress coughing because of colds, flu
and allergies. Dr. Alan Kaplan, head of the department of emergency
medicine at Edward Hospital, said overdosing on DXM is difficult but not
impossible.

"We don't have many cases of kids coming in here high on legal medicines,"
Kaplan said. "We have more cases of people trying to commit suicide on
Sudafed, and it just makes them real sleepy, not dead."

Symptoms of overdose on DXM, according to the "Complete Guide to
Prescription and Non-Prescription Drugs," are euphoria, hyperactivity, a
sense of intoxication, lack of coordination, staggering, stupor and shallow
breathing. There are more than 100 brand-name, over-the-counter medications
that contain some form of DXM.

A nurse in Edward's emergency room who did not wish to be identified said
she treated one high school boy who tried to get high on Sudafed near the
end of summer.

"He just looked kind of sleepy," she said.

Kaplan said he does not want people to be lulled into the wrong idea about
DXM, ephedrine or any other over-the-counter drug. Just because local
hospitals have not seen a serious overdose case does not mean these
substances can't cause harm.

Overdoses can happen, he said, and they quickly can turn into
life-threatening situations, particularly if these drugs are mixed with
other medications, illegal drugs or alcohol.

"Kids don't know what they're getting into because it's over-the-counter
medication," Kaplan said. "But some of the ingredients, especially when
taken in excess of normal dosages, can have serious effects on the heart,
impair judgment and may dangerously react with other medications."

Heading Off Problems

If police have a tough time determining whether someone is high on legal
drugs, then theparents' job can be even more difficult.

Even the proper dose of an over-the-counter medication can affect some
people in an adverse way. That's why there are labels warning users not to
drive or use heavy equipment after taking certain medications.

Authorities agree that not much can be done if someone is found under the
influence of a legal drug. Most of the erratic teens encountered on the
Riverwalk during the summer were on foot, not damaging property nor
assaulting anyone.

"If they're behind the wheel of a car or if they are breaking some other
law, then we may be able to do something with that," Guerrieri said. "But
cough medicine is not a controlled substance, so we can't arrest them for
it."

Paying attention to kids who might purchase excessive amounts of
over-the-counter medications is the first thing parents can do to stem the
tide. Guerrieri suggested looking for empty bottles and boxes of drugs and
open pill packages in the garbage.

Also, unusual physical symptoms, such as profuse sweating, hallucinating
and nervousness, can be a clue. Many parents are thrown off when they see
symptoms of overdose from common drugs, thinking the reaction is because of
the usual suspects, such as marijuana or alcohol.

Naperville police went so far as to ask area drugstores to keep large
supplies of cough medicines behind the counter instead of on shelves. That
way, teens bent on getting a buzz couldn't buy six or 12 bottles at a time
without tipping off someone.

The stores complied, but Guerrieri said police won't be able to regulate
legal drugs this way permanently. Even if stores would cooperate, a few
keystrokes on the computer can bring up Web sites with information about
how to order and use these legal but potentially dangerous drugs.

A cursory search of the Internet revealed at least six Web sites devoted to
the use of DXM, including prices for common sources of the drug, the amount
of DXM in each over-the-counter medication and tips on what other drugs one
can mix with DXM to produce the best high.

One of the sites is run solely by teens for teens. There are sites that
originate overseas and sites from Canada.

For Dobran, this is not good news.

"Sometimes, we don't become aware of these things until they become a
problem," he said. "Until something really serious happens, we don't see
things for what they are."