ABUSE OF COLD AND COUGH MEDICINES CAN BE DEADLY

In this cold and flu season, most parents may not think twice about their
children dipping into the family medicine cabinet.

They should.

Across the country, emergency rooms and schools are reporting a disturbing
wave of youths, some of elementary school age, overdosing on
over-the-counter cough and cold medicines. Dozens of overdoses, including
at least five deaths, have been blamed on common non-prescription medicines
in just the past two years.

The growing phenomenon, health experts say, represents an increasingly
dangerous trend that differs from past decades when some students sought
out cough syrups to try to get a high from the alcohol and codeine they
contained.

These days, most cough and cold medicines no longer contain alcohol, and
those with addictive ingredients such as codeine are available only by
prescription. But more than 120 over-the-counter medicines include
something called dextromethorphan, or DXM, a cough suppressant chemically
similar to morphine that, when taken in large doses, can produce
hallucinations and even a loss of motor control such as that induced by PCP.

The federal government doesn't keep statistics on DXM abuse, but drug
specialists say anecdotal evidence suggests that its use does not approach
that of methamphetamine or the club drug Ecstasy. DXM abusers typically are
young teens seeking a cheap alternative to drugs that are more expensive
and difficult to get.

DXM is found in a variety of cold medicines including Robitussin, Coricidin
HBP, Vicks NyQuil and Vicks Formula 44. First approved by the FDA in 1954,
the ingredient became popular in the 1970s as an alternative to codeine.

The deliberate overdosing by youths on these cold medicines has become so
common that the various cold medicines have gained their own nicknames,
such as Skittles, Triple C's, Rojo, Dex, Tussin, or Vitamin D. DXM abuse is
called "robotripping" or "tussing." Users are sometimes referred to as
"syrup heads" or "robotards."

Youths overdose on these drugs in the mistaken belief that non-prescription
drugs cannot harm them. But that has proved to be a deadly mistake.

The symptoms of cough and cold medicine abuse include excessive sweating,
high body temperature, dry mouth, dry, itchy or flaky skin; blurred vision,
hallucinations, delusions, nausea, stomach pain, vomiting, irregular
heartbeat, high blood pressure, numbness in toes and fingers, red face,
headache, and loss of consciousness.

It doesn't take a bucketful of pills or several bottles of cough medicine
to overdose. A normal dose of DXM is 15 to 30 milligrams. Mind-altering
effects can occur at doses as low as 100 milligrams, but many abusers
consume enough pills or syrup (say, half a 12-ounce bottle) to result in a
dose of 240-360 milligrams.

The growing problem with DXM should be a warning to parents. But it
shouldn't stop there.

Some drug stores have voluntarily restricted access to cough and cold
medicines. Others have moved the cough and cold medications where they can
be routinely watched by store staff.

Those policies should be adopted by all drug stores and chains.

Meantime, parents should keep an eye on the family medicine cabinet and
talk to children about the dangers of experimenting with these
over-the-counter cough and cold medicines. Educating yourself and your
children is the first and best line of defense against this emerging problem.