KENTUCKY TEENAGERS ABUSING COLD PILLS

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.