Prescription drug abuse offers low-cost, high-risk high for teens
Wednesday, July 21, 2010
Kids and teens are getting high using a common over-the-counter drug that can cause hallucinations and even death-and most are getting it from their own family's medicine cabinet.
The high-inducing ingredient is called dextromethorphan, a cough suppressant found in medicines such as NyQuil, Coricidin and Robitussin, among scores of other non-prescription brands. When taken as directed, dextromethorphan, also known as DXM, affects the brain reflex that triggers coughing. But those abusing the drug take up to 50 times the recommended dosage to achieve a high similar to the dissociative, out-of-body experience from the drugs PCP and Special K.
"It's not taking an extra teaspoon or a little too much. It's taking 25 to 50 times the dosage to get the effects they are looking for," says Cam Traut, a school nurse at Libertyville High School. "If too much is taken, the side effects can be very, very serious, if not fatal."
The drug has gained in popularity among teens because it is easily available and doesn't carry the same stigma as illegal street drugs. "It's out there and it is prominent and people need to be aware of the risks," says Traut, a member of a coalition of school nurses on a campaign to educate parents and educators on the prevalence and risks associated with cough medicine abuse.
A little more than 5 percent of teens and young adults have used non-prescription cough or cold medicines to get high at least once, according to a U.S. government report published in 2008. The report, the National Study on Drug Use & Health, also found that more than half of the one million young people who had abused cough or cold medicine in the last year were between 12 and 17 years old, and more girls than boys had reportedly done it. Researchers polled nearly 45,000 people, age 12-25, for the study, conducted in 2006 by the U.S. Department of Health and Human Services' Substance Abuse & Mental Health Services Administration.
"It's much more available to kids because you have it in your house," says Tari Marshall, director of external affairs for Prevention First, a non-profit resource center in Chicago specializing in drug abuse prevention. She says teenagers view over-the-counter drugs as safe because of their availability. Plus, they remember mom administering doses to them as children.
"What they don't understand is it is only safe when taken as directed. They think they can't overdose," she says.
They're wrong. The health risks of taking such high doses of dextromethorphan are severe and potentially fatal, especially when combined with alcohol, illicit drugs or other over-the-counter and prescription drugs, health experts say.
Additional cough medicine ingredients commonly used, such as acetaminophen and antihistamines, carry risks of their own when taken in such high quantities, including severe liver toxicity and breathing difficulties, says Dr. Karen Sheehan, director of the Injury Prevention & Research Center at Children's Memorial Hospital in Chicago.
"A lot of time kids are taking a bunch of different medicines without really knowing what they're taking. And the amount they take is so much greater than what is ever prescribed," Sheehan says, noting the drugs can cause people to forget to breathe or to choke on their own vomit. "It's very concerning. It just puts them at a risk for, essentially, death."
Over the last decade, there have been several deaths across the country connected with dextromethorphan. Experts say exact numbers are extremely difficult to track because emergency rooms do not test for it, and families often don't release cause-of-death information in suspected DXM fatalities.
"This is a drug that emergency rooms will not even look for. It's very hard to track it and get the exact figures. But we know the risk is there," says Dr. Danesh Alam, medical director of Behavioral Health Services at Central DuPage Hospital in Winfield.
Alam, who runs the hospital's substance abuse program for adolescents, has seen a steady number of patients come through the program with a history of cough medicine abuse. He says kids often take the drug in combination with other drugs, sometimes not knowing what substances they were taking. At some parties, teens will first raid their parents' medicine cabinets for anything they think will offer a high and distribute the medicines to friends who in turn share their stash. "Adolescents don't have a steady supply of anything. They'll use whatever they can find."
Tests on rats showed DXM can cause changes in the brain that control behavior and cognitive skills, and can lead to psychosis, Alam says. It also is habit forming. "The treatment course is very hard and challenging for this drug."
Parents are best prevention
The best tool for fighting the trend is being part of your child's life and knowing what they do and who they do it with.
"(Parents) are the most powerful voice in their teen's life," Traut says.
She and other school nurses across the country are bringing cough medicine and other over-the-counter medicine abuse to the forefront with the Home to Homeroom campaign. Working with five mothers who lost their children to non-prescription drug abuse, the nurses hope to highlight the dangers and get parents and educators to take the issue more seriously.
Experts also caution against assuming your kids are too young or too naïve to experiment with drugs. "Too many parents don't realize that kids as young as fifth and sixth grade are beginning to experiment," Prevention First's Marshall says. "Don't make the assumption that they don't already know about it. They're going to find out about it at some point. Don't you want it to be from you and not a friend who is going to glamorize it and make it sound great?"
In addition to communicating, they also suggest hiding cough medicine and any other medication from kids and teens. "This is one area where prevention really works," says Alam, a psychologist. "Number one, lock up all the drugs in the house. Be involved in their lives. Be interested. Be familiar with what your child is doing after school."
Chicago parent Curtis Gonzales decided to lock up all the cough medicine in his house after he heard kids were using NyQuil to get high. "That changed my view big time," says Gonzales, 33, whose son Nicholas is a sophomore at Rickover Naval Academy on the city's North Side. "I want to be the one to give it to him when he's sick."
Prevention needs to be seen as an ongoing effort. "It's not one conversation. It's a series of conversations that begins in and continues through high school," Marshall says. "Parents have to let their kids know that it's not OK to use drugs of any kind."