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"It’s Just Cough Medicine" –
Think Again!
There is an emerging trend
happening in homes across Tennessee, right under
parents’ noses. Recently, there have been news
reports of overdoses and theft of this drug
across the state as well as nationwide. The
Tennessee REDLINE has been receiving calls and
inquiries about it for nearly 3 years from
various areas of the state. What is it? What is
this drug? It is the abuse of over-the-counter
cough suppressants. Dextromethorphan or DXM is a
semisynthetic narcotic related to opium and
found in many over-the-counter cough
suppressants in the United States and most
countries. DXM is contained in any drug whose
name includes "DM" or "Tuss." The drug comes in
various forms. Most common are cough
suppressants in caplet or liquid form, including
Corcidin, Robitussin, Vicks Formula 44,
Drixoral, and several generic brands. (A
caution: Not all medicines under these brands
contain the drug since most brands put out
several formulations. Look on the label for
"DM," "Tuss," or "Maximum Strength.")
Less publicized and more
easily obtained than the more well-known
club-drug ecstasy, DXM’s legal status and
familiarity may lure some kids into taking it,
despite the dangers it poses of addiction,
injury, and death. "It's not an ugly drug. It’s
much less intimidating than snorting a powder or
injecting a strange substance," said William
Bobo, M.D., a psychiatrist who, along with
Shannon Miller, M.D., is conducting an
exhaustive review of the scientific literature
on DXM.
Anyone, including minors, can
buy these medicines at a local convenience mart
or drugstore. And since the Food and Drug
Administration (FDA) approves DXM for sale in
over-the-counter medicines, those seeking a
high, and especially teens, may assume it’s
"safe." "It's a very familiar substance, in
short," said Bobo, and thus "it is felt to be
benign by abusers." This underestimation of the
drug’s dangers and abuse potential is not
limited to abusers, explained Miller. "Many
clinicians simply aren't asking these
questions—and certainly when they are faced with
someone using it, they tend to minimize it."
DXM is related to opiates in
its make-up, and it produces mind-altering
highs. Misuse of the drug creates both
depressant and mild hallucinogenic effects. It
also acts as a dissociative anesthetic, similar
to PCP and ketamine.
Sought-after effects include:
Adverse effects are many:
·
Confusion
·
Impaired judgment and mental
performance
·
Blurred vision
·
Slurred speech
· Loss
of coordination
· Rigid
motor tone and involuntary muscle
movement
·
Tremor
·
Dizziness
·
Nausea, abdominal pain, vomiting,
vomiting of blood
·
Dysphoria (sadness)
·
Paranoia
·
Headache
·
Decreased ability to regulate body
temperature
·
Excessive sweating
·
Reduced sweating and increased body
temperatures, or hot flashes
·
Irregular heartbeat
· High
blood pressure
·
Numbness of fingers or toes
·
Redness of face
· Loss
of consciousness
· Dry
mouth and loss of body fluid
· Dry
itchy skin and occasional patches of
flaky skin
Emergency rooms increasingly
report DXM overdoses and DXM-related crises. In
spite of these serious potential adverse effects
of DXM, the dangerous behavior it induces, and
the ingredients ingested along with DXM-containing
cough medicines, abusers keep returning because
of the drug’s legal status and easy access.
Its use is becoming more
prevalent in dance clubs and at dance events
called "raves," where it is sometimes used as an
alternative for the more well-known drug
ecstasy. Adolescent youth easily can obtain the
drug because stores sell it over the counter,
with no prescription required. Its street names
include:
·
DXM
·
robo
·
skittles
·
Vitamin D
·
dex
·
tussin
WHAT CAN WE DO??
The most important thing for
everyone is simply to be aware that the problem
exists. Parents should look for signs of abuse
such as a child bringing home his or her own
box, or an unexplained dwindling of the family’s
stock. Doctors can look for signs of abuse and
send patients to treatment providers. Treatment
providers need to be aware of the special
considerations associated with the drug’s
availability. And abusers should know that the
drug is dangerous and has addictive properties.
Sources: Tennessee REDLINE &
NCADI Reporter. |