Emergency room physicians are reporting a sharp increase in teens abusing non-prescription cough and cold medicines, which are back in vogue as recreational drugs because the products are accessible and easier to take than ever before.
Users call it “skittles,” “triple C’s” (for Coricidin HBP Cough & Cold tablets) or “robo-tripping” to describe its hallucinogenic effects. Medical personnel are calling it “an epidemic.”
The latest concerns have caused some drugstore chains to limit purchases. But the efforts don’t go far enough, say many critics, who are urging that all such products be sold strictly from behind the counter.
“It’s not illegal to purchase. It’s not even illegal to take in large quantities. It’s just dangerous and foolish, and that is what is scaring everybody,” said Dr. Charles Nozicka, director of pediatric emergency medicine at St. Alexius Medical Center in Hoffman Estates.
Nozicka estimates he has seen about 30 cold medicine-related overdoses in the last year.
While students have been guzzling cough syrup for years, this is a relatively new phenomenon. Sweet syrups contain ingredients that cause vomiting before reaching doses large enough to hallucinate. Tablets don’t have that effect.
The key ingredient is DXM, a cough suppressant that replaced opiates in the 1970s and can be found in more than 120 products, all safe when used as directed. But taking DXM in large quantities can cause slurred speech, tremors, seizures and even death.
Although no national agency tracks fatalities, at least five have been attributed to cold medicines during the last year, including one in September at Illinois State University. More indicative of a growing problem: U.S. poison-control centers logged some 3,200 calls related to the substance in 2003–twice the number as in 2001.
To raise awareness, the Chicago office of the U.S. Drug Enforcement Administration issued a parental advisory last week, citing a “recent escalation” in area DXM abuse. In addition, the American Medical Association voted in December to pursue national restrictions on the products.
Coricidin’s manufacturer, Schering-Plough HealthCare Products, has stepped up efforts in recent months, including working with national retailers and anti-drug organizations, according to Mary Fran Faraji, spokeswoman for the New Jersey-based drugmaker.
Last month, Walgreens nationwide began limiting the sale of Coricidin HBP to three packages, with other chains–such as Osco and Dominick’s–following suit. They leave it to the discretion of store managers whether to clamp down further.
But until all stores keep it out of reach, most health-care professionals won’t be satisfied.
“It’s a joke,” said Dr. Louis Kraus, director of child and adolescent psychiatry at Rush University Medical Center. “Kids who are shoplifting don’t care about how much they can buy. Until it’s behind the counter, we’re going to continue to have an increasing problem.”
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An increasing problem
Health-care professionals have seen a rise in drug abuse cases involving DXM, an ingredient in cough syrup.
ILLINOIS POISON CENTER CALLS
Related to DXM
2001 127
2002 140
160
The ABCs of DXM
Use: Cough suppressant found in over-the-counter cough medicines.
How it is abused: At higher-than-recommended doses, it can produce hallucinogenic effects and distorted perceptions.
Signs of abuse: Includes nausea, vomiting, diarrhea, poor coordination and dizziness. At very high doses, DXM can slow breathing and even cause death.
Slang terms: Dex, Robo, Skittles, Syrup, Triple-C, Tussin
SOURCES: ILLINOIS POISON CENTER, DRUG ENFORCEMENT ADMINISTRATION
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Edited by Curt Wagner (cwagner@tribune.com) and alBerto Trevino (atrevino@tribune.com)
