Pubdate: Sun, 04 Jan 2004 Source: Marshfield News-Herald, The (WI) Copyright: 2004 Gannett Wisconsin Newspapers Contact: http://www.marshfieldnewsherald.com Details: http://www.mapinc.org/media/2236 Author: Jonathan Gneiser KIDS USE NONPRESCRIPTION MEDS TO GET HIGH Central Wisconsin Sunday Central Wisconsin is not exempt from a nationwide trend: youths overdosing on nonprescription cough and cold medicines. Dozens of overdoses in the past two years, including at least five deaths in the United States in which the abuse of over-the-counter medicines was a factor, show how medicines such as Coricidin and Robitussin are becoming recreational drugs for kids as young as 12, according to police and doctors. Jennie Echola, 20, of Marsh-field said an acquaintance introduced her to Coricidin HBP Cough & Cold tablets to get a buzz that provided a couple hours of euphoria and hallucinations. The dangers of DXM Dextromethorphan, also called DXM, is found in more than 120 non-prescription cough and cold medicines, including Robitussin, Coricidin HBP, Vicks NyQuil and Vicks Formula 44. Other facts: Youths' nicknames for DXM: Robo, Skittles, Triple C's, Rojo, Dex, Tussin, Vitamin D. DXM abuse is called "Robotripping" or "Tussing." Users might be called "syrup heads" or "robotards." Symptoms of abuse: They include 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. How much is too much: 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. Its status: The Drug Enforcement Administration classifies DXM as a "drug of concern" because of its potential for misuse, but there are no legal restrictions on buying the drug. Sources: National Institutes of Health, Drug Enforcement Administration Although she's stayed away from illegal drugs, Echola said she thought the cold pills were harmless, because they can be bought legally off the shelf. "I was a walking 'anti-drug,'" she said. Echola got high on the cold medicine five or six times while she was 19 years old, each time becoming more concerned that she was becoming addicted, she said. "It's kind of scary when that's all you think about," she said. "It's like smoking - when you're under stress you want to smoke more. It basically became an antidepressant for me. " After becoming upset and having too much to drink at a friend's birthday party, Echo-la said she accidentally took Sudafed with Tylenol instead of Coricidin and landed in the hospital for several months. "My liver quit working," she said. That incident was an awakening for Echola, who said any sign or smell of the cold pills now makes her gag. "Just thinking about it makes me nauseous," Echola said. But she's concerned others, including her 14-year-old brother, could be overdosing on cold medicine. "It seems to be a thing to do with kids his age," she said. The directions on Coricidin say adults and children 12 years or older can take one tablet every six hours, not to exceed four tablets in 24 hours. The product is not for children under 12. Recommended doses for over-the-counter drugs should not be ignored, said Joseph Gerwood, a psychologist and certified alcohol and drug counselor for Ministry Behavioral Health of St. Michael's Hospital in Stevens Point. "The reason is to prevent death and other side effects," he said. "When you go overboard, you're going to pay the consequences. You can blow out your liver, heart or have a stroke." Overdosing with certain cold medicines can stimulate the central nervous system to create hallucinations, anxiety, restlessness and agitation, or depress the system and cause someone to slip into a coma, said Sheila Weix, manager of Alcohol and Drug Recovery Service at Saint Joseph's Hospital in Marshfield. "Anytime that you're using toxic doses of anything in your body, it's going to have negative effects," she said. Gerwood said he's also met with clients who've added alcohol or marijuana to the mix. "The problem is when you start mixing this with other drugs, you're not only playing with fire - you're in fire," he said. Riverview Hospital's medical staff held an inservice on the trend of overdosing on cold medicines about six months ago, said Dave Mueller, director of community relations for Riverview Hospital in Wisconsin Rapids. "We've had isolated cases of it over the last year," he said. Cases tend to come in streaks whenever there's a greater awareness of a particular product that can be used to get high, Weix said. Adults also sometimes resort to over-the-counter medications when they can't get preferred drugs. "There's always kind of a fringe group that tries these things," she said. Although Marshfield Police Chief Joe Stroik has only seen a couple of cases reported within the past year, he said it's an emerging problem. Stroik said he's especially concerned that teenagers are treating the cold pills like candy. "With the younger kids, it's almost like candy Skittles," Stroik said. "That's dangerous." Residents should clean out their medicine cabinet often to keep tabs on what should be there, Stroik said. Although some retailers won't sell the medicine to children under 18, Echola said she knows kids have shoplifted boxes of it. "It shouldn't be so accessible," said Echola, who'd like to see the medicine require a prescription, or at least moved behind the counter. After two teenage girls and two 20-year-old men in Merrill overdosed on medicines containing dextromethorphan, or DXM, this year, some drugstores in the city began to stow such remedies behind their counters. At the Aurora Pharmacy, customers aren't allowed to buy several boxes of Coricidin tablets at once and must request them. Pharmacist Jim Becker said he wants the drug "where we can keep an eye on it." Although drug manufacturers say they sympathize with concerns about drug abuse, they're resisting efforts to restrict consumers' access to Coricidin, Robitussin and other remedies containing dextromethorphan. "The vast majority of people take them responsibly," said Fran Sullivan, spokesman for Wyeth Consumer Healthcare in Madison, N.J., which makes Robitussin products. "As a medicine, it works hands-down, so we want people to be able to use it if they need it." Wyeth increased the size of the packaging for its anti-cough gel-tabs so that it is difficult to stash in a backpack or pocket, Sullivan said. "We've noticed that the abuse comes and goes in waves," he said. "It gets really popular in a small area for a short period of time and then it dies out. Teens end up in the emergency room, it makes the local newspaper, and the area goes on alert." Schering-Plough, which makes Coricidin, is working with the Partnership for a Drug-Free America to create an educational Web site on dextromethorphan, company spokeswoman Mary-Fran Faraji said. Company representatives also are meeting with pharmacists, parents, schools and retailers to discuss ways to prevent drug abuse. - --- MAP posted-by: Keith Brilhart