Pubdate: Wed, 01 Sep 2004 Source: Chapel Hill News (NC) Copyright: 2004 Chapel Hill News Contact: http://www.chapelhillnews.com/ Details: http://www.mapinc.org/media/1081 Author: Patrick Winn YOUNG TEENS GET HIGH ON OTC COLD REMEDIES A group of former users and parents wants pharmacies to make the drugs harder to obtain by putting them behind counters. CHAPEL HILL -- There's an extremely prevalent drug in Chapel Hill called dextromethorphan, or DXM. It produces a woozy, hallucinogenic effect. It doesn't show up on most drug tests and it's relatively cheap. It's also available in legal, bar-coded products, sold on grocery store shelves alongside mouthwash and body soap. "When it kicked in, it was like, 'Oh my god,' like I've been drinking and smoking all day," said Jordan, 17, describing his first DXM experience at the age of 14. "I felt so messed up." Anyone who's caught a cold has had good reason to use DXM, an active ingredient in over-the-counter remedies such as Robitussin or Coricidin tablets. Depending on the product, recommended doses can suppress coughs and reduce fevers. Quadrupling the dose, however, leaves users with a prolonged high. Coupled with alcohol, the experience is even more severe. "It says it right on the box, 'Alcohol will intensify effects,'" said Jordan, who wished to keep his last name private. "If you take one shot, it feels like you took six." Now Jordan, other former DXM-abusers and their parents are starting a local campaign against misuse of products containing the drug. The group's mission is two-pronged: Its members want more public awareness of the lesser-known, potentially fatal drug, and they're determined to make certain cough remedies harder to shoplift. Most of the effort revolves around the Summit School, a private Chapel Hill program for high-school aged students dealing with drug or alcohol addiction. The school's fees run $5,500 a year, with an additional start-up fee of $1,500. "As long as I've been doing this work, DXM has been a significant problem," said Christa Niven, who's headed the Summit School since 2001. "Kids are stealing it left and right. You can't screen for it. Most parents don't even know what it is." According to Niven and several former users, DXM has a stronger appeal among the under-16 set. Middle school students and high school underclassmen are more intimidated by hardcore street drugs, which require connections and money. Over-the-counter medicines are conspicuous and easy to steal, they said. "It's like they're just selling drugs and alcohol to minors," Jordan said. "When you don't have anything else, you go pick it up and get messed up for free." Ultimately, the group wants the products sold only behind pharmacy counters, where clerks could keep a close eye on how many boxes or bottles are disappearing. "An 11-year-old certainly won't be able to walk into a pharmacy and buy eight boxes," Niven said. Managers at two local Food Lions -- one in Timberlyne Village and another on Jones Ferry Road -- both characterized shoplifting of cold medicines as a minor problem in their stores. Managers at two Chapel Hill Eckerd drug stores and two Harris Teeters would not comment on theft of cold medicines, referring all questions to their corporate headquarters, whose representatives did not provide any information by press time. An Eckerd manager at the Raleigh Road location refused to giver her name but said, "Unless it's a high-theft item, it doesn't go behind the counter." Merchants haven't contacted the Chapel Hill Police Department about a spike in cold medicine thefts, said Matt Sullivan, a police crisis counselor. Though DXM abuse in Chapel Hill is no epidemic, Sullivan said he and other counselors first noticed more incidents about 18 to 24 months ago. Because cough tablets aren't controlled narcotics, awareness of the problem has surfaced through parent phone calls rather than DXM-related arrests, he said. "Sometimes we'll get calls from parents who find four or five bottles of Robitussin in their kid's room," Sullivan said. "One parent told me, 'I just thought my kid was sick all the time.'" Young DXM abusers do typically shoplift medicines rather than purchasing them, Sullivan said. Similar to their protocol regarding alcohol, he said officers who find a suspicious amount of DXM products on a minor will turn his name over to police counselors. "We handle it by working with the family," Sullivan said. "Hopefully the parents would help us find a long-term solution." Effects of DXM can include dizziness, slurred speech, nausea and numbness of fingers, according to the National Institute on Drug Abuse. Abusers often seek different plateaus of intoxication, brought on by ingesting hundreds or even thousands of DXM milligrams. Online calculators even use a person's body weight to suggest how many tablets to consume. One Internet calculator recommends that a 100-pound person consume more than 20 30-milligram pills to reach the highest plateau. On the day Jordan overdosed, he'd taken about 90 pills before doing yard work at Niven's house. "He wasn't responding at all. His pupils were dilating randomly," Niven said. "You would think anyone else would die." Jordan was kept at UNC Hospitals for seven days. Fresh back from treatment, he's now enrolled at the Summit School and actively looking for a job. Emergency room workers at UNC Hospitals said that while patients are sometimes admitted for DXM abuse, they "haven't seen a spike," said Stephanie Crayton, media relations manager for UNC Health Care. One Chapel Hill mother, Sallie Moore, said her 16-year-old son -- a former East Chapel Hill High School student -- has been hospitalized twice for using DXM and is in a Minnesota treatment center. His abuse of cold medicine grew from a pot habit, Moore said. "Just like a lot of kids, he was experimenting with marijuana," she said. "One day he didn't have any marijuana. It wasn't there, so he did this instead." Though "cautiously optimistic," Moore said the recovery is doubly difficult because "he can just walk into a drug store and pick some more up." After several DXM overdoses in Merrill, Wis., which contains only about 10,000 people, several drugstores moved heavily abused medicines from the open shelves to the guarded pharmacy counter. Moore would like local pharmacies to make similar gestures and eventually wants the movement to spread across the state. "It's like having cocaine sitting right out on the store shelves," Moore said. "I don't know when I'll feel safe." DEXTROMETHORPHAN FACTS Street names: . C-C-C . Robo . Skittles . Red Devils . DXM . Robo-tripping . Tussin . Dex Signs of abuse: . Mental status changes . Lethargy . Ataxia . Slurred speech . Confusion . Hallucinations . Delusions Health hazards of abuse: . Seizures . Dry mouth . Loss of body fluid . Dry itchy skin . Blurred vision . Cognitive alterations . Nausea . Abdominal pain . Vomiting . Irregular heartbeat . High blood pressure . Numbness of fingers or toes . Redness of face . Headache . Loss of consciousness . Death - --- MAP posted-by: Josh