Pubdate: Sat, 24 Apr 2004 Source: Daily Press (VA) Copyright: 2004 The Daily Press Contact: http://www.dailypress.com Details: http://www.mapinc.org/media/585 Author: Beverly N. Williams LATEST DRUG OF CHOICE IS OVER-THE-COUNTER Some Children Are Using Easy-To-Get Cold Remedies to Get High. Several Local Stores Have Made It Harder for Certain Brands To Be Bought or Stolen. Coricidin HBP Cough and Cold medication is the one cough and cold medication sold over-the-counter that's safe for people with high blood pressure to use. A few parents are learning, however, that it's also a drug their children are using in large doses to get high. Last month, three Queens Lake Middle School students ended up in the hospital after abusing Coricidin. School officials learned they had taken the drug, often referred to as "Triple C" or "Skittles," because teachers noticed they were acting strange. Dextromethorphan or DXM is a safe ingredient when used correctly and has few side effects, according to the Partnership for a Drug-Free America. In high doses, though, it gives people a high similar to LSD or other hallucinogenic drugs. "People take a multitude of tablets like five or six or 10 to 15 or 20 or 30," said Mark Medford, DARE coordinator for the York County Sheriff's Department. "It all depends on what kind of high they want. But when they do this, the risk involved is not just overdosing." It's overdosing and dying, said Medford, who also serves on the York County School Board. There have been reports of children dying from dextromethorphan abuse in New Jersey, Ohio, Colorado, Kansas, Michigan, Washington and Florida. In the Kansas case, a 19-year-old man stabbed a 22-year-old man to death in April 2003 after taking between eight and 16 Coricidin tablets with alcohol and cocaine. School officials refused to release information about the York students' conditions that day, citing privacy laws. When taken in high doses, however, Coricidin can induce a spaced-out or glazed look, slur their speech and cause them to lose coordination, Medford said. Coricidin contains both chlorpheniramine maleate - an antihistamine - and dextromethorphan hydrobromide - a cough suppressant. The recommended dose is one tablet every six hours for adults and children age 12 and older. No more than four should be taken taken in a 24-hour period and children under 12 shouldn't use it at all. High doses of dextromethorphan make it hard for a person to talk or move their arms or legs or to talk. It also slows down their breathing or stops it altogether, according to the National Institute on Drug Abuse. Cold medicine abuse concerns drug companies like the New Jersey-based Schering-Plough Corp., which makes Coricidin, said Julie Lux, a company spokeswoman. The industry has been aware of the problem for some time, Lux said, because more than 125 over-the-counter medications contain DXM. "Knowing that we have a brand that's being abused, we're trying to do what we can," she said. "It's a brand that's very important for a lot of people, but we want people to know there's the possibility of abuse." Working with Community Health Care Products Association, Schering-Plough helped develop Web sites that alert parents to cold medicine abuse by teenagers and help them recognize the symptoms. The company also works with retail stores because Coricidin, which comes in a box, can be easy to steal, she said. "Some of the options stores have taken is to put electronic theft tags on the product or they've moved it to the pharmacy counter or behind it," she said. "There's also signage directing patients that it's available at the pharmacy." Some Wal-Mart stores have opted to store Coricidin behind the pharmacy counter, but the retail giant does not mandate it, said company spokeswoman Danette Thompson. Instead, it sells the product only to those over 18, and then no more than three boxes at a time, she said. This policy went into effect three years ago in April, she said. "We did it mainly because we began hearing that Coricidin is one of the over-the-counter drugs that was being abused," Thompson said. "We're trying to do our part to lessen the incidences of abuse." Hidenwood Pharmacy in Newport News hasn't taken any special steps for Coricidin because it does not want to draw special attention to it, said pharmacist Anne Hutchens. The staff is on alert, however, to be aware of customers acting suspiciously around the product, she said. "Abusing cold medicine is a cultural phenomenon. It's nothing new," Hutchens said. "And the more you draw attention to it, the more people will want to try it. Coricidin first became available for use in 1957, and the Community Health Care Products Association has been reporting on dextromethorphan abuse since 1994. The Drug Enforcement Administration, however, considers the abuse to be sporadic. David Holzsager, a pediatrician with Hampton Roads Pediatrics in Hampton, said he hasn't seen any cases of Coricidin abuse, but knows there is a problem. Kids using large quantities get drowsy, have problems moving their upper body and hallucinate, Holzsager said. Side effects also include dry-mouth, fatigue, nervousness, dizziness, hypersensitivity and, in rare cases, liver damage, he said. "The problem is that they're never taking just one thing," Holzsager said. The medication, he said, is often abused with other drugs like Ecstasy or alcohol, which only increase the dangerous physiological effects. "So it's tough to see where you're having a problem." - --- MAP posted-by: Richard Lake