Familiar images of adolescent drug abuse include youths sharing a marijuana joint or downing ecstasy pills at a party. Yet, many youths seeking to get high turn to over-the-counter (OTC) drugs, which are legal, but dangerous when abused.

Abuse of OTC drugs often involves the cough suppressant dextromethorphan (DXM) with thousands of young people suffering dangerous side effects. While some youths go no further than the family medicine cabinet to obtain DXM, others may seek the drug from dealers who package it in a more dangerous form and sell it illegally. Parents should understand the risks of using DXM for nonmedical reasons and should be alert to signs of abuse.

Widespread Use

Abuse of DXM among youths is common and shows no sign of declining. A national survey of students in grades 7 through 12 showed that ten percent, or 1 in 10, used cough medicine to get high in 2005. This rate was about the same as in 2004 when nine percent of youths in these grades reported abusing cough medicine.¹

Little Fear

The same survey found that less than half of 7th to 12th graders thought that taking cough medicine to get high was risky. This attitude is alarming because youths who think that a drug will put them at risk are less likely to use it.²

Varying Effects

How DXM makes people feel depends on how much of the drug they take. Low doses may act as a mild stimulant and distort vision, while high doses can produce hallucinations, out-of-body feelings, dizziness, and loss of control of one's body movements. Other side effects include nausea and rapid heartbeat.³

The effects of DXM can be more severe when a person takes additional substances used to treat coughs and colds. These substances include acetaminophen, pseudophedrine, antihistamines, and expectorants.⁴

Serious Consequences

The side effects of DXM send thousands of people to hospital emergency departments (EDs) each year. Nonmedical use of DXM accounted for nearly 5,600 of about 12,600 DXM-related ED visits recorded in 2004. Nearly half of these visits for nonmedical use were by young people aged 12 to 20. Other ED visits related to DXM were due to people taking the drug accidentally, attempting suicide, or having a bad reaction to the drug when taking it for medical reasons.⁵

New Sources

While abuse of DXM in OTC cough and cold remedies is not new, pure DXM in powdered form has become available on the Internet and is sold illegally.⁶ Dealers obtain DXM in bulk amounts and put it into capsules for sale. The Food and Drug Administration (FDA) issued a warning about this trend after the deaths of five teenagers who took powdered DXM that was sold in capsules.⁷

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