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Cough Medicine Abuse On The Rise

Mar 9, 2005 | Potomac News

During a year spent mostly under the influence of a powerful drug, 19-year-old Timothy Harper had numerous brushes with the law, suffered at least one serious overdose and eventually landed in jail.

During the overdose, Harper's heart briefly stopped, his mother said. But the close call didn't dissuade him. He went right back to the old routine: get high, black out and break the law.

Now, Harper lives in the Manassas Adult Detention Center and is involved in a series of hearings for charges that range from car theft and credit card fraud to shoplifting video games from Costco.

But he wasn't stealing to finance an expensive habit, or buy heroin or crack in shadowy alleys. A drug dealer isn't necessary when the monkey on your back can be fed for about $6 at Kmart or Target.

Harper's drug of choice was Coricidin, an ostensibly harmless cough medicine that can be purchased at most pharmacies and convenience stores.

"It made me hallucinate, it made me do things," Harper said during a phone interview from jail. "My body would go numb. It just makes you trip. Like, you couldn't feel anything if you got hit."

Coricidin is one of several cold medicines that contain dextromethorphan, or DXM, a drug that treats cold symptoms in small doses but can induce hallucinations when taken in excess. Over the past few years teen abuse of DXM seems to be on the rise.

In 2000, area poison centers received 2,523 calls about the abuse and misuse of DXM, according to a report provided by the National Capital Poison Center. Three years later, the number had grown to 4,382 calls, and almost 75 percent involved teenagers.

"The public is not aware that their young children are taking this," said Carolyn Wilson, Harper's mother.

In an effort to understand what happened to a child she said was once a "sensitive, loving, close person," Wilson made it her mission to look into Coricidin and its effects after her son was imprisoned.

She started striking up conversations with teenagers she saw out in public. She'd approach them outside the 7-Eleven, or in line at the grocery store, and ask if they had heard of taking cough medicine to get high.

"I just went out on the street and started talking to kids," Wilson said. "They said yeah, that everybody was aware of that drug, that it's been around for at least two years, and a lot of kids have taken it."

Wilson also called Schering-Plough, the company that makes Coricidin, and said she was told that the company is aware of the problem. A spokesman for the communications company that represents Schering-Plough said that the Coricidin HBP Web site contains a link to another page that lists the dangers of abusing the drug.

"Unfortunately, dextromethorphan abuse by teens is a long-standing issue. While over-the-counter cough and cold medications in your local pharmacy, supermarket or convenience store that contain dextromethorphan are safe and effective when used as directed, the abuse of dextromethorphan can have serious health implications," the company's Web site says.

Coricidin abuse is also a long-standing issue in the Prince William County area. In December 1997, six students at Stonewall Jackson High School were taken to the hospital after overdosing on it at school. Though the incident was serious enough that four of the six were kept overnight at the hospital, the results could have been much worse. Other drugs, such as Robitussin and Sudafed, contain DXM. But one variety of Coricidin can be fatal, experts say.

Harper's preference, Coricidin HBP, or "triple C" in the druggie vernacular, is designed for people with high blood pressure. It can also cause fatal heart arrhythmia when taken in massive amounts, said Dr. Frank Giancola of PediatriCare. The problem is the body uses the same enzyme to break down the DXM and the antihistamine in Coricidin HBP, he said.

"The levels just get higher and higher before the body can break it down," Giancola said. "It can lead to the heart stopping."

A quick Web search shows that Coricidin overdoses aren't exactly a rare occasion. Headlines in local papers seem to tell the story: "Teen overdoses on cough medicine" from Des Moines, Ohio, on March 3 and "Cape teens OD on cough medication" from Cape Coral, Fla., on Feb. 27. In the first instance, a junior high student was hospitalized. In the second, two teenagers died and a third was hospitalized.

Part of the reason for the drug's popularity among teens is availability, Giancola said.

"It really all boils down to access," he said. "These medications are things that anybody can walk into any drug store or grocery store and buy, because there isn't any awareness until something bad happens."

In her search for more information about Coricidin, Wilson also found availability to be a part of the problem.

"I had a kid tell me last week, 'I just went into Wal-Mart and bought it,' " she said. "There should be a law that things like that should be pulled off the shelf. Or that you should have to be 18 to buy it."

While there isn't any such law, at least one major pharmacy company sees things the same way. Last year, CVS instituted a chain-wide policy that customers have to be at least 18 years old to buy medicine with DXM.

"We were getting feedback from various communities, usually from local law enforcement, that there was an issue of teenagers abusing the product," said Mike Deangelis, a CVS spokesman.

Locally, the Manassas CVS has pulled Coricidin behind the counter, a move that Deangelis said the company leaves up to individual stores.

Still, a number of other area stores have Coricidin, and other cough medicines that contain DXM, right out in the aisle.

"I went to Target or Kmart, because it was cheaper there," Harper said.

He also said that he would probably have still done it if there had been a warning on the box, or if it had been kept behind the counter. For Harper, Coricidin abuse was an almost daily activity.

"I'd get like two boxes at a time. I'd end up doing one box, and then end up doing another box by the end of the night," he said. "That would last me a whole day, and then somewhat into the next day."

There are 16 tablets in a box. The night he overdosed, Harper took close to 100 tables in a night, his mom said.

"I didn't know where I was," he said. "I didn't know anything."

As for the crimes he is accused of committing, Harper said he doesn't recall any of them.

"Once it wears off, you don't remember anything you did," he said.

Giancola said that a "state of confusion" could be a side effect of taking too much DXM, as can nausea, vomiting, profuse sweating and convulsive seizures. Liver damage can also occur, as well as brain damage in the event of heart failure.

Carolyn Wilson is convinced her son has permanently damaged his brain.

"Now his life is totally destroyed," she said. "I don't want a kid to die from this medication. I don't want any parent to go through that, or to go through the grief that I've had to go through because of the crimes my son committed when he was whacked out on this drug."

But stopping kids from taking Coricidin may not fix the larger problem. Giancola compared the current trend of over-the-counter cough medicine abuse to a rise in the abuse of inhalants 10 years ago.

"Even if parents are aware of these things and looking for them and saying, 'Hey, we have a problem here,' then the adolescents are going to move on to something else," he said.

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