Preventing Cough Medicine Abuse: A Parent's Guide
 

WHAT IS COUGH MEDICINE ABUSE?

Cough medicine abuse is taking extremely large doses of cough medicine to get high. The "high" is caused by taking a large amount of dextromethorphan, which is often abbreviated DXM, a common active ingredient found in many cough medications. This sort of abuse -- whether it's called cough medicine abuse, or dextromethorphan or DXM abuse -- can be dangerous.

WHAT IS DEXTROMETHORPHAN?

Dextromethorphan is a safe and effective active ingredient found in many nonprescription cough medicines, including syrups, tablets, and gel caps. When used according to medicine label directions, the ingredient dextromethorphan produces few side effects and has a long history of safety. When abused in large amounts, it can produce a "high" feeling as well as a number of dangerous side effects.

WHAT ARE THE EFFECTS OF COUGH MEDICINE ABUSE?

The effects of the abuse of cough medicines containing dextromethorphan vary with the amount taken. Common effects include confusion, dizziness, double or blurred vision, slurred speech, loss of physical coordination, abdominal pain, nausea and vomiting, rapid heart beat, drowsiness, numbness of fingers and toes, and disorientation. DXM abusers describe different "plateaus" ranging from mild distortions of color and sound to visual hallucinations, "out-of-body" dissociative sensations, and loss of motor control. Side effects can be worsened if the dextromethorphan-containing cough medicine being abused also contains other ingredients to treat more than just coughs.

WHAT COUGH MEDICINES CONTAIN DEXTROMETHORPHAN, OR DXM?

There are well over 100 OTC (over-the-counter) medicines that contain DXM, either as the only active ingredient or in combination with other active ingredients. There are a number of well-known brands, as well as a number of store brands, that contain DXM.  For example: Alka-Seltzer Plus Cold & Cough Medicine, Dimetapp DM, Mucinex DM tablets, PediaCare cough medicines, certain Robitussin cough products, Sudafed cough products, TheraFlu cough products, Tylenol Cough and Tylenol Cold products, Vicks 44 cough relief products and certain Vicks DayQuil and NyQuil LiquiCaps. Check the label for dextromethorphan in the active ingredients list.

WHAT ARE SLANG TERMS FOR DEXTROMETHORPHAN?

Slang terms for dextromethorphan vary by product and region. Adults should be familiar with the most common terms, which include Dex, DXM, Robo, Skittles, Syrup, Triple-C, and Tussin. Terms for using dextromethorphan include: Robo-ing, Robo-tripping, and Skittling, among others.

HOW COMMON IS COUGH MEDICINE ABUSE?

Recent research indicates that the abuse of DXM cough medicine is a greater problem than previously thought. The research shows that one out of 11 teens, or over two million teens, from across the country and of all backgrounds, has abused cough medicine to get high. Often, these teens are finding information about cough medicine abuse on the Internet.

WHERE ARE TEENS FINDING INFORMATION ABOUT COUGH MEDICINE ABUSE?

There is little in current teen culture -- music, movies, fashion, and entertainment -- that promotes or even mentions cough medicine abuse. The one exception is the Internet.

A number of disreputable web sites promote the abuse of cough medicines containing DXM. The information on these sites includes recommending how much to take, suggesting other drugs to combine with DXM, instructing how to extract DXM from cough medicines, promoting drug abuse in general, and even selling a raw, unfinished form of DXM for snorting. You should be aware of what your teen is doing on the Internet, the web sites he or she visits, and the amount of time he or she is logged on.

Parents can make a positive difference in their teens' lives, and research shows that parents do influence their teens' decisions about whether to take drugs or not. To prevent DXM abuse specifically, the best advice is to educate yourself, communicate with your teens, and safeguard your medications.

Educate Yourself

• Educate yourself about cough medicine abuse and share this information with others who are in contact with your teen, such as school administrators, coaches, and counselors.

• Make sure you're aware of the signs of cough medicine abuse and what to watch out for.

Communication with Your Teens

• Be clear that you do not want your teen taking medicine without your knowledge.

• Teach your teens and younger children to respect medicine. Medicines are important tools in healthcare, but they must be used according to directions.

• Make sure your teen understands that abusing cough medicine -- just as abusing illegal drugs -- can be very dangerous.

Safeguard Medications at Home and Other Places

• Know what medicines are in your home and pay attention to quantities.

• Keep all medications out of reach and out of easily accessible places like medicine cabinets.

• If your child needs medications during school hours, speak with the school officials about medicine policies in the school.

Monitoring also is an effective way you can help your teen stay drug-free, and an important thing to do even if you don't suspect your teen is using drugs. Monitoring means asking young people questions about where they're going, what they're doing, and with whom they're spending time, as well as keeping tabs on their Internet use by using web browser tools and software designed to block certain sites. Put some of these tips to use, and your kids will benefit.

Talk with Your Teen

Kids who say they learn a lot about the risks of drugs at home are up to 50 percent less likely to try drugs. Parents should talk often, listen regularly, and communicate clearly that they do not want their kids using drugs.

To talk credibly and effectively about the dangers of drugs, parents need to know what those dangers are. Teens will know when they're being lied to, so know the facts.

Know Where Your Teen Is

It's important to know where your teen is and what he or she is doing. Research has shown that children without adult supervision are at significantly greater risk of truancy from school, stress, receiving poor grades, risk-taking behavior, and substance abuse.

Introduce Your Teen to Adult Role Models

Find out what adult-supervised activities -- like clubs or after-school sports -- interest your teen and help get him or her involved. Connection with other influential adults in teens' lives also can help them avoid the dangers of drugs, and reinforce the benefits of healthy, drug-free living.

Know Your Teen's Friends

Research from the Partnership for a Drug-Free American reports that more than half of teens say they have close friends who get high regularly. Parent's need to know if these are the close friends with which their teens are spending time.

Recognize Signs Your Teen is Using Drugs

Parents don't always recognize their kids might be using drugs. While it can be hard to know, there are some general warning signs you can watch for. The fact is, any teen could be using drugs, so stay alert. As a general rule, changes that are sudden or extreme may be a warning sign.

Signs your teen could be using drugs include:

• Change in friends

• Change in eating or sleeping patterns

• Changes in physical appearance and hygiene

• Declining grades

• Loss of interest in hobbies or favorite activities

• Hostile and uncooperative attitude

• Unexplained disappearance of household money

• Visits to pro-drug web sites

• Empty drug or medicine containers or drug paraphernalia

• Unusual chemical or medicinal smells on your child or in his or her room

Helping a Teen Who is Using Drugs

The goal is to prevent a drug abuse problem in the first place. If you fear, however, that your teen may have a problem, sit down with your child for an open discussion about alcohol and drug use. Openly voice your suspicious but avoid direct accusations. Do not have this conversation when your teen is under the influence of alcohol or other drugs, and make sure you could calm and rational. Ask your teen what has been going on in his or her life. Discuss ways to avoid using alcohol and other drugs in the future. If you need help during this conversation, ask another family member, your child's guidance counselor, or a physician.

Be firm and enforce whatever discipline you've laid out in the past for breaking house rules. You also should discuss ways your teen can regain your lost trust, such as calling in, spending evenings at home, or improving grades.

If you think your teen needs professional help, your doctor, hospital or school nurse or counselors may be able to help. Or you can call 1-800-662-HELP or visit http://findtreatment.samhsa.gov, the treatment locator hotline and web site of the U.S. Substance Abuse and Mental Health Services Administration.

This information is provided by the Mesa Police Department and the Consumer Healthcare Products Association (www.chpa-info.org). This brochure is available for free from http://www.chpa-info.org/ChpaPortal/ForConsumers/ConsumerPublications/

To learn more about drug prevention, visit the Partnership for a Drug-Free America at www.drugfree.org.