Cough syrup ingredient deadly if misused

By Jennifer Gzesh

After the death of Jon Frary last September, it was clear to many members of the Bloomington, Ill., community that something needed to be done to regulate the sale of cough medicine.

Yes, cough medicine.

Frary died of an accidental overdose of dextromethorphan (DXM), an ingredient found in over-the-counter cough suppresants. Teens attempt to get high by taking much larger than recommended doses of DMX in the form of over-the-counter cough syrup, tablets and gel caps. In high doses, DXM can produce hallugocenic and disassociative effects.

Concerned parents around the country are pushing drug stores to move medicine with DXM behind the counter so sales can be monitored more closely, said Linda Frary, Jon’s mother.

Because Jon’s death was the result of ingestion of DXM in its pure form, Linda hopes her son’s death will be a red flag to teens who think DXM is safe.

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Recently, the Illinois State Medical Society recommended banning pure DXM. In the meantime, activists like Linda Frary say the only way to fight DXM abuse is to raise awareness among parents.

Products that contain DXM include such common brand names as Coricidin Cough and Cold Tablets, Dimetapp DM, Robitussin, Sudafed, Triaminic cough syrup and Vicks Nyquil LiquiCaps.

“Parents just are not aware that this is a drug kids are using,” said LouAnn Lord, a certified alcohol and drug counselor and registered nurse at The Pavilion in Champaign. The Pavilion is a counseling center that offers treatment to youth, adults and their families for alcohol, drug, and psychiatric problems.

While many parents remain oblivious to the increase of DXM as a drug of choice among teens, Lord said more and more adolescents are admitted to the inpatient treatment center every week for using DXM. She said two to three percent of the teens she sees use it on a regular basis.

In the Champaign-Urbana area, Lord said high schoolers between the ages of 14 and 18 are the main users of recreational DXM. These students ingest large doses of cough suppressantss in order to experience hallucinogenic effects. Lord said their product of choice is Corcidin.

There are different levels of hallucination that occur when using DXM, depending on the amount ingested. Students that are interested in reaching higher levels, or plateaus, tend to become hooked on cough medications, Lord said.

Lord also said that many teens are caught stealing bottles of cough syrup and boxes of cough and cold tablets. She believes this is because purchasing cough suppresants can become an expensive habit. Two boxes of Corcidin, the typical amount needed to reach the first or second plateau, can cost up to 15 dollars.

Teens find out about DXM from their friends who have tried it, or by word of mouth, she said. She said it is more of an isolated activity, which is why there is not a lot of talk about DXM on the streets.

Kurt Hegeman, specialist at the Alcohol and Other Drug Office (AODO) at McKinley Health Center, agrees. He said college students find out about DXM by word of mouth, or by doing searches on the internet.

Hegeman said at least seven students have been into the AODO because they have tried, or are interested in trying DXM. He said the numbers are small because students don’t hear a lot about it. Hegeman said “robotripping”, a popular slang term for using DXM, is a closet activity. He said most students that try it are alone in their rooms.

DXM abuse has been around for a long time, Hegeman said, but has never become a large enough problem to create a reaction from authorities.

“Basically, people know that it is happening, but it is not getting a lot of attention,” he said.

A number of websites promote the use of DXM. The information on these sites ranges from recommending how much to take, suggesting other drugs to combine with DXM, instructing on how to extract DXM from cough medicines, and even selling a powder form of DXM for snorting.

Jon Frary ordered pure DXM from one of these Web sites, recommended to him by a friend. Now his family has made it their mission to stop bulk DXM from being sold on the Internet. Heading this mission is Jon’s uncle, Steve Welch.

Welch began the fight by enlisting the help of U.S. Representative Ray LaHood of Central Illinois to take the problem to the government. However, Welch said he is not having much luck.

“A big reason is that there have not been enough deaths resulting from DXM abuse,” Welch said. “The government is interested in statistics and death. Until more people die from it, they are not willing to help.”

DXM is an important ingredient in many powerful drugs on the market. Welch said the government is not willing to take it completely off the market because it would interfere with the pharmaceutical lobby. Welch said he does not want to see it banned, he just does not want the pure form to be available.

“There is no use for pure DXM other than to put it cough medicine,” he said.

Besides its easy availability on the Internet, another problem with pure DXM is that people are buying it in bulk, repackaging it into capusles and selling the capsules to people who are looking for a new kind of high.

“It’s a new way to traffic drugs,” Welch said.

Welch said one reason why DXM is rising in popularity is because it is completely legal to buy and sell. He said the FDA controls certain substances, but has chosen not to control DXM. An FDA spokesman was unavailable for comment.

The other reason is that it it is cheap. Welch said Jon took 1,200 milligrams of pure DXM that he got from a Web site for about two dollars and eighty cents.

He said that for fifty dollars, anyone with a credit card can order 12 grams of DXM from the Internet.

Twelve hundred milligrams is an extraordinarily high dosage of DXM. Welch said that one bottle of extra-strength Robitussin contains 30 milligrams of DXM. Jon ingested the equivalent of 40 bottles.

The Illinois State Medical Society will present their position to the American Medical Association at a convention later this year. Until then, Welch is waiting for the government to take action.

“The government responds to the mass population,” he said, “And until the mass population knows about DXM, nothing is going to happen.”

Many associations such as The Partnership for a Drug Free America have already started to help inform the public about the dangers of DXM. But until more statistics on DXM use are obtained, no authoritative stance will be taken. Many parents, including Linda Frary, are patiently awaiting the day when bulk DXM will no longer be available to the general public.

“Everybody’s life still goes on,” she said. ” But ours stopped as of September 24, 2003.”