Abuse of Rx and OTC Medicines
Recent studies indicate that the abuse of prescription (Rx) and over-the-counter medicines (OTCs) to get high is a growing concern — particularly among young people between the ages of
12-17.

The Bad News
 Generation Rx
Vicodin
Inhalants
GHB
Cough medicine

More Than 100 Cough & Cold
Remedies Contain DXM

Abuse of Rx and OTC
Medications
Kids often turn to prescription or over-the counter
(OTC) drugs, which are as easy to find as opening a family medicine cabinet.

To abuse cough and cold medicines that contain dextromethorphan (DXM)

National Institute on Drug Abuse’s
Monitoring the Future 2006 Survey
Reports intentional abuse of cough medicine by:
8 th graders = 4% of all students
10 th graders = 5% of all students
12th graders = 7% of all students
On par with abuse of other illicit drugs among this population group

Kids Who Abuse OTC Cough
Medicine to Get High Because:
• Their friends are doing it;
• It’s legal (therefore more accessible);
• It’s low-cost or free;
• It’s seen as being safer than other forms of drug abuse.

Kids Don’t Understand the Risks
& Dangers of Abusing DXM
Only 45% of teens and pre-teens believe that abusing cough medicine to get high is risky, which means that over half believe it is not.

The active ingredient or one of the active ingredients in cough medicines which causes the “high”

DXM is Effective & Generally
Safe When Taken in
Recommended Doses
• Approved by the FDA in the 1950s;
• The most widely used cough suppressant in the U.S.;
• Filled the need for a medication that lacked codeine’s addictive qualities.

• Alka-Seltzer Plus
Cold & Cough
Medicine
• Coricidin HBP Cough and Cold
• Dayquil LiquiCaps
• Dimetapp DM
• Robitussin cough products
• Sudafed cough products
• Triaminic cough syrups
• Tylenol Cold products
• Vicks 44 Cough Relief products
• Vicks NyQuil
LiquiCaps
• Generic/store brands

“ Code names” for DXM or
Specific Products
• “Dex, DXM, Robo, Skittles, Syrup,
Tussin;”
• “Triple-C or CCC” refers to a cold and cough remedy, which has potent doses of DXM.

“ Code names” for Abusing DXM-
Containing Cough Medicines
“ Roboing, Robo-tripping, Robo-fizzing,
Smurfing (buying cough medicines from multiple retail stores), and
Skittling”

“Syrup heads” or “robotards"

• Similar to an ecstasy-like high
• Experience mild distortions of color and sound
• Strong visual hallucinations
• “Out-of-body" sensations
• Confusion
• Slurred speech
• Loss of motor control

• Dehydration
• Delusions
• Panic attacks
• Memory problems
• Blurred vision
• Stomach pain, nausea, and vomiting
• High blood pressure and rapid heart beat
• Numbness of fingers and toes
• Drowsiness and dizziness
• Fever and headaches
• Rashes and itchy skin
• Loss of consciousness

Side Effects Can Be Worsened
If…
• The DXM-containing cough medicine being abused also contains other ingredients to treat more than just coughs;
• Taken with alcohol and illegal drugs;
• Used in combination with other medications.

Of Major Concern is Combining
DXM With…
• Non-drowsy antihistamines
• SSRI anti-depressants
• MAOI inhibitors
Combining DXM with these drugs is extremely dangerous and can send young people to the ER.

A Normal Dose of Cough
Medicine is 15-30 Milligrams
• Mind-altering effects can occur at doses as low as 100 milligrams;
• Kids consume enough pills or syrup to equal 240-360 milligrams, or 25-50 times beyond the recommended doses;
• Some even take up to 80 pills/day.

• Pills easier to conceal and consume;
• Drink cough syrup undiluted;
• Consume pure, unfinished DXM powders and pills, purchased over the Internet;
• Mix pills, powders or syrup with sodas or alcohol, called “Robo-fizzing.”

“Pharming” Parties
• Kids collect Rx and
OTC pills;
• Mix together and randomly consume handfuls of tablets;
• Oblivious to consequences;
– Taking excessive amount of pills
– Potential danger of combining drugs

• Hundreds of web sites/online communities provide information about abuse of DXMcontaining cough medicine;
• Sites assume visitors are users;
• No questions asked;
• Has helped create a subculture of abuse.

Web Sites Provide
Information About…
• How to achieve an ecstasy-like high based on a user’s height and weight;
• How best to combine DXM with other drugs, alcohol, etc., and the dangerous side effects of other combinations.

Web Sites Are Also Online
Drug Dealers
• Sell pure, raw, DXM “in bulk” with no questions asked;
• Kids can log-on to specific sites and purchase bulk amounts of the pure
DXM with only a credit card or PayPal and shipping address.

Social Networking Web Sites
Spread Info About DXM Abuse
• MySpace
• YouTube
• LiveJournal
• Facebook

• Detailed instructions and conversations about DXM abuse;
• Blogs and videos with postings of how and when kids will take
DXM-containing cough medicines;
• Footage of kids while
“high.”

• www.third-plateau.org
• www.erowid.org
• www.dextroverse.org
• www.lycaeum.org
• www.myspace.com/dextromethorphan
• http://forum.grasscity.com/general/1208
75-dxm-trip-report.html

• Alka-Seltzer Plus
Cold & Cough
Medicine
• Coricidin HBP Cough and Cold
• Dimetapp DM
• Robitussin cough products
• Sudafed cough medicines
• Triaminic cough syrups
• Tylenol Cold products
• Vicks 44 Cough Relief products
• Vicks NyQuil and
Dayquil Medicines
• Generic/store brands

StopMedicineAbuse.org
:
Online resource on cough medicine abuse
 StopMedicineAbuse.org, comprehensive site featuring all educational programming aimed at addressing medicine abuse
 FiveMoms.com
—a social networking site where parents can interact with other parents, read blog entries, and learn more about medicine abuse
 DXMstories.com
— an interactive website where you can view testimonials on medicine abuse.
 DoseOfPrevention.org
, —engage groups in your communities to prevent medicine abuse with the toolkit created by CADCA and
CHPA

• 73 percent of coalition members said they do not think parents in their communities are aware that OTC medicine abuse is a problem among youth.
• 75 percent responded that parents do not talk to their children and teens about the dangers of abusing OTC cough meds.

• Many coalition leaders also felt that schools were not adequately addressing the issue.
• More than half said school surveys in their community do not include questions about the abuse of cough medicines.

In response, CADCA partnered with the
Consumer Healthcare Products Association
(CHPA), which represents the makers of over-the-counter medicines, and launched the Dose of Prevention campaign, to educate communities about cough medicine abuse.

• Online in downloadable format to be replicated and modified for local use.
www.DoseOfPrevention.org

• An Overview
• Targeted Outreach Fact Sheets
− Parents
− Educators
− Healthcare Providers
− Retailers
− Law Enforcement
• An Internet Alert
• Sample Media Outreach Materials
− Op-Ed
− Press Release & Media Advisory
− Statistics and Quotes Sheet