Dextromethorphan (DXM) is a substance found in dozens of over-the-counter medications, often under brand names such as Robitussin, Theraflu, and Vicks. It can also come in a variety of forms, including liquid, gelcaps, tablets, and more. Reports of abuse by teenagers of DXM reach back as far as the 1960s.
Yet, many parents remain relatively unaware of how serious a dextromethorphan abuse problem can be. In fact, an estimated 6,000 teenagers visit emergency rooms each year in connection with DXM misuse.
Suicide or self-harm remains unlikely, but high doses of DXM can invoke hallucinations and psychotic symptoms that could lead to negative consequences.
The True Story of Maya Gold
Last month, Consumer Reports published a story about a girl named Maya Gold. By age 11, she was already an ambitious girl, and later, had plans to volunteer in Nepal and work with girls who had been forced into the sex trade. But just a few weeks after she turned 15, she took her own life.
Maya’s rabbi said at her eulogy that her “descent into darkness” was “quick and unexpected.” Indeed, Maya’s parents dug deeper into their daughter’s life and found that two weeks before her suicide that she had begun abusing OTC medicines containing DXM.
Then, they discovered a stash of cough and cold products in her bedroom, and that she had been shoplifting the drugs and taking doses higher than recommended. While her parents admit that other factors may have been at play, they contend that she might not have committed suicide if she were not under the influence of high doses of DXM products.
The Scope Of The Problem
According to the National Institute on Drug Abuse (NIDA) about one-third of teenagers report knowing someone who has abused drugs containing DSM, and just over 3% of American adolescents report abusing cold and cold medications.
Those who engage in dextromethorphan abuse have reported experiencing a wide range of effects. Doses that are triple or quadruple the label’s recommended allowance can have effects similar to alcohol.
In higher doses, DXM can induce highs comparable to phencyclidine (PCP), which may include auditory and visual hallucinations, euphoria, dissociative thinking and out-of-body sensations.
Also, many OTC medications that include DXM also contain other substances such as decongestants, pain relievers, and antihistamines. Extreme doses of any of these other ingredients pose their own risks.
For example, acetaminophen is lethal to the liver is very high doses, and antihistamines can also invoke hallucinations. The synergy of any combination of these ingredients can multiply the overall risk of harmful effects.
The primary reason why teenagers abuse these drugs is because they are easily obtained, not unlike inhalants. For many youths looking for a high, DXM may be any port in a storm when they are unable to garner illicit drugs or alcohol.
And social media has brought a whole new element to the DXM community, a place where dextromethorphan abusers can share recipes and experiences, and prompt others to do the same. For vulnerable teens, the Internet can be a tremendous influence, especially if it is their primary means of a social outlet.
What’s Being Done
In 2008, makers of cough and cold medications voluntarily a warning on product packing that stated “PARENTS: Learn more about teen medicine abuse: www.stopmedicineabuse.org.”
Then in 2010, the industry employed a plan to reduce dextromethorphan abuse via parental education, outreach to at-risk youths, and support of restricting access. For example, the Consumer Healthcare Products Association now monitors Internet searches related to DXM misuse and directs teenagers to information about its potential dangers.
Since 2012, fourteen states have put laws in place to restrict the sale of cold and flu medications that contain DXM to persons under age 18. In these states, retailers require proof of age before the sale of any products which contain DXM and are subject to fines if they permit minors to purchase these medications.
Nationwide, several drugstore chains such as Walgreens and Rite Aid state they have voluntarily employed these measures for their all of their stores, according to Consumer Reports. Still, even with these regulations in place, access is not impossible – they can still be obtained by an adult (18 or older) who is willing to purchase them for the use of minors.
And while some pharmacies around the U.S. keep these medicines behind the counter, many do not, leaving them on the shelf within easy reach of would-be-shoplifters.
What Parents Can Do
Even with perfect limitations in place, there is always room for error. Parents who are unaware of the risks of medications containing DXM may have them available in their family’s medicine cabinet.
Experts recommend that parents monitor all medications in the home, and never leave medicines or drugs with potential for abuse available to teenagers. Even for those teens that do not appear to be actively seeking a drug experience, seeing a bottle of Robitussin in a bathroom might be temptation enough.
If your teenager has anxiety, depression or any other mental health condition(s), don’t assume that they haven’t secretly been considering self-medication.
Finally, just like any potential signs of drug or alcohol abuse, don’t ignore adverse changes in behavior, mood, or peer group affiliation.