Why the FDA must curb cough syrup abuse

YouTube search the term “DXM.” You’ll find thousands of videos that chronicle the adventures teenagers “robotripping,” or getting high on dextromethorphan. This drug is known on the streets as DXM, CCC, Triple C and Skittles. It’s also known as Robo because it is found in a number of over the counter cough and cold medications like Robitussin DM.

An alarming number of young adults are abusing DXM by chugging bottles of cough medicine or taking excessive does of tablet and gel capsules that contain the compound. According to the Food and Drug Administration, between 2004 and 2008, the number of dextromethorphan abuse related emergency room visits increased over 70 percent. In 2008 approximately 8,000 people were hospitalized due to DXM injuries, and more than half of these cases were people 12-20 years old. The Department of Health and Human Services is currently reviewing ways to counter this dangerous drug abuse trend in the United States.

Pharmacologicaly, the dextromethorphan acts similar to hallucinogens like PCP. It produces euphoric effects when it is ingested in concentrations 10 to 20 times greater than the recommended 10-30 mg dose. FDA researchers say “robotripping” has increased over the past few years because DXM is cheap and easy to access. It is currently found in over 125 over the counter medications.

Furthermore, many people think dextromethorphan is harmless. YouTube footage often features teens having fun or enjoying their high in the company of others. Few videos, depict the health hazards of abusing dextromethorphan. When used inappropriately, DXM can increase blood pressure and heart rate and cause a fever. Large quantities of cough and cold medication can also cause an abuser to overdose on the other active ingredients present in the mixture. These ingredients may damage the liver, suppress the central nervous system, prohibit respiratory function, and even lead to death.

The increasing prevalence of abuse has prompted the FDA to review restrictions on over the counter remedies containing DXM. Over the next two weeks the agency will consult a number of specialists to determine whether or not dextromethorphan containing substances should be a controlled. If the FDA decides to tighten regulations, these products may soon be available only by prescription or behind the counter. Prescription medications require a physician’s approval and behind-the-counter medications require a pharmacist’s approval prior to purchase. There is no doubt both regulations will will prevent a number of teens from purchasing or stealing these medications for recreational use.

While new FDA regulations may reduce access to cough syrup, controlled substances are also subject to abuse. Students who want a competitive edge will buy prescription Adderol from their friends and minors who want to drink alcohol will get fake IDs. Similarly, teens who want to get high on DXM will guzzle cough syrup. That is, new FDA regulations will not sufficiently curb teens’ desire to engage in risky behavior.

Five Moms, is an organization focused on stopping cough medicine abuse through education. As demonstrated by this public service announcement, the organization acknowledges the Internet’s role in the growing “robotripping” trend. ”…The Internet is driving the spread of cough medicine abuse. There are hundreds of web sites that tell kids exactly how much medicine to take to get high. And there are other sites that allow children to buy the ingredient used to make cough medicine in its raw, unfinished form.”

Blaise Brooks, is a founding member of Five Moms. As an African-American woman she takes advantage of her role in the church to educate her community about DXM abuse. She also uses social media platforms like Facebook and MySpace to counter the negative influence of YouTube videos, musicians and sports icons that endorse the use of ‘sizzrup’ to get high.

In order to successfully reduce the prevalence of DXM abuse, both parents and teens need to understand the risks associated with this behavior. The government needs to go beyond access based regulations and investigate ways to increase awareness and prevent young adults from wanting to experiment in the first place. A successful campaign could be modeled after the multifaceted and multi-platform campaigns designed to prevent America’s youth from smoking cigarettes.

YouTube could contribute to this effort by preventing videos that depict DXM abuse from being seen by minors too.