Increasing numbers of California teens abuse over-the-counter cold medicine

The number of reported cases of dextromethorphan abuse in California increased 10-fold between 1999 and 2004, an increase that parallels national trends, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. About three-quarters of the reported cases were among individuals age 9 to 17.

"Dextromethorphan has been used safely for years as a cough suppressant and is available in many over-the-counter (OTC) cough and cold preparations," the authors write as background information in the article. But when taken at high doses, the drug can cause hallucinations, and it has been abused for as many as four decades. Since the late 1990s, dextromethorphan abuse has increased among adolescents, in part because the drug is easily accessible and is perceived to be safe. Severe side effects have been reported at high doses, including rapid heartbeat, high blood pressure, agitation, loss of muscle control and psychosis (a loss of contact with reality).

Jodi K. Bryner, Pharm.D., School of Pharmacy, University of California, San Francisco, and colleagues analyzed the trend of dextromethorphan abuse in California as reflected in cases reported to the California Poison Control System (CPCS), a 24-hour emergency telephone service. The findings were then compared to national trends as reported to the American Association of Poison Control Centers and the Substance Abuse and Mental Health Service Administration's Drug Abuse Warning Network.

During the six-year period between 1999 and 2004, 1,411 calls to the CPCS were coded as dextromethorphan abuse. The researchers manually reviewed each one and found 1,382 non-duplicate cases. The frequency of dextromethorphan abuse calls increased by about 50 percent each year compared with the previous year, up to a total ten-fold increase (from .23 cases per 1,000 calls in 1999 to 2.15 cases per 1,000 calls in 2004). Calls involving youth

Contact: Ilene B. Anderson
JAMA and Archives Journals

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