Drug and Poison Information Center Issues Drug Abuse Alert
CINCINNATI -- The Cincinnati Drug and Poison Information Center (DPIC), a service of Children's Hospital Medical Center of Cincinnati, has noted an alarming new drug abuse trend: teenagers and young adults, mostly 13- to 19-years-of-age, are deliberately ingesting large amounts of Coricidin" HBP™ for Cough and Cold. Some take as many as 15 or more tablets at one time.
The teenagers are seeking what they describe as an LSD-like "high" from dextromethorphan, a non-prescription cough suppressant. Most discovered the practice on the Internet or from friends at school.
Reported symptoms included increased heart rate, elevated blood pressure, increased pupil size, drowsiness, dizziness, slurred speech, unsteady gait, hallucinations, confusion, and nystagmus (involuntary rapid, rhythmic movement of the eyeballs).
At least 28 calls about abuse of dextromethorphan, 22 specifically about Coricidin", have been reported to the Cincinnati DPIC between Jan. 1 and Feb. 14. Nineteen of the 28 calls were ingestions, and 12 of the 19 were treated in hospitals.
Most other calls were from health professionals, school officials and law enforcement officials seeking information about multiple cases of drug abuse or shoplifting of Coricidin", or from parents who discovered that their children were abusing Coricidin" or other dextromethorphan-containing products.
Dextromethorphan abuse is not new. Large amounts of Robitussin"-DM and other similar dextromethorphan-containing liquids have been uncommonly abused for years. Most contain up to 15 mg of dextromethorphan per teaspoon. This new trend of Coricidin" abuse is an attempt to avoid drinking four to eight ounces or more of cough syrup at one time, which frequently causes nausea.
The most common product involved in the current trend is Coricidin" HBP™ for Cough and Cold. The product contains 30 milligrams of dextromethorphan per tablet. It also contains four milligrams chlorpheniramine, an antihistamine, per tablet. As a result, anticholinergic toxicity may result from large ingestions. Signs and symptoms of anticholinergic toxicity include an increased heart rate, elevated blood pressure, elevated temperature, hallucinations or delirium, dry mouth, increased pupil size, and constipation.
Large doses of dextromethorphan may cause hallucinations, confusion, excitation, increased or decreased pupil size, nystagmus, seizures, coma and decreased breathing. An excessively large amount of either agent could be fatal. An additional risk for teens is choosing the wrong Coricidin" product.
Some of the other Coricidin" formulations include other ingredients such as acetaminophen (the active ingredient in Tylenol") and/or phenylpropanolamine (a decongestant). Overdoses of acetaminophen can cause liver damage. Large doses of phenylpropanolamine are toxic to the heart and central nervous system.
It is likely that this sharp increase in calls is representative of a large increase in abuse in the Cincinnati, Youngstown and Akron areas that the DPIC serves. Pharmacists, emergency department physicians, retailers, counselors, school nurses, teachers and parents need to be aware of this new trend. Children should be warned that this drug abuse practice can be dangerous.
For more information or for interviews, please all Dr. Karen Simone at the Cincinnati Drug and Poison Information Center, 513-636-5111.
Contact Information
Jim Feuer,
jfeuer@chmcc.org
