Three students to ER after taking over-the-counter meds

Four local junior high students were rushed to the Pagosa Mountain Hospital emergency room last Thursday after overdosing on over-the-counter (OTC) cold medication.

According to Archuleta School District 50 Joint Superintendent Mark DeVoti, one student admitted to stealing the medications from a local grocery store then passing the medication on to three other students.

Late Thursday morning, one of the students involved reported sick to the nurse’s office and was sent home for the day. Less than an hour later, another student checked in and, according to DeVoti, the nurse became suspicious. That student’s conversation with the nurse and a school counselor eventually led to the student admitting to taking the cold medicine, along with naming other students involved.

According to DeVoti, the students involved were aware that the cold medication in question could, if used in sufficient amounts, cause hallucinations.

In fact, the medication involved — Coricidin — has become increasingly popular among high school students over the past few years for its ability to generate euphoria as well as visual and auditory hallucinations. Among the street names used for the drug (and its analogue, Robitussin) are Triple C’s, Skittles, DXM and The Poor Man’s PCP.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the danger of OTC medication abuse with teenagers is threefold. Because the drugs are OTC medication, they are readily available in home medicine cabinets or from a local retailer. Second, as OTC medication, the assumption is that abusing the medication is somehow “safe” and a risk-free way to get high. Finally, since parents and educators tend to focus on alcohol or illicit drugs when discussing substance abuse, the subject of OTC medication abuse can be minimized — or ignored completely.

The abuse of OTC medication is not without risk, however, and kids and parents should be aware of the dangers posed by the abuse of those drugs. According to SAMHSA, abuse of OTC medication can interfere with breathing, sometimes with fatal results. Likewise, ingesting OTC cold and cough remedies beyond the recommended dose can cause blurred vision, nausea, vomiting, dizziness, coma and even death. Furthermore, mixing OTC medications with alcohol (as many teens report doing) can lead to respiratory failure that could result in death.

Acute and chronic abuse of Coricidin and Robitussin have also been associated with permanent liver and/or brain damage.

Dangers to health aside, teenagers abusing OTC medication risk ruining a promising future if school officials or law enforcement become involved. In fact, the student who distributed the medications at the junior high will have awhile to consider the ramifications of distributing drugs at school. According to Pagosa Springs Junior High Principal Chris Hinger, that student will face administrative sanctions, saying, “As a matter of policy, the student who distributed the medications faces automatic expulsion for one calendar year.”

However, that student cannot be charged with any crime, according to Pagosa Springs Police Chief Jim Saunders. “We consulted with the DA and, because the drugs involved were over the counter medications and perfectly legal, there were no charges we could file.”

Hinger said school officials have asked City Market to pull Coricidin and Robitussin from shelves so that it would not be readily accessible to children. However, Kelli McGannon, marketing and community relations executive for King Soopers/City Market said there are simply too many products with a potential for abuse to keep them all behind the counter. “We’re doing everything we can,” McGannon said. “Unfortunately, what they’re looking for is in over 120 products.”

McGannon said that Coricidin and Robitussin sales are restricted, “with the same guidelines as tobacco. As soon as those products are scanned, cashiers are prompted to check age and ask for an ID. For those products, we have required customers to be over the age of 18 and they’re limited to the quantity they can buy.”

McGannon noted that Sudafed, a cold OTC medication (with the constituent ingredient Pseudoephedrine which can be used in the manufacture of methamphetamine or “meth”) is available only from behind the pharmacy counter and requires customer registration and ID documentation for purchase.

In fact, current federal and state law requires the tracking of Sudafed sales through consumer registration of purchases and keeping the drug behind the pharmacy counter. Although the National Institute on Drug Abuse (NIDA) reports a decline in meth use during the past few years, the decrease could not be directly attributed to restrictions placed on the sale of Pseudoephedrine. Conversely, NIDA data indicates a steady rise in abuse of OTC and prescription medications by teenagers, over the past few years, including abuse of Coricidin and Robitussin.

With the spike in popularity of the abuse of OTC and prescription medications by teens, the best response by parents is to be involved and to get educated (see side-bar for information resources). According to Anna Royer, district School and Community Prevention Coordinator, “above all, we need to constantly make an effort to strengthen our relationships with young people, whether we’re parents and school staff or not. The most important protective factor against substance abuse is a relationship with a caring, non-judgmental adult who sets clear boundaries and upholds those boundaries as a healthy role model and keeps the lines of communication open.”

Royer emphasized that students in the district are always free to talk to their school counselor, “if they are concerned about a friend, or want some support themselves, or if they need further information.”

As reported in last week’s edition of The SUN, the district is instituting a new substance abuse and sexual health curriculum for students from the kindergarten level through the ninth grade. According to Royer (who spearheads the district’s prevention efforts), the substance abuse curriculum will include information on OTC and prescription drugs, along with addressing issues of alcohol and illicit drug abuse.

The recent incident at the junior high serves to illuminate the need for a comprehensive approach to substance abuse as, for many, the abuse of OTC medication was far under the radar. With the district embracing a new prevention program with an evidence-based approach to substance abuse and sexual health, local schools have not only appeared to be proactive but ahead of the curve.

However, the final piece in a truly comprehensive substance abuse program is the involvement of parents. For several local students and parents, last week’s incident at the junior high was a difficult lesson, but one that, fortunately, was learned without tragic results.

Parents, educators, and law-enforcement shoud be aware of the rising popularity of over the counter (OTC) and prescription drug abuse amongst teens.

DXM (Dextromethorphan, the psychactive ingredient in Coricidin and Robitussin) is readily available in the home and through local stores and, while useful for cold, cough or flu symptoms, has a potential for abuse.

Some of the street names used for the OTC medications involved in Thursday’s incident at the junior high include:

• DXM.

• Orange Crush.

• CCC.

• TripC’s (or Triple C’s).

• Skittles.

• Robo (or Robo-trippin’).

• Tussin.

• Syrup.

• Dex.

The Archuleta County School District 50 Joint’s School and Community Prevention Coordinator Anna Royer has provided the following web sites for further information on OTC medication abuse and how to talk to your teenager about these issues: