Beginning yesterday, Arizonans must be 18 or older in order to purchase cough medicine containing the ingredient dextromethorphan (DXM) without a prescription. Arizona becomes the fifth state to pass such legislation, joining California, New York, Virginia, and Washington.
The legislation came about in response to a growing pattern of cough medicine abuse amongs teens, says Steve Pasierb, President and CEO of the Partnership for Drug Free Kids. Dextromethorphan is contained in classic cough suppressant medicine, Pasierb says, but when taken in large quantities it can create what's called a dissociative high. Teens call this high--which combines feelings of drunkenness with hallucination--robo-tripping, drinking syrup, or doing skittles, Pasierb says.
The Partnership for Drug Free Kids, which studies all forms of medication misuse, first began seeing cough medicine abuse about 12 years ago, Pasierb says. Over the years, their research showed a steady group of 5 to 6 percent of kids engaging in cough medicine abuse, Pasierb says.
"Then when social media took off, there were flare-ups," he says. "Kids would read about other kids doing it. Social media keeps pushing it out to 13, 14, 15-year-olds who are too young to buy booze, but old enough to buy cough medicine."
Misuse of dextromethorphan can result in vomiting, dizziness, and lack of motor control, Pasierb says. In large quantities, it can act as a respiratory depressant. "But the big challenge of all medicine abuse is it can exacerbate underlying health factors," Pasierb says. "It's simply unhealthy."
In 2010, a Food and Drug Administration advisory committee examined dextromethorphan abuse. They determined that the ingredient, which has been around for decades and is effective if used properly, should remain in use. But they also recommended that legislation be enacted to prevent teens under 18 from purchasing such medication over-the-counter.
Pasierb's organization, along with national and community partners, worked for several years to get such legislation passed at the federal level. Federal legislation already bans those under 18 from buying cough medicine containing codeine (called 'sizzurp' in slang) without a prescription, but so far, there's been no luck in getting similar legislation passed for dextromethorphan.
Pasierb speculates that much of Washington's focus on ending drug abuse centers on prescription medications -- "rightfully so," he says -- but at the expense of a focus on over-the-counter medication misuse. "And this is part of the overall medicine abuse behavior," Pasierb says.
Pasierb hasn't faced opposition in Washington -- "I've seen no vociferous objection," he says -- but finding sponsors for a federal bill has proven difficult.
So in the meantime, his organization has worked to pass legislation state by state. Arizona becomes the fifth state to enact the legislation.
"We had some folks in Arizona who took a very commonsense approach to this," Pasierb says. He gives credit to Representative Heather Carter, who proposed the legislation.
Pasierb says implementation has not been much of a problem in the four states that already have these laws. Stores can simply use their bar-coding systems to alert cashiers to ask for an ID when someone tries to purchase dextromethorphan-containing medication, he says.
But preventing teens under 18 from purchasing the medication won't end its abuse, Pasierb admits. After all, many teens can find cough medicine right in their own medicine cabinets.
"Parents need to understand this is a problem. Safeguard the medicines in their own home. Have a conversation with their kids about why this is unhealthy," he says.
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