Ellen Campbell-Grizzle
This year started with fresh concerns about abuse of a well-used class of medicines that is available without prescriptions. The United States Food and Drug Administration (FDA) is closely monitoring the abuse of dextromethorphan, also known as DXM, Dex, Robo, among teens because of reported overdoses that have resulted in coma and death.
The medicine, DXM, is a legal drug with a long history of safety and effectiveness and is approved for use all over the world. It is a cough-suppressant that is able to remove mucus from the respiratory tract. Other medicinal uses include temporary relief of sinus congestion, runny nose, sneezing, itching of nose and throat and watery eyes. During the cough and cold season at this time of year, DXM's capacity to raise the cough threshold makes it a very popular product.
History of DXM
The FDA first approved DXM for use in 1958. As far back as 1975, its potential for abuse was recognised. Manufacturers moved to limit recreational use by creating products with unpleasant taste if consumed in large quantities. However, more pleasant tasting forms have appeared on the market. The American authorities have reacted to current levels of recreational abuse by increased monitoring and warnings to consumers.
Users taking DXM-containing products typically swallow 10 to 20mg every four to six hours or 30mg every six to eight hours. Abusers ingest massive amounts every day, purchase several bottles per day. Some extract the DXM from syrups and inject the active ingredient. DXM abuse has developed into a new trend that involves the sale of pure drug in powdered form.
At high doses, users experience hallucinations, confusion, dizziness, blurred vision, slurred speech, loss of coordination, stomach pain, vomiting and rapid heartbeat. Effects last for six hours but worsen when the drug is abused with illegal drugs or alcohol. This potential for abuse leading to physical and psychological damage has led Jamaican regulatory authorities to restrict consumer access to DXM-containing products from pharmacies only.
Signs of abuse
Signs of abuse are similar to those for most habit-forming drugs:
The presence of several empty cough medicine boxes in your child's room.
Changes in friends, physical appearance, sleeping and eating patterns.
Declining grades.
Loss of interest in hobbies.
Hostile and uncoperative attitudes.
Unexplained disappearance of household money.
Unusual chemical or medicinal smell on your child or in his or her room.
What parents should do
DXM abuse is preventable. The drug is safe when taken according to the directions on the label. Jamaican parents must monitor their children in 2007. It is necessary to talk to teens about all types of drug abuse, including the abuse of medicines. Dangerous predators and online promoters encourage the abuse of all sorts of drugs. Parents must educate themselves about problems that lead to drug abuse and be on the alert to changes in their children's attitudes. Educational brochures are available from the National Council on Drug Abuse.
New Year's resolution
These are tough times and many persons, including the youth, turn to abusing drugs in order to hide from problems. This unhealthy habit leads to the destructive behaviour. This year, let us focus on holistic health through the preservation of the mind, body and spirit.
Ellen Campbell-Grizzle is president of the Caribbean Association of Pharmacists; director, information and research, National Council on Drug Abuse; email: yourhealth@gleanerjm.com.
