OTC Drug Abuse Soaring, New Study Says. History May Provide Another Lesson
> 12/6/2006 9:50:00 AM

Information published in the December issue of the Archives of Pediatrics and Adolescent Medicine shows that teens in California have been abusing over-the-counter cough medications in increasingly larger numbers. By studying calls to California's Poison Control System, a public hotline run by the University of California at San Francisco, researchers at the school have determined that between 1999 and 2004 abuse of dextromethorphan (DXM) increased by more than 10 times. Abuse among the youth age group of 9- to 17-year-olds saw a 15-fold increase in abuse, with 15- and 16-year-olds exhibiting the highest frequency of abuse.

On its surface, the study seems to present a powerful statement of how abuse of common OTC drugs is a growing problem. Unfortunately, this most recent appearance of OTC drug abuse in the news is only part of a long and storied history. In fact, the only support for UCSF's claim of increasing levels of abuse is that more calls have been placed to the poison control hotline. The duration of the study was the years 1999 to 2004, and it is equally possible that the increase in the number of calls is merely a reflection of increased awareness on the part of California residents of the system that was only established in 1997.

We don't mean to imply that OTC drugs are not being abused, and beyond that, the frequency of abuse may in fact be on the rise, but this study tells us very little of significance. The comprehensive and informative "Monitoring the Future" study doesn't ask respondents about OTC drugs, thereby leaving untapped a critical resource for determining the extent of the problem. Beyond that, there seems to be other disconnects. On their home page, the National Institute on Drug Abuse doesn't even list OTC drugs as a "Drug of Abuse." Prescription medication abuse has been a hot topic in the media and with those involved with addiction research and prevention efforts. Likewise, other OTC medications have been popping up in news cycles, mostly in relation to the methamphetamine situation and the role that OTC drugs play in that drug's creation.

Ironically, the drug currently at the center of media scrutiny, DXM, was actually first patented as an anti-tussive in 1958 as an alternative to codeine, which was being used as a cough suppressant and had become a popular recreational drug itself. As evidence that these problems work in cycles, codeine has now become a hot prescription drug of abuse, monitored as a Schedule II controlled substance. Originally marketed in pill form, DXM was actually pulled from shelves in 1973 before eventually making a return as a cough syrup. Ever since, the drug has continued to be abused by many.

What we do know is that since the arrival of the internet, information about DXM and other OTC drugs that can be used recreationally has been much more out in the open. Those looking to get high can execute a simple Google search and turn up thousands, if not millions, of suggestions for abusing OTC drugs. And while legislation, such as moving these OTC treatments behind pharmacy counters, may effect supply, it will do little if anything to effect demand.

UCSF's study, despite its potential faults, has at the very least drawn attention to the problem of OTC abuse. Let us not kid ourselves that this is a new area of trouble, because its not. But that doesn't mean that new attitudes and new ideas won't help to change it. As with other drug prevention efforts, the battle should be fought with education. OTC drugs are legal, which is certainly one of their main attractions, but that doesn't mean that parents educated about the dangers and possibilities can't police their children. Legal status also doesn't mean that pharmacists aware of the dangers can't be wary of those doing business who might simply be looking for a high.

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