Medicine with a warning

Three days before Christmas, Jim and Jill Darling went to check on their daughter Jennifer, 18, to see if she was getting ready for school. They found her laying on the bathroom floor. Moments after when the paramedics arrived, Jennifer was pronounced dead.

The Darlings’ said in an article in the Orlando Sentinel that Jennifer’s friends told them she had recently started abusing cold tablets. The Darlings also said they think the cold medicine was Coricidin HBP Cough & Cold. The high school senior’s exact cause of death still awaits results from a toxicology report, said David Bryon, spokesperson for the Volusia County medical examiners office. However, upon investigation, Seminole County sheriffs found 32 red Coricidin pills in a small plastic bag in Jennifer’s dresser.

Coricidin HBP Cough & Cold is designed for people with high blood pressure who can’t use decongestants; yet, there have been reports of effects that range from a drunken feeling to hallucinations. This dangerous combination of feelings involves dextromethorphan (DXM), and by exceeding the amount recommended on the product label can cause many to have impaired judgment, loss of coordination, dizziness, nausea, dissociation and a sense of euphoria to the point it is unsafe.

According to the Council on Family Health and Antidrug.com, there are 125 to 135 over- the-counter cold medicines that contain DXM. When used correctly, DXM is a safe and effective way to suppress cough and cold symptoms. Often teenagers who are looking to get high turn to over-the-counter drugs that contain DXM because they are readily available at home or a local drug store.

DXM has been used safely for more than 47 years in several over-the-counter drugs, such as Vicks 44 Cough Relief and Robitussin Maximum Strength Cough Suppressant. However, since 1994, reports of abuse of DXM have increased.

After Jennifer Darling’s death, two Central Florida stores took Coricidin HBP Cough & Cold medicine off their shelves, and stores around the country have taken a similar action after reports of fatal overdoses in California, Michigan and Ohio.

Carol Hively, spokesperson for Walgreens, said in the Tampa area, there have been no reports of unusual problems with Coricidin lately. Hively said that means the stores are not experiencing any abnormal levels of theft or people trying to buy large quantities of the drug, which occurs when the product is abused.

“Some of our stores nationwide do have these problems, and the store manager can make the decision to move Coricidin into the pharmacy so it can’t be stolen,” Hively said. “Our store managers and loss prevention supervisors monitor this situation closely.”

Sgt. Mike Klingebiel, spokesperson for the University Police, said it isn’t uncommon for students to take more than the needed amount of an over-the-counter drug to help them relax or sleep.

“We have heard of substance abuse of over-the-counter drugs because they are readily available,” Klingebiel said.

Yet Klingebiel said he has never heard of Coricidin and had no idea the drug was being used as a way to get high.

Jim Lawenda, spokesperson for Schering-Plough of New Jersey and makers of Coricidin, said the company has taken a number of steps to help provide better awareness of over-the-counter abuse.

“We heard that over-the-counter abuse was becoming a bigger and bigger issue,” Lawenda said. “We went to the Office of National Drug Control Policy, along with the Council of Family Health, to help make adolescents aware of the over-the-counter drugs and their abuse.”

Lawenda also said that besides helping companies become more aware of over-the-counter abuse, they hired an abuse expert. The expert will help Schering-Plough conduct research and counsel, Lawenda said.

“We will be sharing our information with our retail partners and will also look to provide our expert to speak to parents and the media,” he said.

Addressing parents and schools, Lawenda said, is important to help inform them about signs of over-the-counter abuse.

“Adolescents are stretching the levels so they can get high at any time,” he said.

Leonard Kirklen, clinical coordinator for the Counseling Center for Human Development at USF, said most of the time, when students come in with a problem, drug abuse is not the main reason why they seek help.

“Students come in saying that they are stressed, having relationship problems or have other concerns,” Kirklen said. “It isn’t until further questioning that we find they are taking over-the-counter drugs to relax or to sleep.”

Kirklen added that the majority of the time, students with a drug abuse problem know how many pills they are taking. He said it is, on occasion, that some don’t realize the drug can become habit forming.

Both Kirklen and Lawenda said the majority of overdosing on these over -the -counter drugs, such as Coricidin occur in conjunction with the use of alcohol or another drug.

“It is rare that we see a story where Coricidin or any other drug containing DXM is all that the person took,” Lawenda said.

The Food and Drug Administration provides recommendations for proper dosage, Lawenda said. However, the dosage someone takes could depend not only on their age, but also weight, and can play a factor in overdosage.

“This could affect the productivity of the person or could cause other actions,” he said.

“But trying to raise awareness about DXM and over-the-counter drug abuse can be hard,” Kirklen said.

“One of the problems is trying to tell the person they have a problem and to find a solution, such as counseling, to relieve the dependence of the drugs from them,” Kirklen said.

Both the Council on Family Health and Anitdrug.com said to look for signs that friends or family members are taking excessive amounts of a cold or flu remedy after their symptoms have subsided. Also, if cough and cold medicines begin to disappear from medicine cabinets, or if packages of the drug are found in a friends backpack or room, he or she may be abusing the product.

Jim Darling said he hopes his daughter’s death has served as a wake-up call for law enforcement, teachers and parents.

For more information about over-the-counter drugs that contain DXM go to http://www.nlm.nih.gov/medlineplus/druginfo.

Also, visit the Web sites of www.theantidrug.com and the Council on Family Health www.cfhinfo.org.

Contact Stefanie Greenat oraclestefanie@yahoo.com