In Canada, Cough Syrup Moves Behind the Counter

Victoria Times-Colonist

A dozen pharmacies in Greater Victoria are moving cough remedies containing dextromethorphan -- known as DM or DXM -- behind the counter at the request of the College of Pharmacists of B.C.

The move follows a rash of overdoses -- in the last two weeks, four teenagers have landed in treatment after overdosing.

DXM, a cough suppressant and pain reliever, is easily accessible at drugstores. Youth use it to get high by exceeding the recommended dose.

From the U.S. DOJ Office of Diversion Control:

Dextromethorphan (DXM) is an over-the-counter (OTC) cough suppressant commonly found in cold medications. DXM is often abused in high doses by adolescents to generate euphoria and visual and auditory hallucinations. Illicit use of DXM is referred to on the street as "Robo-tripping" or "skittling." These terms are derived from the most commonly abused products, Robitussin and Coricidin.

The prime recreational users of DXM are ages 14 to 15, although there are reports that children as young as 10 also use the drug, according to the College of Pharmacists.

Signs will be placed on pharmacy shelves where cough remedies are kept directing purchasers to the dispensary for a consultation, said college registrar Marshall Moleschi yesterday.

If the spike in DXM use catches on in other areas, more pharmacies will be stowing the affected drugs behind the pharmacy counter.

"We're going to continue to monitor the situation," said Moleschi, adding consumers' need for the drug must be balanced with preventing youth from harming themselves.

Some youth see cough medicine as a harmless way to get high, said 14-year-old Sarah Hackett, who has started a Facebook page called "DXM is not cool!" that has 287 members after two weeks.

"One of my friends went to the hospital because she overdosed on it," said Hackett, who attends West Shore Learning Centre. "I just really freaked out and didn't know what to do."

The friend landed in drug detox and is now OK, but Hackett said yesterday that many of her peers don't know the dangers of abusing DMX. Overdoses can cause breathing difficulties, vomiting, dizziness and rapid heartbeat, among other symptoms.

"At first they say it's just cough medicine," Hackett said. "I went home and researched it. I found out what it does is messes up your brain and can give you brain damage. Your brain will stop telling your lungs to breathe."

The risks of exceeding the recommended dose even include death, said Cheryl Chaytors, manager of Victoria's specialized youth detox.

The four youths who recently survived overdoses were referred to drug detox by social workers and Victoria hospitals, said Chaytors, noting the detox process lasts seven to 10 days. "They will have some lasting effects from using the DXM -- dizziness ... no fine motor controls, confusion, memory loss, depression and anxiety.

"The problem is, youth see it as safe because it's something they get from the drugstore."

Young teens are going for cough medicine because it's easier to get than alcohol, she said. "It's easy to go to the drugstore and buy that kind of stuff, or it's quite easy to shoplift."