Increasingly abused: OTC medications

Courtesy of the 435th Mission Support Group

The abuse of over-the-counter medications is an increasing concern for law enforcement and health care personnel throughout the United States.

This problem has been alarmingly highlighted locally through recent incidents where adolescents were admitted to the emergency room for treatment of disorders related to the abuse of OTC drugs.

Juveniles were able to purchase the items at base exchanges, shoppettes, and commissary quick check-out lines. Although AAFES and DECA are working hard to be part of the solution, parents and guardians need to play an active role in stemming this health risk.

Most common is the abuse of OTC medications containing the drug dextromethorphan, or DXM. An ingredient in more than 140 cough and cold medicines, DXM is a safe and highly effective cough suppressant; however, when ingested in excessive amounts, DXM produces physiological effects that include: hallucinations, feelings of detachment from surroundings and self, loss of motor control, drowsiness, rapid heartbeat and vomiting.

With prolonged abuse users may become paranoid, delusional, and psychotic, and these effects can remain weeks after the discontinuation of the medication.

Risks to abusers are increased because medications that contain DXM often also contain expectorants, pain relievers, and antihistamines. Overdoses of these ingredients can produce additional side effects such as liver damage, coma, and death.

Adolescents are the primary abusers of OTC medications, because they are inexpensive, relatively easy to obtain, and are perceived to carry few risks.

Further compounding the problem is that few parents know about the potential for abuse of these medications. Awareness and education are the best tools for parents and guardians.

For more information or screening/advice contact your school’s Adolescent Substance Abuse Counseling Services (ASACS) personnel or visit websites such as or

DXM abuse: what to look for

Parents should be aware of the following factors:
• Changes in friends
• Changes in sleeping/eating habits
• Declines in personal grooming and hygiene
• Declining grades
• Mood swings
• Empty medication containers   
• Adolescents asking for certain kinds of cough/cold medications
• Decreased interest in activities, hobbies, sports

• Students report that they learn about abusing OTC medications from older siblings or friends’ siblings
• Many teens report first using DXM in 5th/6th grades
• Slang terms for DXM include DM, robo, rojo, velvet, triple C, skittles, dex, candy, and red devils
• Start early to teach your children to respect medication and take it only as directed
• Be clear with children that they should not take any medication without your knowledge
• Ensure your children understand that abusing cough medicine can be deadly
• Know what medications and amounts you have in the home
• Keep medication in secure areas
• Monitor teen visits to pro-drug Web sites