The Feb. 18 hospitalization of four teenagers who took an over-the-counter cold medication is not the first such occurrence in Bexar County. In fact, the county had the state's highest total of similar cases referred to poison centers during 1998 and 1999, according to statistics from the South Texas Poison Center at The University of Texas Health Science Center at San Antonio.
"While we usually think of drugs of abuse as illegal substances, any drug that alters our perceptions has the potential to be abused," said clinical toxicologist William Watson, Pharm.D., associate professor of surgery and chief of the Poison Center division. "The South Texas Poison Center has been studying the abuse of non-prescription cough and cold medications such as Coricidin®, Robitussin®, and similar products to understand the patterns of abuse in South Texas. Understanding how the abuse of these medications spreads is important in order to develop better programs to prevent their abuse."
The ingredients in cough and cold medications can be dangerous, Dr. Watson said. Acetaminophen, various antihistamines, decongestants and the cough suppressant dextromethorphan often are combined. Harmful results can include liver problems, seizures, increased blood pressure and heart rate, unpleasant hallucinations and sensations, and even death.
"It appears that adolescents, usually between 13 and 16 years of age, often experiment with these products, taking from 10 to 15 tablets at one time," Dr. Watson said. "They are attracted to the medications because of information they get from peers, although the Internet may be the increasing source of knowledge about the abuse of this group of drugs. Abusers have the perception that these medications must be safe, since they can be purchased without a prescription, which further increases the likelihood that they may take large amounts resulting in dangerous effects."
The abuse of non-prescription cough and cold medications has been described for decades in the United States. An evaluation of cases referred to the poison centers in Texas in 1998 and 1999 demonstrated that more cases occurred in Bexar County than in any other county in Texas. Bexar County had 47 cases. Statewide, the total was 331 from 68 counties. "The cases often occurred in groups, as has been described in the San Antonio media recently," Dr. Watson said.
"It is important that the community is aware of the abuse of these medications, and that we educate adolescents that this practice can be very dangerous when large amounts are taken. Parents, school employees, substance abuse counselors and stores that sell these products should all be aware of unusual use of these medications."
The South Texas Poison Center may be reached by calling 1-800-222-1222 at any time day or night. Poison Center specialists are able to answer many questions about poisons and their toxic effects.