Turning to Anything, Just to Get That High
A cough syrup ingredient is a popular drug
When a high school junior at the Peddie School, a preparatory school in Hightstown, N.J., failed to show up for the year-end sports awards dinner last week, one of her teammates knew something bad must have happened. Slipping out of the ceremony, she walked into town, where she found her friend and another classmate under the influence of a drug, both unable to speak or walk. She flagged down a police car heading for the school's campus, where ambulances had already been called for two other students, a girl and a boy, found in a similar state.
School officials weren't sure what was going on, but concerned students had an idea. They said their friends might have taken DXM, or dextromethorphan, a drug commonly found in cough medicine. "We went into the boy's room and found a white, powdered substance," says Susan James, director of communications for the school. "Then we downloaded information on the drug from the Internet and took it with us to the hospital."
James says getting the information this quickly might have helped emergency medical workers treat the four students, one of whom was briefly in intensive care. But ready access to the Internet also partially caused the problem. One of the four had purchased the drug from an Internet site--and had it shipped directly to the school, Peddie officials said. It's not a unique incident; two people in Boston who ended up in the hospital last February after overdosing on DXM turned out to have bought it from two teenagers who had also gotten it off the Internet.
Chugging cough syrup--or "roboing," as it is often called, after the over-the-counter medication Robitussin--has been around for decades, but experts believe that use of DXM, in syrup or powder form, is on the rise. That comes not only from online availability but also because DXM is considered a poor man's version of the popular drug ecstasy: It mimics its effects, offering users a sense of euphoria and physical hallucinations, at a fraction of the price. But this high is achieved only through dangerously large doses. "If a person takes too much dextromethorphan, it would be like taking an overdose of morphine," says Ray Woosley, chairman of the pharmacology department at Georgetown University. "That person could slip into a coma or stop breathing altogether."
What's even more dangerous is using DXM and ecstasy together. Some teens have done so unwittingly: At least 12 versions of ecstasy sold at raves--the all-night dance parties that have popularized it--have been found cut with the cheaper drug. Though safe to use in approved doses, to calm coughs due to colds, DXM poses a special risk for people who cannot produce the liver enzyme needed to metabolize the drug, Woosley says. Seven percent of the population naturally does not make this enzyme, nor do people taking Prozac, the popular antidepressant. "There is a portion of kids taking this drug in megahigh doses who are not going to be able to get rid of it," he says. "They are at higher risk for overdose."
Adding up. But rather than mention these risks, most DXM Internet sites contain information on, say, how much DXM popular cough-medicine brands contain. There are even online DXM "calculators": Plug in your weight and how high you want to get, and the Web site will tell you how much of the drug you need to take. While the recommended adult dose of DXM in cough syrup formulations is about 30 milligrams every six to eight hours, some sites suggest taking more than even the 240 mg in an entire bottle.
Thomas McGinnis, director of pharmacy affairs at the Food and Drug Administration, says the agency is looking into whom the New Jersey students bought the drug from. "The FDA has only approved dextromethorphan in a cough syrup with specific labeling," he says. "This was not sold in the proper formulation, and we will be investigating who sold it to them." But it is extremely difficult to track who is selling the drugs and where they are located. "New sites pop up every day," McGinnis says.
The Peddie students bought the drug using a computer supplied by the school. "They have free access to the Internet," says Peddie's James, a policy that she says will not change. "We give them laptops, and we ask them to sign an agreement that they will use them responsibly." Though the four students were released from the hospital the day after they took the drug with no apparent permanent injuries, none of them will be returning to the school in the fall.
With Carolyn Kleiner
This story appears in the June 5, 2000 print edition of U.S. News & World Report.