The latest study, published in the December issue of the Archives of Pediatrics and Adolescent Medicine, found that the growth of dextromethorphan abuse is being driven by children ages 9 to 17.
Abuse is most common among 15- and 16-year-olds, the study found. The number of 12- and 13-year-olds using the drug exceeds the number of 18-year-olds, indicating that it is popular in middle schools as well as high schools, according to senior author Ilene B. Anderson, a toxicology management specialist at the California Poison Control System.
"I did not expect 12-year-olds to be abusing it," Anderson said.
The study was based on a review of 1,382 calls made to the California Poison Control Center over a six-year period involving cases of dextromethorphan exposure. Those calls were generally made in emergency situations, usually by physicians treating overdose patients in hospitals. They represent only a fraction of overall drug use, Anderson said.
"If someone is abusing dextro and gets a high, they don't call us," she said. "I think it is grossly underreported."
Of the cases reported to the state poison control center, seven -- amounting to 0.5% of the total -- were life-threatening. None resulted in death, according to the study. The number of deaths nationwide is unknown.
The researchers compared the California findings with general statistics from the American Assn. of Poison Control Centers and the Drug Abuse Warning Network and found that the trends here are in line with the rest of the country.
Dextromethorphan appeals to teens because it "is easily and legally available in most pharmacies and large grocery stores," Anderson said. "It's relatively inexpensive -- in many cases, one package can cause hallucinations."
Websites offer testimonials about the buzz the drug provides. Some users describe it as "slightly intoxicating," though others compare their experiences with the hallucinatory effects of ketamine or PCP.
Dextromethorphan users can consult online calculators -- where they enter their weight, brand of medicine and "plateau" of high they want to achieve -- to determine how big a dose to take.
And because the cough remedies look innocuous, Anderson said, "you can have a package, and your parents would never even suspect it, compared to a little white bag of powder, which certainly would cause a red flag to go up."
