CADCA Newsletter - Generation Rx: Teens' Recreational Use of Prescription and Over-the-Counter Drugs Requires Community Action

Op-Ed

By:  Chuck Grassley Joe Biden, Jr.
Date: May 16, 2007
Location: Washington, DC

By United States Senators Joseph R. Biden, Jr. and Chuck Grassley

On the morning of July 16, 2003, Misty Fetko, a registered nurse who works in an Ohio Emergency Room, tragically discovered her son Carl had died in his own bed the night before. A talented and promising artist, Carl had just graduated from high school and was preparing to enroll at Memphis College of Art in just two days. However, his ambitions were cut short by a lethal mix of medications, including a potent prescription narcotic and Dextromethorphan ("DXM"), the active ingredient in many common cough and cold medicines. Carl's story is not unique. In February, three California students took dramatically excessive amounts of Coricidin HBP Cough and Cold pills to get high from its DXM ingredient. One student reportedly took 25 pills. The students became quite sick, but are recovering from their overdose.

It is not always the illegal drug - smuggled across our border in the dead of night or grown in the far fields of Afghanistan - that parents need to worry about their kids using. Sometimes it's the substance sitting on the shelf in their medicine cabinets.

As Senators who have worked tirelessly to stem the tide of illicit drug and excessive alcohol use, we are alarmed by an emerging scourge: teens abusing medicines such as prescription and over-the-counter drugs. This raiding of the medicine cabinet demands national attention.

According to the annual Monitoring the Future survey, a prominent University of Michigan study of the behaviors, attitudes, and values of teens and young adults, teens' use of illegal drugs has declined over the past five years. But that good news has been accompanied by other bad news. Improper and excessive use of legally available drugs has risen sharply during the same period. Recent studies indicate that 1 in 10 teens - 4.5 million young adults - have used prescription drugs non-medically. According to the 2005 National Survey on Drug Use and Health, more people age 12 or older recently started misusing prescription pain relievers than started using marijuana.

Teens are also getting high on cough and cold medicine. They do this by consuming excessive amounts of these drugs containing the ingredient DXM. While safe and effective when taken in its recommended dosage, DXM produces hallucinations, and can kill when consumed in excessive amounts. Children ages 9 to 17 are the fastest growing group of recreational users of DXM; in fact, one in 10 teens recently used cough and cold medicines to get high. DXM use among 8th, 10th, and 12th graders is now on par with cocaine.

These trends are unacceptable.

This rise in the non-medical use of these drugs can be chalked up to two key factors. First, too many teens are under the impression that "legal" drugs are safe anytime, in any dose. They are gravely mistaken. Excessive prescription drug use can lead to dependency, overdose, and even death, if not prescribed and monitored by a physician. And many over-the-counter drug medications contain acetaminophen which, when taken in large quantities, can cause serious liver damage, among other things.

Second, these drugs are cheap and easy to buy. A bottle of cough syrup costs a few dollars and a prescription drug can be taken from a medicine cabinet for free. A February 2007 report released by the Office of National Drug Control Policy reveals that a shocking 47 percent of youth interviewed said they got their prescription drugs for free from a relative or friend. The last thing a parent wants is to become his or her child's "dealer." But that is precisely what happens when they leave medications lying around at home. This double-edged sword - a false perception of the dangers and a cheap, accessible high - has put our teens in grave danger and we must act quickly and decisively to protect them.

We must all raise public awareness of these dangers in order to stem this rising tide. We need to better inform and educate people about the proper disposal of unused medication. The Office of National Drug Control Policy, the Department of Health and Human Services, and the Environmental Protection Agency recently released new federal guidelines for the proper disposal of prescription drugs. This is a positive first step, but it does no good if parents and other adults don't act. We must do more to educate and inform the general public about the safest ways to dispose of prescription drugs. We must teach parents to clean out their medicine cabinets on a routine basis and to keep track of their contents.

Further compounding the problem is the phenomenon of rogue Internet pharmacies. These "pharmacies" often short-circuit the traditional doctor-patient-pharmacy relationship by selling controlled substances without diagnosing the patient in person, assessing the need for medication, or issuing a valid prescription. A consumer can just type his or her desired drug into an Internet search engine and find countless websites ready and willing to dispense dangerous, habit-forming controlled substances. The current lack of standards can easily blur the distinction between a legitimate medical need and a recreational pill-popper. We must rein in these rogue pharmacies and demand comprehensive regulation.

Prevention is a key component of the solution, and education is a key component of prevention. We must do our level-best to raise awareness on this matter. We wrote the law creating the Drug Free Communities Program, and we know that community anti-drug coalitions on the ground in these communities are best situated to educate people and prevent the harms associated with non-medical use of prescription and over-the-counter drugs. One good example of prevention efforts is, A Dose of Prevention, Stopping Cough Medicine Abuse Before it Starts, an educational toolkit developed by the Community Anti-Drug Coalitions of America (CADCA) and the Consumer Healthcare Products Association. The toolkit includes guides to educate parents, teachers, law enforcement officials, doctors and healthcare professionals, and retailers about the potential harms of cough medicines. This is exactly the kind of prevention work that we've got to push.

Only a comprehensive and balanced approach - focusing on prevention, treatment, and enforcement - will lead to significant results. Unfortunately, the President's 2008 budget request cuts funding in these crucial areas. While we recognize that the budget is tight, this is the wrong direction and the health and safety of our children must not be sacrificed.

In recent years, we have made some progress on the fight against illicit drugs. But the new challenge of non-medical use of legal drugs demands similar attention. We are confident that with the combined expertise of CADCA, its Institute, community anti-drug coalitions, and other community-based organizations - coupled with robust funding - we can work to reverse this dangerous trend.

After Carl's terrible death, Misty Fetko courageously tells the tale of her tragedy and urges parents and their children to be vigilant and aware of these disguised dangers. Misty is exactly right, and our children's health and safety depend on it. We must not ignore or forget the story of Carl who, like so many others, fell victim to these dangerous legal and lethal highs.

This op-ed was printed in the Community Anti-Drug Coalitions of America's Coalitions (CADCA) Newsletter, Spring/Summer 2007

Sen. Joe Biden (D-DE) is Chairman of the Senate Judiciary Subcommittee on Crime and Drugs and Chairman of the Caucus on International Narcotics Control. Sen. Chuck Grassley (R-IA) is Co-Chairman of the Caucus on International Narcotics Control and a member of the Senate Judiciary Committee.