Drug industry launches warnings on cough medicine

The over-the-counter drug industry is rolling out a campaign to raise awareness about the abuse of cough medicines in an effort to head off harsh restrictions on the sales of the widely used products.

The Consumer Healthcare Products Association (CHPA), which represents pharmaceutical and consumer-products companies, debuted the latest component of its campaign when it launched its “Five Moms” website this month. The site features accounts from mothers about the dangers of using cough medicines to get intoxicated.

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The over-the-counter drug industry, along with the retail pharmacy industry, is looking to reduce the prevalence — or at least the perception — of children consuming large quantities of cough medicines to get high. Many cough remedies contain small amounts of alcohol, but the most common active ingredient in the medications, dextromethorphan, also can produce intoxicating effects.

More than 100 over-the-counter medicines contain dextromethorphan, a cough suppressant found in products such as Robitussin, according to Virginia Cox, a CHPA spokeswoman.

The two sectors are looking at whether dextromethorphan sales should be restricted to adults, a policy endorsed by the CHPA. Drug retailers, represented by the National Association of Chain Drug Stores (NACDS), are also considering a recommendation from the association’s policy staff that it back age restrictions, NACDS spokeswoman Julia Belcher said.

These latest industry efforts come two years after Congress enacted legislation setting strict limitations on the availability
of nonprescription decongestants containing pseudoephedrine, such as Sudafed. The legislation came amid media and law enforcement reports that the drug was being processed to make methamphetamine, also known as meth and crystal meth.

The new federal law on the distribution and sale of pseudoephedrine, as well as some further-reaching state laws, has made drug-makers and retailers particularly sensitive to the abuse of their products and the possible imposition of additional laws on the sale of cough medicines.

“Recent research has shown sort of a trend for teens looking to the medicine cabinet to get high,” Cox said.

A National Institutes of Health-funded University of Michigan study issued in December concluded that the use of illegal
drugs among eighth- through 12th-graders has declined since 2001. But researchers expressed concern about the rates of abuse of legal prescription and nonprescription medicines.

The report marks the first time that the university’s researchers have looked at the abuse of dextromethorphan since they began the study in 1975. Among its other findings, it shows that the use of illegal drugs remains more common, while the abuse of prescription drugs such as Vicodin and OxyContin remains widespread.

According to a statement issued by the university, “4.2 percent of eighth graders, 5.3 percent of 10th graders, and 6.9 percent of 12th graders reported taking cold or cough medicines with dextromethorphan (DXM) during the past year to get high.”

These figures are lower than the rates for illegal drugs or prescription drugs. The combined average for eighth, 10th and 12th graders who reported illegal drug use within a month of being surveyed was 14.9 percent.

Definitive research on how common abuse of these drugs is, or how many people suffer harmful side effects, has not been conducted, Belcher acknowledged. But anecdotal accounts of widespread abuse of cough medicine have gotten the attention of the industry as well as federal and state lawmakers.

Rep. Fred Upton (R-Mich.) is the sponsor of the only bill in Congress dealing with dextromethorphan. Upton’s bill would ban bulk sales of the raw ingredient except to drug makers, but it does not contain provisions on the retail sale of medicines containing dextromethorphan. Belcher said that NACDS expects Sen. Joseph Biden (D-Del.) to introduce a dextromethorphan bill.

The CHPA is trying to use its resources to provide parents, schools, doctors and children with information about the potentially harmful effects of cough medicine abuse, Cox said.

According to a CHPA-sponsored website, www.dxmstories.com, the side effects of cough medicine abuse “can include confusion, dizziness, double or blurred vision, slurred speech, impaired physical coordination, abdominal pain, nausea and vomiting, rapid heart beat, drowsiness, numbness of fingers and toes, and disorientation.” The website, which is aimed at young people, also says that the medicine could be fatal at very high doses.

In addition to promoting the “Five Moms” and “DXM stories” websites with Internet banner ads, sponsored search results on Google and videos posted to YouTube, the CHPA will run a print advertising campaign in newspapers, including the Washington Post.

Belcher said that although the NACDS has not coordinated an industry-wide dextromethorphan campaign, about 20 individual companies have taken steps to provide information about cough medicine abuse to their customers. Walgreens, CVS and Rite Aid are among those chains, she said. “They want to be in front of it rather than behind,” Belcher said.

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