- Dextromethorphan/DXM Overdose: Dangers of Abusing Cough Medicine
- Dextromethorphan Dosing and Intoxication
- Overdose Symptoms
- What to Do During a Dextromethorphan Overdose
- Why Do Dextromethorphan Overdoses Occur?
- DXM and Serotonin Syndrome
- Related Consumer Updates
- For More Information
- Vicks DayQuil FAQ
- Q: What does DayQuil do?
- Q: What is DayQuil?
- Q: How often can you take DayQuil?
- Q: How long does DayQuil last?
- Q: How long does it take for DayQuil to work?
- Q: What’s the difference between DayQuil and DayQuil SEVERE?
- Q: Can I take DayQuil while pregnant or breast-feeding?
- Q: Does DayQuil contain alcohol?
- Q: Does DayQuil expire?
- Q: Does DayQuil make you tired?
- Q: Does DayQuil contain acetaminophen?
- Q: Does DayQuil contain caffeine?
- Q: Can I take DayQuil if I have high blood pressure?
- DayQuil and Alcohol
- Liver Damage
- Dextromethorphan Dangers
- How much NyQuil Dextromethorphan does it take to get high? Does NyQuil even work?
Dextromethorphan/DXM Overdose: Dangers of Abusing Cough Medicine
Dextromethorphanis a cough suppressant found in many over-the-counter cold and flu medications, including cough syrups. When codeine, a mild opioid narcotic, was moved to Schedule III and required a prescription for purchase, drugs containing dextromethorphan were popularized since the active ingredient was believed to be safer.
Unfortunately, dextromethorphan has been shown to be habit-forming and intoxicating. It is now a drug of abuse that can even cause a life-threatening overdose when a person consumes too much. Nonmedical abuse of DXM can lead to experiences that are reportedly similar to those caused by PCP or ketamine. It is legal for purchase, although many states may require a driver’s license or other identification to prove purchasers are of age.
Symptoms of dextromethorphan intoxication include:
- Impaired motor function
- Dissociative episodes
- Audio and visual hallucinations
- Nausea or vomiting
- Increased heart rate
- High blood pressure
- Elevated body temperature
- Buildup of acid in body fluids
Although dextromethorphan alone can cause intoxication, other drugs often found in cold or flu medicines can enhance the ingredient’s effects. These include analgesics like acetaminophen, antihistamines, and decongestants like pseudoephedrine.
Long-term abuse of dextromethorphan-based drugs often leads to dependence, tolerance, and addiction.
Dextromethorphan Dosing and Intoxication
Taking DXM-containing drugs for nonmedical reasons has become extremely popular among adolescents in the US. According to a study in 2008, one in 10 teenagers abused DXM products. This makes dextromethorphan abuse more popular than abuse of other recreational drugs like cocaine, ecstasy, crystal meth, and LSD.
The Drug Enforcement Administration (DEA) lists different dose-dependent plateaus, as experienced by people who abuse DXM. The maximum recommended daily dose of DXM is 120 mg; beyond that, intoxication and dangerous side effects begin to appear.
- A dose of 100-200 mg induces mild stimulation and euphoria.
- A dose of 200-400 mg leads to stronger euphoria and hallucinations.
- A dose of 300-600 mg causes loss of motor coordination and visual distortions.
- A dose of 500-1500 mg leads to out-of-body sensations.
Intoxication from a nonmedical dose begins between 15 and 30 minutes after ingestion, as the stomach digests the drug, and the effects typically last for 3-6 hours. At 1500 mg or more, a person is likely to overdose on dextromethorphan. This is 5-10 times the recommended dose of any over-the-counter medicine containing DXM.
Symptoms of an overdose on dextromethorphan include:
- Breathing problems, especially irregular or shallow breathing
- Bluish tint under the fingernails or on the lips due to lack of oxygen
- Blurred vision
- Blacking out
- Stomach or intestinal spasms
- Anxiety or paranoia
- Extreme drowsiness
- Changes in blood pressure, either too high or too low
- Muscle twitches
- Heart palpitations
- Elevated body temperature
Common behavioral symptoms from DXM overdose include hyperexcitability and somnolence. If a person displays either, or both, of these symptoms, they may be experiencing an overdose. Also, if a person appears to experience hallucinations or psychosis, they may be overdosing on DXM.
Dangerous physical symptoms of dextromethorphan overdose include tachycardia, slow breathing, changes in blood pressure and body temperature, and seizures. It is important to get help for a person suffering from a DXM overdose before these symptoms begin because they are more likely to lead to coma or death.
What to Do During a Dextromethorphan Overdose
If a person is overdosing on DXM, they require emergency medical attention. Call 911 immediately. There are no drugs that counteract a DXM overdose; the only way they can survive the condition is to get help in a hospital immediately.
In the hospital, a dextromethorphan overdose will be treated with several emergency procedures to stabilize the individual. Some of these may include:
- Activated charcoal to absorb the remaining DXM
- Blood and urine tests to understand how much has been consumed
- Breathing support
- Electrocardiogram to measure heart activity
- IV fluids to maintain hydration and nutrients in the body
- Laxatives to help the body expel DXM faster
- Gastric lavage, or stomach pumping, to remove the drug
Why Do Dextromethorphan Overdoses Occur?
Many cases of DXM overdose involve people intentionally ingesting large amounts of cold or flu medications to get high. Recreational abuse of drugs is extremely dangerous, and it can lead to dependence, tolerance, addiction, acute and chronic side effects, and death.
However, some people are simply poor metabolizers. People who fall into this category do not metabolize medications as efficiently as the average person. Typically, these people should take smaller doses than recommended for over-the-counter or prescription medicines to avoid intoxication, addiction, and overdose. However, a person may not know that they fall into this category until it is too late. It is important to know the symptoms of overdose, and if they are experienced, call 911 or go to the nearest emergency room.
Overdose Concerns for Specific Drugs
- Synthetic Cannabinoids
DXM and Serotonin Syndrome
Although dextromethorphan is not an antidepressant, it does act on serotonin pathways in the brain. This is part of why the substance is intoxicating and can cause hallucinations in large doses. It also means that DXM interacts with psychiatric medications, including antidepressants like SSRIs, tricyclic antidepressants, and MAO inhibitors. These medicines are designed to change the levels of serotonin in the brain, and they can be dangerous when mixed. They can also be dangerous when taken with too much dextromethorphan.
Combining DXM and antidepressants can cause serotonin syndrome. This occurs when the brain is flooded with too much serotonin. Symptoms of serotonin syndrome include:
- Restlessness or agitation
- Changes in heart rate or blood pressure, especially elevated levels
- Dilated pupils
- Twitching muscles, tremors, or loss of coordination
- Muscle rigidity
- Excessive sweating
- High fever
- Irregular heartbeat
This is not an overdose of DXM, but it is a very dangerous condition that requires emergency medical attention. People experiencing serotonin syndrome or those witnessing someone who is, should call 911 immediately.
Get Help before Overdose
Nonmedical abuse of intoxicating substances, including legal or over-the-counter drugs like dextromethorphan, is extremely dangerous. These drugs can cause acute and chronic side effects, including overdose, organ damage, and early death.
It is important to get help to end substance abuse problems before side effects become life-threatening. Detox with the help of a medical professional, a complete rehabilitation program, and social support are the components of a successful rehab program. Professional programs offer various kinds of therapy and supportive treatments to help clients end substance abuse issues related to specific drugs, including DXM.
A recent study suggests many people may be abusing over-the-counter drugs without even knowing it, and we only have labeling to blame. Although it is FDA regulation to list all ingredients of OTC drugs on labels, many consumers do not have adequate enough knowledge about these drugs to take them properly. As a result, many people are mixing drugs, or taking multiple drugs with the same ingredients with little knowledge of the potential health repercussions.
According to their findings, published in the Journal of Public Policy & Marketing, researchers are concerned about our ill-informed overmedicating. “A consumer who takes a cold medicine containing, for instance, acetaminophen, may see nothing wrong with taking an additional medicine that also contains acetaminophen,” said researchers Jessie R. Catlin and Connie Pechmann of the University of California, along with Eric P. Brass of UCLA. “But in that case, he or she will likely ingest at least 1300mg of acetaminophen, and if those doses are repeated every four to six hours, the consumer will take in at least 5200mg of acetaminophen per day, well over the limit.”
Researchers examined how participants responded to drug labeling, studying groups of individuals with and without medical expertise. After asking the two groups to identify whether or not two separate medications contained the same ingredient, researchers found both groups were able to identify when OTC drugs had the same components, but only those with medical expertise were able to ascertain the risks of taking the medications simultaneously.
Researchers thus did not find it farfetched to conclude that the average consumer, who very likely does not have much medical knowledge, may find no risk in taking multiple OTC drugs at once, even if they can tell both drugs have the same ingredients. We are naïve when it comes to our cold medicines, and tend to think that because it is over-the-counter, it cannot hurt us. It is this relaxed perspective researchers are hoping to change with clear warning labeling and public service announcements.
“Programs to educate the public on the risks of double-dosing must clearly emphasize that even over-the-counter medications can be dangerous when combined or misused,” wrote the authors in a recent press release. “More broadly, this study suggests that it is vitally important for practitioners and policymakers to address safety issues by first working to understand what is at the root of the consumer’s misunderstandings.”
Source: Catlin J, Pechmann C, Brass E, et al. Dangerous Double Dosing: How Naïve Beliefs Can Contribute to Unintentional Overdose with Over-the-Counter Drugs. Journal of Public Policy and Marketing. 2015.
FDA is a member of the Acetaminophen Awareness Coalition (AAC), a diverse group of leading health and consumer organizations. AAC’s outreach campaign, “Double Check, Don’t Double Up,” is all about the safe use of acetaminophen. Visit www.knowyourdose.org for more information.
Subscribe: FDA Consumer Health Information
You have flu symptoms, so you’ve been getting some relief for the past two days by taking a cough and flu medicine every few hours. Late in the day, you have a headache and you think about grabbing a couple of acetaminophen tablets to treat the pain.
Stop right there.
What you may not realize is that more than 600 medications, both prescription and over-the-counter (OTC), contain the active ingredient acetaminophen to help relieve pain and reduce fever. Taken carefully and correctly, these medicines can be safe and effective. But taking too much acetaminophen can lead to severe liver damage.
Acetaminophen is a common medication for relieving mild to moderate pain from headaches, muscle aches, menstrual periods, colds and sore throats, toothaches, backaches and to reduce fever. It is also used in combination medicines, which have more than one active ingredient to treat more than one symptom.
‘Tis Cold and Flu Season
The National Institutes of Health (NIH) says that Americans catch one billion colds per year and as many as 20% of Americans get the flu. Moreover, 7 in 10 Americans use OTC medicines to treat cold, cough and flu symptoms.
Fathia Gibril, M.D., M.HSc., a supervisory medical officer at the Food and Drug Administration (FDA), explains that consumers looking for relief from a cold or the flu may not know that acetaminophen comes in combination with many other medications used to treat those symptoms. “So if you’re taking more than one medicine at a time,” she says, “you may be putting yourself at risk for liver damage.”
Symptoms of acetaminophen overdose may take many days to appear, and even when they become apparent, they may mimic flu or cold symptoms. The current maximum recommended adult dose of acetaminophen is 4,000 milligrams per day, To avoid exceeding that dose:
- don’t take more than one OTC product containing acetaminophen,
- don’t take a prescription and an OTC product containing acetaminophen, and
- don’t exceed the recommended dose on any product containing acetaminophen.
“When you’re at the store deciding which product to buy, check the ‘Drug Facts’ label of OTC cold, cough and flu products before using two or more products at the same time,” Gibril says. If you’re still not sure which to buy, ask the pharmacist for advice.
Rely on Health Care Experts
Acetaminophen is used in many commonly prescribed medications in combination with pain relievers such as codeine, oxycodone and hydrocodone. As of January 2011, FDA reported that overdoses from prescription medicines containing acetaminophen accounted for nearly half of all cases of acetaminophen-related liver injury in the U.S. When your health care professionals prescribe a drug, be sure to ask if it contains this active ingredient, and also to inform them of all other medicines (prescription and OTC) and supplements you take.
Even if you still have fever or pain, it’s important not to take more than directed on the prescription or package label, notes FDA supervisory medical officer Sharon Hertz, M.D. But be careful, the word “acetaminophen” is not always spelled out in full on the container’s prescription label. Abbreviations such as APAP, Acetaminoph, Acetaminop, Acetamin, or Acetam may be used instead.
When buying OTC products, Hertz suggests you make it a habit of telling the pharmacist what other medications and supplements you’re taking and asking if taking acetaminophen in addition is safe.
When the medicine is intended for children, the “Directions” section of the Drug Facts label tells you if the medicine is right for your child and how much to give. If a dose for your child’s weight or age is not listed on the label and you can’t tell how much to give, ask your pharmacist or doctor what to do.
If you’re planning to use a medication containing acetaminophen, you should tell your health care professional if you have or have ever have had liver disease.
Acetaminophen and alcohol may not be a good mix, either, Hertz says. If you drink three or more alcoholic drinks a day, be sure to talk to your health care professional before you use a medicine containing acetaminophen.
January 24, 2013
Related Consumer Updates
- Have a Baby or Young Child With a Cold? Most Don’t Need Medicines
- New Steps Aimed at Cutting Risks from Acetaminophen
- Reducing Fever in Children: Safe Use of Acetaminophen
- Putting a Patch on Migraines
- FDA Warns of Rare Acetaminophen Risk
- Sometimes Drugs and the Liver Don’t Mix
For More Information
- Acetaminophen Information
- Acetaminophen Awareness Coalition�s Know Your Dose Campaign
- Acetaminophen Toxicity
- Using Acetaminophen and Nonsteroidal Anti-inflammatory Drugs Safely
Vicks DayQuil FAQ
Q: What does DayQuil do?
A: The DayQuil line of products offers non-drowsy relief of your worst cold and flu symptoms, so you can get your power back and enjoy the day.
Q: What is DayQuil?
A: DayQuil is an over-the-counter medication that treats daytime symptoms of the cold and flu, including nasal congestion, cough, headache, minor aches and pains, fever and sore throat.
Q: How often can you take DayQuil?
A: DayQuil can be taken every four hours. Do not exceed four doses within 24 hours.
Q: How long does DayQuil last?
A: DayQuil treats cold and flu symptoms for approximately four hours
Q: How long does it take for DayQuil to work?
A: This depends on many factors but it usually takes 30 minutes for DayQuil to start working.
Q: What’s the difference between DayQuil and DayQuil SEVERE?
A: DayQuil SEVERE delivers maximum symptom-fighting ingredients to relieve your worst cold symptoms. It contains 200 mg of guaifenesin, an expectorant that helps clear mucus and phlegm from the chest. DayQuil does not contain guaifenesin.
Q: Can I take DayQuil while pregnant or breast-feeding?
A: If you are pregnant or breast-feeding, check with your health professional before taking DayQuil. He or she can determine if it is safe for you.
Q: Does DayQuil contain alcohol?
A: No, DayQuil does not contain alcohol.
Q: Does DayQuil expire?
A: Yes. Do not use DayQuil beyond the expiration date on the package.
Q: Does DayQuil make you tired?
A: DayQuil is a non-drowsy formulation for relief of your cold and flu symptoms.
Q: Does DayQuil contain acetaminophen?
A: Yes, DayQuil contains 325 mg of acetaminophen per liquicap or 650 mg per liquid dose. Severe liver damage may occur if you: take more than four doses of DayQuil within 24 hours, take DayQuil with other drugs containing acetaminophen, consume three or more alcoholic drinks every day while taking DayQuil.
Q: Does DayQuil contain caffeine?
A: No, DayQuil does not contain caffeine. Learn more about the active ingredients in DayQuil and DayQuil SEVERE.
Q: Can I take DayQuil if I have high blood pressure?
A: In patients with hypertension, the use of certain medications may raise their blood pressure. Decongestants provide relief by narrowing blood vessels to reduce nasal stuffiness, but this can potentially affect other blood vessels, which may increase blood pressure. DayQuil™ HBP is free of decongestants for people with high blood pressure. To learn more, click here
DayQuil and Alcohol
Most people don’t think twice about taking an over-the-counter medication to treat a cold or the flu. And when used as directed, most of these drugs are safe. But drinking alcohol while taking popular over-the-counter cold and flu remedies can be a recipe for disaster.
Vicks DayQuil is a common over-the-counter medicine that can help relieve the symptoms of a cold or the flu, such as sneezing, sore throat, headache, cough, fever and mild aches and pains. But like any medication, DayQuil contains ingredients that can interact with other substances, including alcohol.
While DayQuil products come in a number of different formulations, many contain the drugs acetaminophen and dextromethorphan — and neither ingredient is safe to use with alcohol. For people who suffer from alcohol addiction, it may be safest to avoid medications containing acetaminophen or dextromethorphan.
Acetaminophen, which is also sold under the name brand Tylenol, is the most common drug ingredient in the United States. It’s found in more than 600 medications, including many popular over-the-counter medicines for flu and colds.
While acetaminophen is an effective pain reliever and fever reducer, the drug can also be toxic to the liver. Acetaminophen overdose is the leading cause of acute liver failure in the United States and the second-leading cause of liver failure requiring transplantation. Drinking alcoholic beverages while taking acetaminophen increases your risk of liver damage.
Acetaminophen is found in more than 600 medications.
DayQuil manufacturer Procter & Gamble cautions on its website that “severe liver damage may occur” if someone takes more than four doses of DayQuil within 24 hours, takes other products containing acetaminophen or consumes three or more alcoholic drinks every day while taking DayQuil.
A safer choice, though, is not to drink at all while taking DayQuil, especially if you are someone who drinks heavily and regularly.
The standard two-tablespoon dose of DayQuil contains 650 milligrams of acetaminophen. Although the maximum daily dose of acetaminophen for a normal, healthy adult is 4,000 milligrams, liver damage has been known to occur at lower doses in some people.
For those who drink three or more alcoholic beverages a day, the safe daily limit is likely much lower.
A 2016 article in the Journal of Clinical and Translational Hepatology notes that “more conservative” dose limits of 2,000 milligrams are appropriate for patients with chronic liver disease — particularly those with extensive liver disease or active alcoholism. A person taking the maximum daily dose of DayQuil, however, would consume 2,600 milligrams of acetaminophen in a 24-hour period.
How Liver Injury Occurs
The danger of taking too much acetaminophen or combining alcohol and acetaminophen stems from how the body breaks down acetaminophen. When it’s metabolized by the liver, acetaminophen is broken down into several substances, most of which are excreted in our urine. But one of those substances, known as NAPQI, is notoriously hard on the liver.
Fortunately, when acetaminophen is consumed in safe doses, the body has an effective way to deal with the harmful effects of NAPQI: The liver uses a powerful antioxidant called glutathione to neutralize the NAPQI and prevent it from damaging liver cells.
But in someone who drinks heavily (three or more drinks a day), glutathione levels drop, allowing NAPQI to build up to dangerous levels that can damage liver cells. Because of this, chronic drinkers are more at risk for an unintentional acetaminophen overdose, which can result in severe liver damage or even liver failure.
Symptoms and Treatment of Acetaminophen Overdose
If a person exhibits signs or symptoms of acetaminophen toxicity, they should seek medical help immediately. Fortunately, there are ways to treat an acetaminophen overdose and prevent liver injury or death, but time is of the essence.
Without rapid treatment, a large overdose of acetaminophen can lead to liver failure and death within a few days, according to the U.S. National Library of Medicine.
Symptoms of an acetaminophen overdose can include:
- Abdominal pain
- Loss of appetite
- Yellowing of the skin and eyes
People seen in the hospital emergency room within an hour of an acetaminophen overdose will be administered activated charcoal to absorb the drug. They will also likely be prescribed a drug called N-acetylcysteine (NAC), which can help prevent liver damage.
NAC is most effective if given within eight hours of the overdose, but the life-saving treatment can be difficult to tolerate because acetylcysteine tastes like rotten eggs. The liquid medication is taken as one large “loading” dose, followed by 17 smaller doses that are given every four hours.
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Dextromethorphan, or DXM, an ingredient in DayQuil that helps suppress coughing, is also unsafe when combined with alcohol. Side effects of dextromethorphan can include dizziness, lightheadedness, drowsiness, nausea and vomiting — and alcohol can worsen these side effects.
Unfortunately, abuse of cough medicine products containing DXM is a common problem among American teens, who take excessive amounts of the drug for its psychoactive effects. Slang terms for the practice include “robotripping” and “skittling.”
Consuming more than the recommended dose of DXM can cause euphoria and trigger visual and auditory hallucinations. DXM intoxication can also result in hyperexcitability, lethargy, uncoordinated movements, slurred speech, sweating, high blood pressure and a host of other symptoms.
Combining alcohol with products containing dextromethorphan can cause significant health problems. For example, mixing Mucinex DM and alcohol can increase a person’s risk for liver damage.
Alcohol exacerbates the effects of DXM overdose. If high doses of DXM are ingested along with alcohol, a person may experience shallow breathing, stupor or coma. Combining high doses of DXM with alcohol can even lead to death.
DXM abuse by teens is such a problem that some states, such as Florida, have banned children under the age of 18 from purchasing over-the-counter cough syrups that contain dextromethorphan.
NyQuil, a similar flu and cold medication intended for use at night, carries the same risks as DayQuil, and more, because of additional ingredients. You should also abstain from using NyQuil and alcohol together.
Considering the serious risks to your health, it’s best to abstain from drinking while taking DayQuil. On the other hand, if you have an alcohol addiction and are unable to stop drinking, then it’s safest to skip the DayQuil and just tough out your cold.
The risks of mixing drugs and alcohol — including prescription medications, over-the-counter medications and illegal drugs — are significant. If you’re ever unsure whether it’s safe to drink alcohol while taking a medication, talk to your pharmacist or doctor.
Jan. 9, 2004 — Parents have their hands full trying to keep kids away from alcohol, smoking and drugs. Now there’s yet another substance that teens are using to get high — legally. They’re taking big doses of ordinary cold medicine.
Watch John Stossel’s full report on kids abusing Coricidin tonight on 20/20.
A group of kids who spoke to ABCNEWS said they were using Coricidin HBP Cough and Cold Pills to get stoned. The ingredient that gives kids a high is dextromethorphan, or DXM. It suppresses coughs safely, but in large amounts it produces a chemical imbalance in the brain that allows the kids to get high.
Click here for information on your local poison control center.
Dextromethorphan is in more than 100 cold medicines, not just Coricidin, but one type of Coricidin has the particular cocktail of ingredients that the kids prefer. This week, the American Association of Poison Control reported teen abuse of these types of over-the-counter cold medications has doubled in the last four years.
‘It Tastes Just Like Candy’
Molly, 17, described how taking a large dose of the pills made her feel, “You turn your head and everything went in slow motion. It was like you were in The Matrix or something.”
The abuse of Coricidin is so appealing, kids say, because it’s easy to get, it’s legal, and parents and teachers usually don’t have any idea they’re taking it.
“As far as drugs go, you don’t need to know a dealer, you know. If you can find a Walgreen’s or a grocery store, you’re set,” said Jeff Helgeson, a 20-year-old from Minneapolis. Helgeson says he’s been getting high on Coricidin for four years.
Some kids call the habit “skittling,” because the pills look like the popular candy Skittles. “It’s just like pot, except it’s better and it tastes just like candy and your parents won’t know if you get high cause your eyes won’t be red,” said Ashley, 16.
Jason, a 15-year-old from Seattle, said he liked the feeling so much he took the pills every day for five months. Another teen, Kevin, said he took Coricidin for a year and a half.
Parents, Teachers Often Unaware of Abuse
When parents see that their kids have cold pills, they don’t think twice. It’s just cold medicine, after all; it seems innocent enough.
School principal Judi Hanson says she’s finding that Coricidin is becoming kids’ drug of choice. It’s easier to conceal. There’s no smell, there’s no dealing with a dealer. It makes it hard to detect.
But Jason’s father, Pat, noticed his son seemed stoned when he came home with friends and he confronted him. Jason finally admitted to abusing the medicine. Like many parents, Pat didn’t know kids could get high on cold pills.
Often the kids don’t even buy the Coricidin — they steal it. Helgeson said he stole it. “I’d wear my coat in there or stuff it in my underwear.”
The shoplifting has led some stores to move that type of Coricidin behind the counter. James Holm, a pharmacist at a Hopkins, Minn., store, said they had no choice.
“These kids just seem to find it, zero in on it, and believe me, if you have it on the shelf, it’s going to be gone,” he said. “They’ll steal it right out from underneath your nose. … They just grab it and go.”
As the kids talked about getting stoned, there was a lot of laughter, even when they talked about accidents and injuries they suffered while taking the pills. Helgeson laughed as he talked about breaking his elbow and ankle while snowboarding and skateboarding when he was high on Coricidin.
Sometimes they laughed about not getting caught. Helgeson said he drag-raced a police car, and thought it was funny the officers couldn’t tell he was high when they pulled him over. “They gave me a Breathalyzer. I hadn’t been drinking. I didn’t have any drugs on me.
So they didn’t know,” he said.
Helgeson was the oldest among the group of young people who talked with ABCNEWS about their experiences. As the younger kids continued to laugh about their experiences, we noticed that Helgeson seemed sort of separate from them.
Helgeson says it’s still fun when he takes Coricidin, but he says it’s wrecked his life.
His mom has to drive him places because he’ll lose his license if he gets another ticket. He dropped out of school and now lives at home, spending most of his time playing his guitar or just sitting.
“Living in the household with Jeff the past few years has been like living with somebody who’s sick and they never get well,” said his mom, Merrilly Helgeson.
Jeff Helgeson has a twin brother, John, a junior at the University of Wisconsin, whose life is good. His mom says Jeff “always has a reminder right in front of him of where he would be right now if he were not doing Coricidin.”
And Jeff doesn’t seem happy with himself. “My brain has gone and I’m just wasted. It took all my friends away from me. I threw my life away.” Yet he keeps using.
Abuse on the Rise
Failing grades or a trip to the hospital is sometimes what it takes to alert kids and their parents to the danger. Doctors say they’re seeing more and more kids in emergency rooms who’ve taken too much Coricidin.
Over the last three years, there’s been approximately a 300 percent increase in calls to poison control centers about dextramethorphan, said Dr. Edward Boyer, an emergency room physician in Massachusetts.
Boyer says the kids who come in to the emergency room are agitated, difficult to control, sweating and unresponsive when you try to speak to them.
Molly and Ashley had a recent close call.
They told Ashley’s mom they were going to bed. Instead they took Coricidin, sneaked out of their house, and went to a party where they took more Coricidin.
“My fingers were so numb that I couldn’t open the package. So me and Molly were literally trying to rip the package open with our teeth,” Ashley said.
They went to a boy’s house where Ashley may have had sex, but she doesn’t know.
“He took me in a bedroom and I guess he tried to have sex with me. … He was on top of me. But I fell asleep.”
Later, a hospital test revealed she and the boy had not had sex. She and Molly did get home and later went to sleep. But by morning, they were still very high. The Coricidin high can last a day. Ashley’s mom called the poison control center and was told to get the girls to the hospital.
Sometimes Deadly Consequences
At least five people have died after taking Coricidin, but even death doesn’t seem to scare the kids. Jason had heard about a boy who died, but said he knows that the boy took the type of Coricidin that contains acetaminophen. And he knows not to take that type. “It tends to cause you to die,” he said.
He’s right, because acetaminophen can cause liver damage or death when taken in large doses.
Boyer said, “If you talk to kids, they know they should take the stuff that doesn’t have acetaminophen in it.”
It’s hard to believe the kids know which type of medicine is going to hurt them less.
But Boyer says he believes they do, and he says they can get a lot of information from an online drug encyclopedia called Erowid. While Erowid warns that high doses of acetaminophen can be fatal, the Web site appears to have been written by drug users. They describe first-time experiences, and suggest dosages — and in the case of Coricidin, warn of its dangers.
In fact, you can get more information from these than you get from the government’s drug-abuse Web site, Boyer said. “If I need information on a drug of abuse, I go to this Web site,” he said.
Easy Access Makes Drug a Greater Threat
Some parents say Coricidin, because it’s so accessible, is worse than other drugs. They want it taken off store shelves.
But the company that makes Coricidin, Schering-Plough HealthCare Products, said removing it from the shelves would deny cold sufferers access to a helpful medication.
“We want to minimize abuse by warning people and changing the package so it’s harder to shoplift, but Coricidin HBP is a valuable cold medicine, the safest and most effective product for patients with high blood pressure,” the company said in a statement.
It also said putting it behind the counter would deprive those who need it.
Wal-Mart’s policy is to sell it only to customers 18 or older, and the chain limits the number of boxes people can buy to three.
Still, kids who want to abuse the medicine can still find it in stores or buy it over the Internet. Ultimately, making the decision not to abuse the medicine will be up to the kids.
Ashley said it’s difficult to stop taking it once you get started. “It’s addictive,” she said. “here’s some ingredient in those pills that makes you want to take it again no matter what.”
That’s not correct. Dextromethorphan is not physically addictive. Ashley and Molly have now stopped taking it. People do quit. Jason has been clean since June, and Kevin for almost a year. But Jeff Helgeson still uses.
“I know that the right answer is for me to never do it again. Or drugs in general,” he said. “But once you’ve been down that road, it’s really difficult to get on a different path and stay on that path.”
Poison Control Information 1-800-222-1222 is the 24-hour emergency number to call to find a poison control center your area. Poison control centers have additional information concerning abuse and misuse of cold medicines containing dextromethorphan.
How much NyQuil Dextromethorphan does it take to get high? Does NyQuil even work?
Nyquil has 3 ingredients. Tylenol, an ingredient that loosens mucous, and an antihistamine.
All antihistamines make you sleepy. Well, I should say ones like Allegra claim not to make you sleepy, but one will flat put me asleep.
Now when you say “high,” are you referring to an elevated mood, like cocaine, ADHD meds, things like that? Because that’s what “high” means to me, but I am old!
If you include feeling sleepy and laying around as “high,” then Nyquil will cause that. As will benzo’s, some narcotics, alcohol and lots of other things. I would call that “low!”
Obviously I am not going to try to prescribe anything to you. But if you want to feel sleepy, without a prescription medicine, Benadryl is the best thing. It is measurable-the tablets almost always are 25 mg, you can buy them 50 mg but those are capsules. And cheap.
The normal dose for Benadryl is 1/2 to 1 mg per pound.
I knew an older lady who took 8 25 mg Benadryl at bedtime as well as her shrink had ordered the same dose-200 mg, but the bottle was labeled diphenhydromine, which is the generic name for Benadryl. She asked me to check over her meds, brought me a bag of bottles. But when I tried to convince her that she was taking 400 mg of Benedryl/diphenhydromine, I couldn’t get through to her. She had been taking that dose for years.
Do NOT mix sedating drugs. Toss in some alcohol, a few Lortabs, maybe some Xanax, and you will be a very sick girl and maybe in the ER or funeral parlor.