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What Kids are Doing to Get High: Part 2
In this series, we review several of the most popular substances being used specifically by teens today because they are easily accessible. Keep in mind that the availability of a few of the substances that will be mentioned varies based on state law. However, regardless of where you live or work, you should be aware of what kids are doing these days to get high.
Dextromethorphan (slang names include dex, orange crush, rojo and velvet syrup1)
Method of Abuse: ingestion via liquid, capsules, chewable tablets, lozenges and quick dissolving strips
Availability: over-the-counter at pharmacies, “big box” stores, grocery stores and convenience stores
Cough syrups and cold medications containing dextromethorphan (DM or DXM) act as cough suppressants in over-the-counter (OTC) products such as Robitussin DM and Vicks NyQuil, Dayquil and Formula 44 Custom Care Dry Cough. However, in larger doses DM mimics the effects of LSD, including dissociative effects and hallucinations.2
There are more than 200 OTC products that contain DM, and in March 2011 the Food and Drug Administration (FDA) issued a safety alert about certain cough, cold and allergy product combinations containing DM due to the possibility of improper use in children, and the risks of taking too much DM through improper dosing, either accidentally or intentionally.2
If the patient is available to provide the package, pay close attention to the ingredients and dosing instructions. Most states require buyers to be at least 18 years old to purchase products containing DM, but some states such as Mississippi require buyers to be at least 21. 3
Energy Drinks (Monster, Red Bull, 5-hour Energy, Rockstar, AMP and Full Throttle)
Method of Abuse: ingestion
Availability: Any store that sells bottled drinks
Whether you mix it with alcohol or drink it straight from the can, energy drinks can have powerful effects.
Side-effects can include tachycardia, tachypnea, hypertension, agitation, seizures and in extreme cases, cardiac arrest. Long-term effects are still being evaluated. Unfortunately, anyone can buy energy drinks, including children. A 13-ounce can of energy drink can contain up to 13 teaspoons of sugar, and the same amount of caffeine that can be found in four cups of coffee. Depending on what brand of drink is consumed, additional ingredients can include taurine, glucuronolactone, ginseng, guarana and ginkgo biloba,4 which are also stimulants by themselves.
Pharm Parties (also called skittles parties, polypharmacy and fruit salad parties)
Method of abuse: ingestion
Availability: varies according to location
Pharm parties have been around for several years, although some scholars claim they don’t exist at all.5 They first came on the scene in the 1960s when they were labeled “fruit salad parties” due to the colorful appearance of the pills mixed together in a container. They are now also referred to as “Skittles parties” for the same reason.
The Pharm Party concept involves partygoers collecting as many medications as possible and putting them together into a container. This includes OTC as well as prescription medications found in the medicine cabinet. While this article focuses on OTC medications, it is common to see prescription medications among the OTC medications being consumed. As the night wears on, the participants swallow pills a handful at a time and wait to see the effects.
For this reason, it is important to bring the remainder of the medications and the empty containers with you while transporting a patient, to help identify what pills might have been taken once you arrive at the receiving facility. There are several applications available for pill identification that can be downloaded to a smartphone. 6,7
Antidotes available to EMS personnel depend upon knowing what the patient may have taken. Supportive care is all we can offer until we know for sure what was taken and how much.
References
1. WebMD. Teen Slang for Cough and Cold Medicine Abuse, www.webmd.com.
2. MedlinePlus. Dextromethorphan, www.nlm.nih.gov/medlineplus.
3. The National Alliance for Model State Drug Laws. Dextromethorphan (DXM) – State Statutes and State Legislation, www.namsdl.org.
4. Brody JE. Scientists See Dangers in Energy Drinks. The New York Times, www.nytimes.com.
5. Shafer J. Still More Pharm-Party Phoolishness. Slate, www.slate.com.
6. Drugs.com. Pill Identifier, www.drugs.com/apps.
7. iTunes.com. iPharmacy, itunes.apple.com.
Janet Taylor has been a nurse for over 17 years. She began her career working on a medical-surgical unit and floating to various other departments, gaining knowledge and experience along the way. After working for 7 years in the ICU, obstetrics, outpatient and ER, Janet began working as a flight nurse for Mercy Life Line in 2004 and helping in EMS education as an Instructor for all levels of classes including basic, advanced and critical care.
Janet serves as the site coordinator for International Trauma Life Support at Citizens Memorial Hospital and also serves as support staff as a Pediatric Advanced Life Support Instructor. She completed her Bachelors Degree in Science and Nursing in May of 2013. Visit her website at www.emsteacher.com.
