Although this winter seems to have been exceptionally cold, there have been bouts of warmer days which often contributes to a drawn out cold and flu season. It's hard to go anywhere - work, school, church - without hearing a variety of coughs. It's no surprise then that this is the time of year to stock up on cough medicine. What may be a surprise though is the dangers that can be associated with over-the-counter (OTC) cough suppressants.

Dextromethorphan (DXM) is approved by the Food and Drug Administration as a cough suppressant that is found in over 140 medications used to treat cold and flu symptoms. And, like most medications, when taken correctly, it produces the desired results. However, this OTC medication, when taken in large doses can produce disassociative effects similar to PCP.

DXM is the ingredient in many common cough medicines that suppresses the cough. However, when taken in large doses DXM produces serious impairments such as euphoria, dizziness, loss of coordination, and poor judgment. In some cases, overuse of DXM can result in seizures, panic attach, psychosis and brain damage.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the federal government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services. In their 2006 National Survey on Drug Use and Health, over three million people between the ages of 12 and 25 had used an OTC cough medicine to get high. The web-site Partnership for a Drug-Free America reports that 1 in 11 youth admit to using cough medicine to get high. According to the 2008 Alcohol, Tobacco, and Other Drug Survey of Montgomery County, 13 percent of local sophomores have used OTC for unintended purposes.

According to another SAMHSA study conducted in 2004, over 12,000 emergency room visits in the United States involved products containing DXM. In addition, over half of those 12,000 visits involved patients between the ages of 12 and 20. In some cases, users reported taking up to four bottles of cough syrup.

As evidenced in these numbers, use of DXM among teens is very high - because it is easy to get (just go to a local drug store) and cheap (you can buy a two-pack bottle for under $5 in some stores). Despite the risk of coma or death from taking too much DXM, it remains a popular choice for American teens. Many stores report these products are frequently shop-lifted. There are also web-sites which give "advice" to youth on how to use DXM to get high.

Parents and other care-givers need to pay attention to how much cough syrup their children are taking. Prolonged use can lead to addiction of products with DXM and withdrawal symptoms could include restlessness, muscle or bone aches, insomnia, diarrhea, vomiting, and cold flashes. Street names for DXM include Orange Crush, Triple C's, Red Devils, Skittles, Dex, Vitamin D, and Robo. These names reference the brand name of the product and/or the flavor of the product.

In addition to the dangers posed by DXM alone, many cold and flu products also contain other medications such as acetaminophen, guaifenesin, ephedrine, and chlorpheniramine maleate which can also be harmful if taken in large amounts. Some side effects of these other ingredients may be vomiting or diarrhea. However, Acetaminophen, which is community used to treat mild pain, can result in severe liver damage when taken in excessive amounts.