Panel: Cough meds should stay over-the-counter

More than 8,000 ER visits linked to abuse of the products in 2008

updated 9/14/2010 7:10:37 PM ET

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WASHINGTON — A panel of medical experts said Tuesday that cough medicines like Robitussin and Nyquil should continue to be sold over-the-counter, despite increased abuse among teenagers that has prompted calls to restrict sales of the products.

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The Food and Drug Administration panel voted 15-9 against a proposal that would require a doctor's note to buy medicines containing dextromethorphan, an ingredient found in more than 100 over-the-counter medications.

The FDA is not bound to follow the group's advice, though it often does. Specifically, panelists were asked if the ingredient should be "scheduled," a regulatory move designed to decrease access to drugs with high potential for abuse.

"For me there was no data to show us that scheduling this product would decrease abuse," said panelist Janet Engle, professor and department head of pharmacy practice at the University of Illinois.

Abuse of dextromethorphan, dubbed "robotripping," is popular among teenagers as an inexpensive way to get high, but it carries risks, including elevated blood pressure, heart rate and fever. Abusers can also suffer side effects from other ingredients mixed in cough medicines, such as acetaminophen, which can cause liver damage.

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Medical complications from the behavior are on the rise with nearly 8,000 emergency room visits reported in 2008. That was up more than 70 percent from reports in 2004.

"Many teenagers are thinking that because it's a legal drug it must be safer to abuse, and that's why we're also seeing a growing trend in prescription drug abuse," said Engle, in a telephone interview with The Associated Press.

The FDA agreed to revisit how it regulates the medicines at the behest of the Drug Enforcement Agency, which suggested making them prescription drugs.

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But many of FDA's panelists said making the drugs prescription-only would go too far — creating an enormous amount of extra work for doctors and pharmacists.

Dextromethorphan products were purchased by more than 40 million U.S. households last year. Popular brands containing dextromethorphan include Wyeth's Dimetapp, Bayer's Alka Seltzer Flu Plus and Procter & Gamble's Vicks cough medicines. The drug is available in pills, gel caps, liquids and other forms.

Surveys by cough medicine manufacturers show that less than 2 percent of youngsters ages 12 to 17 reported abusing dextromethorphan in 2008, far less than those abusing marijuana or prescription painkillers.

The Consumer Healthcare Products Association supports prohibiting sales of the medicines to people under age 18. Such age restrictions require legal changes, and the industry trade association has lobbied on the issue at the state and federal levels.

Video: 'Robo-tripping' prompts possible FDA restrictions

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Transcript of: 'Robo-tripping' prompts possible FDA restrictions

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BRIAN WILLIAMS, anchor: We're back. We mentioned this at the top of the broadcast, a decision that surprised some people late this afternoon. Despite an alarming number of teenagers who are using common, over-the-counter cough medicines to get high, a government panel considering whether or not to recommend a prescription to buy them has decided that is not a good idea for now. Our own Tom Costello has more on the decision and the problem.

Unidentified Woman: Are you -- are you recording me?

TOM COSTELLO reporting: It's a teenage craze that's fueled in large part by the Internet , thousands of teens posting video of themselves robotripping, getting high on common cough medicines , like Robitussin , that contain the key ingredient dextromethorphan, also known as "dex" or " DXM ."

Unidentified Man: On DXM I feel like going beedy-beedy-beedy...

COSTELLO: Health experts say it's become a national problem, with 8 percent of all teenagers admitting they've tried it, 8,000 ER visits in 2008 , up 73 percent in four years. The symptoms of overdose can range from mild intoxication to a far more serious irregular heartbeat, seizures, loss of consciousness, even brain damage. Despite being an ER nurse, Misty Fetko never saw the signs her 18-year-old son Carl was abusing cough syrup . He died after mixing it with prescription drugs .

Ms. MISTY FETKO: I noticed an empty bottle of cough syrup in the backseat of his car; but unfortunately, by the time I had gotten to his room I discovered that he had passed away during the night.

COSTELLO: Today in Washington , an FDA panel heard testimony about the abuse of dextromethorphan.

Dr. MICHAEL KLEIN (FDA Controlled Substance Staff Director): DEA has reported to us increasing problems related to the drug's abuse.

COSTELLO: And whether cough medicines should require a prescription. But the cough medicine industry opposes that, insisting, "These medicines are very safe, abuse is low, and the harm from abuse is rare." And millions of Americans depend on the dozens of cough medicines that contain DXM as an ingredient. Already some national chains simply refuse to sell to anyone younger than 18. Late today, the independent advisory panel recommended against requiring prescriptions for cough medicines , but the decision is still up to the FDA itself. It could decide to place age restrictions on buying cough medicines . The question is whether any action would be warranted or, instead, an overreaction. Brian :

WILLIAMS: All right, Tom Costello with the very latest from our Washington bureau tonight. Tom , thanks.

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