CAMP FOSTER, Okinawa — With the approaching cold and flu season comes another health concern: children abusing over-the-counter cough suppressants.

Although military officials on Okinawa say they have not seen an uptick in teenagers chugging Robitussin or swallowing handfuls of Coricidin tablets to get high, it’s becoming a serious problem in the United States.

So serious that the Army and Air Force Exchange Service and Navy Exchange Service will sell dozens of such drugs only to people 18 or older.

The targeted ingredient is dextromethorphan, or DXM, which is a key ingredient in more than 140 cough and cold medicines. Taken in large doses, DXM produces an effect similar to an LSD trip.

But many of the trips turn bad. The U.S. Food and Drug Administration warns that overdosing on DXM-based cough suppressants can cause brain damage, seizures, loss of consciousness and irregular heartbeats.

There also have been reports of teenagers dying from overdosing, especially when taking the more potent tablet forms of Coricidin, called “skittles” or “red devils” because of the bright red pills’ resemblance to the popular candy.

According to the Partnership for a Drug-Free America, DXM abusers claim “robotripping” or “skittling” experiences range from mild distortions of color and sound to visual hallucinations and “out-of- body” sensations.

But the effects also can include extreme confusion, dizziness, double or blurred vision, slurred speech, hot flashes, loss of physical coordination, abdominal pain, nausea and vomiting, rapid heartbeat, drowsiness, numbness of fingers and toes, and disorientation, according to the FDA.

Many products containing DXM can be easily identified from words such as “DM” or “tuss” in the names. AAFES and NEX have about 60 DXM items on their restricted lists.

The Defense Commissary Agency has no age restriction on the cough suppressants it sells, according to a DeCA spokesman.

Two incidents of people abusing tablets of AAFES Exchange Select Cough & Cold Relief — the AAFES generic brand of Coricidin — occurred in the Kishaba Housing Area of Camp Foster over the summer, according to base residents. The incidents were not reported to military authorities and the young men involved, both older than 18, have moved back to the U.S.

In December 2003, Yokota High School officials distributed a letter to parents warning them of the dangers of DXM abuse, citing the prevalence of teens “robo- tripping” at the Yokota Teen Center. Around the same time, Seoul American High School officials reported several students had been hospitalized for overdosing.

Wally Humenick, counselor for Yokota’s Adolescent Substance Abuse Counseling Services program, said Friday that the base engages in aggressive general-prevention efforts aimed at discouraging abuse of over-the-counter medications.

In 2005, he wrote an e-mail warning AAFES about Coricidin risks. All Yokota schools participated in last month’s national Red Ribbon Week, an observance designed to remind students about the dangers of drug abuse and benefits of healthy lifestyles.

“It was a week about awareness of use of illegal drugs and illegal use of legal drugs,” Humenick said.

Off-base Japanese pharmacies carry over-the-counter medications that would require prescriptions in the United States, he added.

That includes some that contain a derivative of codeine.

Humenick, a licensed clinical social worker and licensed independent substance abuse counselor, says teenagers have gone through phases over the years in their experimentation with different substances — from “huffing,” or inhalant abuse, to laughing gas and now cough medicine.

“There seems to be a cyclical pattern when these kids are looking for things to make them feel different — but there are consequences,” he said. “It’s very dangerous, especially with the amounts these kids are taking. There’s a belief that if one is good, two is better.”

Military officials say such abuse is rare on Okinawa.

“According to the U.S. Naval Hospital, the Marine Corps Bases Japan Staff Judge Advocate’s Office, the Department of Defense Dependents Schools and the Naval Criminal Investigative Service, incidents involving the misuse of over-the-counter drugs are not at all common or a trend on Okinawa,” said Marine Gunnery Sgt. Chuck Albrecht, a Marine Corps spokesman, in a written response to a query from Stars and Stripes.

While the sale and possession of over-the-counter substances is lawful aboard U.S. installations, their use “with the intent to induce intoxication, excitement, or stupefaction of the central nervous system” is prohibited and prosecuted under military law through either nonjudicial punishment or court-martial, he said.

He added he was unaware of any such cases involving Marines on Okinawa.

Likewise, there have been no reports of legal action taken for DMX abuse against any airmen on Okinawa, said Johnathan Monroe, a spokesman for the 18th Wing.

Stars and Stripes reporter Vince Little contributed to this report.

Signs of drug abuse

The U.S. Substance Abuse and Mental Health Service Administration advises parents to watch for the following signs of their children abusing over-the-counter drugs with dextromethorphan:

Your child takes large amounts of cold or cough remedies or takes a medication when not ill.Such drugs vanish from the medicine cabinet.You find drugs containing DXM stashed in your child’s room or backpack.— David Allen

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