• Dextromethorphan: Preventing Teen Cough Medicine Abuse

    CHPA supports legislation that would prohibit the sale of over-the-counter (OTC) cough medicines containing dextromethorphan to teens under the age of 18.

    DXMKidsDextromethorphan (DXM) is a safe and effective ingredient found in more than 100 over-the-counter (OTC) cough and cold medicines. First approved by the U.S. Food and Drug Administration (FDA) in the 1950s, it is an effective, non-narcotic cough suppressant that works by raising the coughing threshold in the brain. It has no pain-relieving properties and is not addictive.

    While millions of Americans use DXM safely each year to relieve cough symptoms due to the common cold or flu, data released in December 2015 by the National Institute on Drug Abuse (NIDA) annual Monitoring the Future survey shows that approximately 3 percent of teens admit to abusing cough medicines to get high.

    To address this, CHPA has collaborated with established and trusted leaders that specialize in drug abuse prevention and community mobilization and makers of OTC cough and cold medicines containing DXM to engage in efforts aimed at curbing abuse for over a decade. We’ve highlighted the results of this case study on targeted interventions below and in a short video here.

    Federal and State Congressional Activity

    CHPA supports federal and state legislation to ban the sale of over-the-counter cough medicines containing dextromethorphan (DXM) to minors (those aged 17 or younger) and to ban the sale of raw, unfinished DXM to ensure only entities registered with the FDA – such as scientists, researchers, and manufacturers – have access to this form of the ingredient. A nationwide ban on sales of cough medicine to minors would lead to a greater decrease in the abuse rate of these medicines by teens, while also maintaining access for the millions of legitimate consumers of these products each year. To complement our educational efforts, we continue to advocate for federal legislation while we have had a full legislative agenda in the states.

    States Taking Action to Prohibit Sales to Minors

    • California became the first state to prohibit sales to minors when Governor Jerry Brown signed S.B. 514. State Sen. Joe Simitian (D-Palo Alto) sponsored the bill, which took effect January 1, 2012.
    • New York Governor Andrew Cuomo signed into law AB 933-B and SB 696-B. Sponsored by State Asm. Ellen Jaffee (D- Suffern) and Mark Grisanti (R-Buffalo), respectively. The bills took effect on March 26, 2014.
    • Arizona Governor Jan Brewer signed H.B. 2086, which was sponsored by Heather Carter (R-Cave Creek.) The law took effect July 24, 2014.
    • Louisiana Governor Bobby Jindal signed H.B. 514, which was sponsored by Cameron Henry (R-Metairie.) The law took effect August 1, 2014.
    • Virginia Governor Terry McAuliffe signed into law H.B. 505, which was authored by State Del. Keith Hodges (R- Urbanna). The law took effect January 1, 2015.
    • Tennessee Governor Bill Haslam signed S.B. 45, which was sponsored by State Rep. William Lamberth (R-Cottontown) and Sen. Ferrell Haile (R-Gallatin). The law took effect January 1, 2016.
    • Kentucky Governor Steve Beshear signed H.B. 24, which was sponsored by State Rep. Fitz Steele (D-Hazard). The law took effect June 24, 2015.
    • Washington Governor Jay Inslee signed 2S.H.B. 2163, which was sponsored by State Rep. Paul Harris (R-Vancouver). The law took effect July 1, 2015.
    • New Jersey Governor Chris Christie signed A.B. 622, which was sponsored by State Sen. Peter Barnes (D-Edison) and Asm. Paul Moriarty (D-Gloucester), Patrick Diegnan, Benjie Wimberly, Valerie Vainieri Huttle, Reed Gusciora and Shavonda Sumter, Mary Pat Angelini and Nancy F. Muñoz. The law took effect February 1, 2016.
    • Florida Governor Rick Scott signed S.B. 938, which was sponsored by State Sen. Benacquisto (R-Fort Myers) and Rep. Broxson (R-Gulf Breeze). The law will take effect January 1, 2017.
    • Alaska Governor Bill Walker signed H.B. 125, which was sponsored by House Majority Leader, Rep. Charisse Millett (R-Anchorage). The law took effect June 3, 2016.
    • Delaware Governor Jack Markell signed H.B. 329, which was sponsored by State Rep. David Bentz (D-Newark) and Sen. Nicole Poore (D-New Castle). The law will take effect June 16, 2017.

    Comprehensive Efforts to Curb DXM Abuse

    The leading makers of OTC cough medicines have also engaged in educational efforts to curb abuse for a number of years. Our efforts include:

    • Educating and engaging parents via the Stop Medicine Abuse campaign. In 2009, CHPA launched StopMedicineAbuse.org after manufacturers voluntarily placed an icon the packaging of DXM-containing cough medicines, pointing parents to the website. StopMedicineAbuse.org is the home of the Five Moms blog and a host of resources and information on prevention including free educational brochures for parents and communities. The Stop Medicine Abuse campaign is also active on Facebook, Twitter, and YouTube.
    • Leveraging the peer-to-peer influence of real moms via our Five Moms initiative. In May 2007, CHPA launched Five Moms: Stopping Cough Medicine Abuse, a parental awareness campaign that brings together five moms who work to educate other parents and spur them to action – to educate themselves, to talk with their children, to safeguard their medicines, and to spread the word to other parents.
    • Collaborating with established and trusted leaders that specialize in drug abuse prevention and community mobilization and have access to parents, educators, healthcare providers, and community leaders.

      The Partnership for Drug-Free Kids
      CHPA and the Partnership for Drug-Free Kids began joint work in 2003 to ensure that adults with influence and oversight over young people are aware that teens may be considering abusing DXM. More recently we launched a digital and social media-based intervention initiative targeting those teens actively searching online for information on how to abuse DXM.

      Community Anti-Drug Coalitions of America
      CHPA and the Community Anti-Drug Coalitions of America (CADCA), CADCA representing over 5,000 community coalitions nationwide. have developed an educational community toolkit to help coalition and prevention leaders mobilize their communities and educate key stakeholders about the dangers of OTC cough medicine abuse. Additionally, CHPA and CADCA support the designation of October as National Medicine Abuse Awareness Month and host town hall meetings nationwide with local CADCA affiliates.

      National Association of School Nurses
      CHPA and the National Association of School Nurses created Home to Homeroom, an educational program that teams parents with the medical expert in their teen’s school — the school nurse — to help prevent and address teen medicine abuse.

      D.A.R.E. America
      CHPA and D.A.R.E. America partner to educate their officers and youth advisors about DXM abuse prevention.

      Others
      Additionally, CHPA reaches out to a variety of organizations, including parent groups, education associations, health professional societies, law enforcement, the retail community, pharmacists, and others to raise awareness on the issue.

    • Directly reaching teens looking to abuse Directly reaching teens looking to abuse with provocative content that intercepts their searches to abuse cough medicine. In May 2012, CHPA joined forces with The Partnership for Drug-Free Kids to launch a digital and social media-based prevention initiative targeting those teens actively searching online for information on how to abuse DXM or chatting about abuse. We reach teen “likely triers” where they hang out online with dissuasive, peer-to-peer messaging and imagery. Our goal is to increase teen perception of risk and social disapproval, two proven ways to reduce abuse. We’ve validated the approach through extensive research and are monitoring and measuring impact.

      Elements of the teen campaign include:
      • Public service announcements
      • WhatisDXM.com
      • YouTube videos
      • Mobile app
    DXMActionCenter
    Visit the Stop Medicine Abuse Legislative Action Center
    and ask Congress to prevent teen cough medicine abuse.

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