Dextromethorphan Abuse in Adolescence: An Increasing Trend: 1999-2004 | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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December 2006

Dextromethorphan Abuse in Adolescence: An Increasing Trend: 1999-2004

Author Affiliations

Author Affiliations: Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco (Drs Bryner, Wang, Hui, Bedodo, MacDougall, and Anderson), and San Francisco Division, California Poison Control System (Dr Anderson).

Arch Pediatr Adolesc Med. 2006;160(12):1217-1222. doi:10.1001/archpedi.160.12.1217

Objectives  To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends.

Design  A 6-year retrospective review.

Setting  California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004.

Participants  All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome.

Main Outcome Measure  The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases.

Results  A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43-1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets.

Conclusions  Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population.