[Congressional Record Volume 153, Number 167 (Wednesday, October 31, 2007)]
[Senate]
[Pages S13626-S13628]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN (for himself, Mr. Grassley, Mr. Durbin, and Mrs. 
        Feinstein):
  S. 2274. A bill to amend the Controlled Substances Act to prevent the 
abuse of dextromethorphan, and for other purposes; to the Committee on 
the Judiciary.
  Mr. BIDEN. Mr. President, ``Robotripping,'' ingesting large amounts 
of cough suppressants containing a common over-the-counter ingredient 
called Dextromethorphan, or ``DXM,'' is a dangerous, potentially 
lethal, threat to our Nation's children. That is why today I am 
introducing the Dextromethorphan Abuse Reduction Act of 2007, which 
takes significant steps towards countering this alarming problem.
  DXM is a cough suppressing ingredient found in many over-the-counter 
products. While DXM is safe at the recommended dosage, it can produce a 
hallucinogenic effect similar to that of PCP if ingested in abnormally 
high doses. Because many drugs containing DXM are legal and widely 
available over-the-counter, too many teens have the perception that 
they are not dangerous regardless of the amount ingested. Nothing could 
be further from the truth; overdosing on DXM can cause a rapid 
heartbeat, high blood pressure, seizures, brain damage, elevated body 
temperatures, and even death.
  Recent studies reveal troubling rates of DXM abuse. The number of 
reported cases in California has increased ten-fold since 1999 and 
experts believe that this mirrors national trends. Moreover, the 
Partnership for a Drug-Free America estimates that 2.4 million teens--1 
in 10--got high on over-the-counter cough medicines in 2005. Children 
ages 9 to 17 are the fastest growing group of DXM abusers. Indeed, the 
latest Monitoring the Future survey revealed that

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nearly 7 percent--or one in about every 14--12th graders reported 
abusing cough or cold medicines to get high during the past year. Mr. 
President, these shocking numbers speak for themselves.
  To be certain, this is not the first time we have seen the abuse of 
over-the-counter medications. As you will recall, we spent much of the 
109th Congress debating how to address the dangers posed by 
pseudoephedrine, which can be used to manufacture methamphetamine. We 
passed the Combat Methamphetamine Epidemic Act of 2005, which took the 
important step of moving medications containing pseudoephedrine behind 
the counter and closely regulating their sales. While this move was 
controversial at the time among those who believed it imposed an 
unnecessary inconvenience on law-abiding Americans, it has worked: 
domestic manufacture of methamphetamine has been reduced dramatically 
and there is no indication that people who legitimately need medicines 
containing pseudoephedrine are not receiving them.
  My bill takes two key steps to combat the abuse of medicines 
containing DXM. First, it regulates bulk DXM--the powder that has not 
been combined with any other ingredients--by placing it in Schedule V 
of the Controlled Substances Act. Cough medicine with codeine is also a 
Schedule V substance. This gives DEA the authority to monitor and 
control DXM in its unfinished form. While DXM-containing commercial 
end-products like Robitussin and Coricidin Cough and Cold will not be 
scheduled, the bill requires that any would-be purchaser of a DXM-
containing product be 18 years of age, a move that many grocery stores 
and pharmacies have already voluntarily taken.
  Second, and equally important in my view, the bill infuses 
substantial funding into efforts to raise public awareness about the 
problem of prescription and over-the-counter drug abuse, and it 
establishes coordinated efforts to educate teens and parents about 
medicine abuse. I have always said that tough enforcement efforts must 
be coupled with equally tough prevention and treatment measures. 
Prevention is a key component to solving the problem of rising medicine 
abuse, and my bill provides robust funding for educational television 
advertisements, community awareness and prevention programs, and 
targeted grants made available to local community coalitions to develop 
comprehensive strategies to reverse the rise in medicine abuse in a 
particular community.
  Senators Grassley, Durbin, and Feinstein are original cosponsors of 
the legislation. The bill is also supported by a number of retail 
organizations including the National Association of Chain Drug Stores, 
NACDS, the Consumer Healthcare Products Association, CHPA, and the Food 
Marketing Institute, FMI. The Community Anti-Drug Coalition of America, 
CADCA, and the Partnership for a Drug-Free America also support the 
bill.
  I would like to thank Senators Grassley, Feinstein, and Durbin for 
their support on this and many other important drug issues facing our 
country, and I hope all members of this body will join us in this 
effort and support this bill.
  Mr. GRASSLEY. Mr. President, I am pleased to join my colleague, 
Senator Biden, in introducing the Dextromethorphan Abuse Reduction Act 
of 2007. As senior members of the U.S. Senate, and as chairman and co-
chairman of the Senate Caucus on International Narcotics Control, we 
have seen firsthand how trends in drug abuse have changed over the 
years and we have worked to provide effective solutions to the drug 
problem whether the matter is foreign or domestic.
  Together, we have been monitoring the recent reports in the media and 
in the health community detailing new and emerging trends in drug abuse 
among teens. The reports have established that the fastest rising area 
of drug abuse among teens is the abuse of prescription drugs that are 
available in the drug cabinets of parents, family, and friends. These 
reports indicate that there is also a trend among teens to abuse 
nonprescription cough and cold medicines that are available without a 
prescription, over the counter, OTC, at pharmacies and grocery stores 
across the country. These trends highlight a new danger to America's 
youth as these products are readily available and are often times 
perceived to be safe even if used outside their intended use. We cannot 
afford to ignore this trend and need to ensure that we are doing all we 
can to protect our kids. If we don't address this problem now, the use 
of prescription drugs and OTC cough and cold medicines could become 
more prevalent than the use of traditional illegal narcotics such as 
marijuana, cocaine, heroin, and methamphetamine.
  To illustrate this point, the 2006 University of Michigan annual 
survey of U.S. adolescents found that while illicit drug use among 
teens is down, use and abuse of prescription drugs remains high. This 
includes the abuse of powerful painkillers such as OxyContin and 
Vicodin. Another survey by the Partnership for a Drug Free America 
released just last year also found similar results stating that 1 in 5 
teens admitted to abusing prescription drugs.
  These surveys also included new questions on nonprescription drugs. 
The University of Michigan survey found that nearly 1 in 14 12th grade 
students had used nonprescription drugs to get high. The Partnership 
for a Drug Free America also found that nearly 10 percent of teens have 
abused cold and cough medicines that contain dextromethorphan or DXM, 
the active ingredient in OTC cough suppressants. Taken together, these 
surveys are further evidence that abuse of both prescription and 
nonprescription OTC drugs is more common than abuse of many illicit 
drugs. As such, it is our duty to ensure that the laws on the books are 
adequate to address the new trends in drug abuse.
  Of particular concern to me is the abuse of medicines that are 
available OTC because of how prevalent these products are. Further, 
many parents may not know about the abuse of such products. For 
instance, many parents have never heard of dextromethorphan or DXM and 
are unaware that there is a problem with the abuse of this drug. For 
those unfamiliar, DXM is the main active ingredient in a number of OTC 
products, primarily in cough medicines. DXM is the active ingredient 
and is generally available in two forms, a ``finished dosage form'' and 
an ``unfinished dosage form''. Finished dosage form means a product 
contains DXM and other inactive ingredients that are approved for human 
use, such as cough and cold syrups and pills. Unfinished dosage form 
refers to the raw chemical DXM in any concentrated amount that is not 
in finished dosage form for consumption. Unfinished DXM is generally 
not available at local pharmacies and grocery stores; however, it is 
available over the Internet and finding its way into our communities. 
Because both forms, finished and unfinished, are readily available to 
teens, we need to ensure that reasonable controls are put in place to 
ensure that access to DXM is limited to those who need the products for 
true medicinal purposes.
  So why regulate DXM at all? Aside from the increasing number of teens 
abusing the product, the potential dangers are cause enough. Abuse of 
DXM produces a hallucinogenic effect similar to that of PCP or LSD. To 
get this effect, teens must often ingest large quantities of DXM and 
given the uncertain dosage to reach this hallucinogenic effect, 
overdosing on the product is a real danger. If an overdose occurs, the 
effects can include an irregular heartbeat, elevated blood pressure, 
seizures, brain damage, and even death. In fact, both the Food and Drug 
Administration, FDA, and the Substance Abuse and Mental Health Services 
Administration, SAMSHA, have posted warnings about the abuse of DXM in 
OTC finished dosage form and the unfinished dosage powdered form that 
kids are obtaining over the Internet.
  Because of these dangers that abuse and overdose pose, we are here 
today introducing legislation that will place reasonable restrictions 
on the sale of DXM. The Dextromethorphan Abuse Reduction Act of 2007 
strikes the appropriate balance of regulating access to DXM and 
products that contain DXM for those under 18 years old while making 
sure these products remain available for those who have a legitimate 
medical need.
  First, our legislation will regulate the sale of unfinished DXM by 
placing it on Schedule V of the Controlled Substances Act. This is the 
tier of the controlled substances list that currently

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regulates other forms of cough syrup that contains codeine. As a 
Schedule V product, DXM will be regulated by the Drug Enforcement 
Administration, DEA, and will allow the Attorney General to regulate 
the sale of unfinished DXM over the Internet.
  Second, the legislation provides civil penalties for retailers who 
knowingly or intentionally sell DXM in finished dosage form to an 
individual under the age of 18. This requirement will ensure that 
stores and retailers sell products containing DXM in a responsible 
manner. However, to ensure that retailers are not improperly fined, the 
bill contains an affirmative defense for those who are presented false 
or fraudulent identification. The bill also provides the Attorney 
General the authority to tier the scheduled fines to reduce the 
penalties for retailers who provide an effective employee training 
program.
  Lastly, this legislation provides vital funding to three important 
programs for the prevention of abuse of prescription and 
nonprescription drugs. The legislation authorizes funding to the 
National Youth Anti-Drug Media Campaign for education to children under 
age 18 about the dangers of prescription and OTC drug abuse. I have 
been an outspoken critic about the National Youth Anti-Drug Media 
Campaign's latest efforts; however, there is a clear need for further 
education to parents and communities across the country about the 
dangers of prescription drug abuse and the abuse of nonprescription 
drugs such as DXM. These funds should help provide an immediate impact 
in informing parents of the danger that can be found in a medicine 
cabinet at home.
  This bill also authorizes funding for the Community Anti-Drug 
Coalitions of America, CADCA, to provide education to children under 18 
about prescription and OTC drug abuse. It also creates a small federal 
grant program under SAMHSA at the Department of Health and Human 
Services to provide communities across the country funding if they 
demonstrate a major prescription or OTC drug problem and have an 
effective strategy to deal with that problem.
  This legislation is part of an ongoing effort to prevent the abuse of 
DXM, along with other nonprescription and prescription drugs. This 
legislation is supported by number of groups including the National 
Association of Chain Drug Stores, NACDS, the Food Marketing Institute, 
FMI, their member organizations, and the Community Anti-Drug Coalitions 
of America among others. I urge my colleagues to support this important 
legislation and help prevent the abuse of prescription and OTC drugs.
                                 ______