title: "Pharming": the abuse of prescription and over-the-counter drugs in teens.
abstract: OBJECTIVE
  Prescription and over-the-counter cough and cold medication abuse is rapidly becoming a national health concern for adolescents. Increased awareness of this growing epidemic is essential toward diagnosing, treating and preventing this type of substance abuse.
  
  
  RESULTS
  Data from surveys and poison control center records demonstrate an increased nonmedical use of prescription and over-the-counter cough and cold preparations, particularly those containing dextromethorphan. The nonmedical use of prescription medications may result in serious clinical effects with potential life-threatening complications, dependence and withdrawal syndromes. Dextromethorphan causes alterations in mental status that may contribute to judgment impairment leading to injury or fatality. Co-ingestion of other substances found in over-the-counter medications may also cause significant morbidity. Alcohol and illicit drug use is highly associated with the abuse of these medications. The incentive for abuse, such as easy accessibility, low cost and decreased perception of potential for harm, and potential interventions are described.
  
  
  CONCLUSIONS
  The recent trend of prescription and dextromethorphan-containing over-the-counter medication abuse in adolescents is alarming. Improved awareness for these readily available, seemingly benign yet highly dangerous medications is essential. Prevention and early education on substance abuse in young teens are critical in combating this recent epidemic.
authors.affiliation: Department of Pediatrics, Bellevue Hospital Center, 27th Street and First Avenue, New York, NY 10016, USA. MLevine336@aol.com
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Levine
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D003915:Dextromethorphan / Q000009:adverse effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D004366:Nonprescription Drugs / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000628:therapy
chemical_list: D000701:Analgesics, Opioid; D000697:Central Nervous System Stimulants; D006993:Hypnotics and Sedatives; D004366:Nonprescription Drugs; D003915:Dextromethorphan