BILL ANALYSIS
AB 1853
Page 1
Date of Hearing: March 23, 2003
ASSEMBLY COMMITTEE ON HEALTH
Rebecca Cohn, Chair
AB 1853 (Simitian) - As Introduced: January 29, 2004
SUBJECT : Dimenhydrinate: dextromethorphan: sale to minors
prohibited.
SUMMARY : Prohibits the sale, without a prescription, of a
nonprescription drug containing dimenhydrinate or
dextromethorphan to a minor. Specifically, this bill :
1)Makes it an infraction for any person to sell a substance
containing dimenhydrinate or dextromethorphan, as defined,
over the counter (OTC) without a prescription to a person
under the age of 18.
2)Provides that a violation is presumed, except under specified
circumstances, if the person making the sale does not obtain
proof of age, as defined.
EXISTING LAW
1)Establishes the Sherman Food, Drug, and Cosmetic Law, which
contains various provisions regarding the packaging, labeling,
and advertising of food, drugs and, cosmetics.
2)Specifies that an infraction is not punishable by imprisonment
and that except where a lesser maximum fine is expressly
provided, is punishable by a fine not exceeding $250.
FISCAL EFFECT : Unknown
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, minors
purchase and consume large quantities of these products (which
are also referred to as the street names DXM, robo, skittles,
Vitamin D, ex, and tussin) to produce intoxication,
hallucinations and overall disturbances in thinking, senses,
and memory. When used in the doses recommended on cough syrup
and tablet packaging, dextromethorphan is a very effective
cough suppressant. When taken at much higher doses, however,
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it acts as a disassociative anesthetic, similar to PCP and
ketamine. At high doses, dextromethorphan is also a central
nervous system depressant. Although ingesting too much cold
medicine can be just as hazardous as drinking too much
alcohol, it is legal for young people to obtain. The author
asserts that easy access to these products for kids should be
restricted.
2)BACKGROUND . According to the National Library of Medicine
(NLM), dextromethorphan is found in close to 200 brand name
OTC products, such as Alka-Selzer Plus, Children's Tylenol,
DayQuil, Vicks 44, Robitussin, Sucrets, Hold DM, and St.
Joseph Cough Suppressant and is typically used to relieve a
nonproductive cough caused by a cold, the flu, or other
conditions. Dimenhydrinate is an antihistamine, which is
commonly used to relieve or prevent the symptoms of hay fever
and other types of allergies. Antihistamines can also be used
to prevent motion sickness, nausea, vomiting, and dizziness.
The NLM lists over 60 common brand name OTC products that
dimenhydrinate can be found in, including Allegra, Dimetapp
Allergy, PediCare Allergy, Nytol, Benadryl, Claratin,
Dramamine, and Zyrtec.
3)ABUSE OF DIMENHYDRINATE AND DEXTROMETHORPHAN . When taken in
doses that exceed the amount recommended, dextromethorphan and
dimenhydrinate may produce feelings of euphoria and/or mild
hallucinogenic effects. A person may abuse OTC cough and cold
preparations that contain dextromethorphan because they are
easily available at home or the local drug store. In extreme
cases, an overdose can cause seizures, convulsions,
hallucinations, irregular heartbeats, heart attacks and death.
Internet sites dedicated to providing information and
instructions on how to use these substances for recreational
purposes. Examples of information provided include how much
cough medicine to consume, how to distill dextromethorphan
powder from medication, and how to buy the powder in bulk.
4)PREVELANCE OF MISUSE . There have been a number of local and
national news stories about teen use of OTC medicines
containing dextromethorphan. These reports highlight the ease
of access for kids and include anecdotal information regarding
overdoses of the drug. The reports also indicate that there
is a view among some health professionals that
dextromethorphan abuse is on the rise. According to the
American Association of Poison Control Centers (AAPCC), out of
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2.4 million total calls in 2002, there were 2,881 (.1%)
reported cases of abuse and misuse of medicine containing
dextromethorphan. In that same year, there was one death in
the United States that was partially attributed to the misuse
of dextromethorphan. The death occurred in a case where a
15-year-old consumed this drug along with morphine and an
unidentified antihistamine. According to AAPCC data, reported
cases of teen abuse of dextromethorphan has remained steady
since 2000. There is no data available regarding the abuse of
dimenhydrinate.
5)POLICY QUESTIONS . Dimenhydrinate and dextromethorphan are
generic ingredients that are found in over 200 OTC
medications. This bill would place the burden of regulating
the purchase of the products that contain these ingredients on
retail clerks. Can this group of employees be expected to
recognize every medication that contains these ingredients?
Additionally, there appears to be a lack of evidence
supporting the notion that the abuse of dimenhydrinate and
dextromethorphan is a widespread problem among youth. Is
there a less intrusive way to address this problem?
6)OPPOSITION . The California Retailer Association asserts that
the majority of young persons making purchases of these
products for legitimate, legal use in alleviating symptoms
will be penalized for the poor decisions of a small number of
young people. Additionally, the prohibition of sales to
minors will open up a whole new area for private attorneys to
sue and/or extract settlements. The Consumer Healthcare
Products Association contends that dextromethorphan is the
most widely used nonprescription cough suppressant and is
found in over 3,200 different types, dosage forms, brands, and
sizes of OTC medicine products. This bill limits a consumer's
ability to purchase many common and cold remedies.
7)OPPOSE UNLESS AMENDED . The United Food and Commercial Workers
has asked for amendments to protect store clerks from any
civil or criminal penalties and disciplinary action or
discharge by his or her employer.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file
AB 1853
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Opposition
Bayer Health Care
California Grocers Association
California Independent Grocers & Convenience Stores
California Retailers Association
Consumer Healthcare Products Association
United Food and Commercial Workers, Region 8 State Council
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097