One would have expected a deafening outcry when the American College of Chest Physicians (ACCP) released their clinical practice guidelines on the diagnosis and management of cough in the January 2006 issue of Chest.1 But oddly enough, there was nothing to hear but an overwhelming silence.
The ACCP determined that over-the-counter cough medicines do little, if anything, to actually relieve coughs. In essence, they are a sham with side-effects. Had such an announcement been made about a particular herb (or chiropractic adjustment to a particular part of the body), consumer activists and political health organizations would have been stumbling over each other in an effort to demand that the public be protected from such products (or practices).
But instead, we heard nothing ...
Why is that?
Sadly, the answer probably comes down to money.
Let's do some math to better understand: 2,3,4
- There are approximately 30 million teenagers in the United States.
- Approximately 9 percent of those teens are abusing some kind of over-the-counter drug to get "high."
- One of the more popular drugs is dextromethorphan or DXM. It effects are similar to those of PCP. It is one of the primary ingredients in most cough medicines. But in order to get high, you pretty much have to drink the whole bottle, if not a few bottles.
Assuming that the average teenage drug abuser gets high at least once a month, that could mean substantial sales to the drug companies:
30,000,000 teenagers x 9 percent x 1 bottle per month = 32.4 million bottles sold per year to abusers.
So, let's recap.
The ACCP has determined that the cough medicines being sold have no value in relieving coughs. The makers of these drugs admit that they do have serious side-effects. And one of their primary ingredients is shown to be a source for drug abuse by an estimated 2.7 million teenagers.
The obvious reaction from conscientious health officials, health care providers, consumer advocates and retail establishments would be to immediately release policies demanding that the sale and use of cough medicines be discontinued in the interest of public safety. But virtually none of these organizations has made a peep.
I call that both hypocrisy and prostitution.
What about us?
Are our chiropractic organizations willing to step up and make statements about the appropriateness of selling and using cough medicines?
Thus far, the platform is empty.
Your patients should know the truth. A patient-friendly version of this information on OTC cough medicines, titled "Treating the Common Cough: Time to Think Natural" is available online at www.chiroweb.com/cough. The article has been written in such a way that you can print it out and hand to your patients, so that they will be informed and protected. Ask your staff to hand these out or put a stack in your waiting room for the next few months.
Let's make the effort to protect our patients and encourage them to tell their friends, family and co-workers.
- Diagnosis and management of cough: executive summary. ACCP evidence-based clinical practice guidelines. Chest 2006;129 (supplement):1S-23S.
- The Partnership Attitude Tracking Survey (PATS): Teens 2004. Released April 21, 2005. Conducted by Roper Public Affairs and Media for the Partnership for a Drug-Free America; a survey of adolescents in grades 7 through 12. Total sample: 7,314 teenagers nationwide.
- Generation Rx: National Study Reveals New Category of Substance Abuse Emerging: Teens Abusing Rx and OTC Medications Intentionally to Get High. Synopsis of findings from the PATS 2004 Study.
- The survey and the synopsis of findings (references 2 and 3, respectively) are available on the Partnership for a Drug-Free America Web site (www.drugfree.org).
Click here for more information about Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher.