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Sept. 9, 2008 -- Snurf pills and other "herbal" euphoria-enhancing drugs are part of a surge in abuse of over-the-counter drugs by young teens, experts tell WebMD.
Today's reports of four Pennsylvania 10th-graders hospitalized after taking pink pills sold over the Internet as Snurf have parents scrambling to learn more about this little-known drug.
It's not yet clear exactly what the Snurf product actually contains. But the kids' symptoms -- and the effects reported by Snurf takers in online drug-user message boards -- point to dextromethorphan, the cough suppressant ingredient in Robitussin and other over-the-counter medicines.
Dextromethorphan, known by users as DXM, dex, or robo, is a synthetic morphine analog that lacks opioid-like effects, says Deborah Levine, MD, attending physician at New York's Bellevue Hospital Center. Levine recently published a study on "pharming," the abuse of prescription and nonprescription drugs by teens.
"It's the ninth- and 10th-graders who are doing the dex," Levine tells WebMD. "One in 10 kids in grades seven to 12 have used it. In California, they have seen a 15-fold increase in kids age 9-17."
While use of illegal drugs is down among teens, use of DXM and other over-the-counter drugs is on the rise from eighth grade onward, says Michael Windle, PhD, chair of behavior sciences and health education at Emory University's Rollins School of Public Health.
"The message isn't out there of the potential dangers of using these substances. You have a very dangerous combination of fairly easy access with absence of messages of potential harm," Windle tells WebMD.
The Pennsylvania teens may not have been trying to get DXM when they obtained the Snurf pills. Users report that the package listed its "herbal" ingredients as "Fevizia, Palenzia, and De la Amazon."
No such herbs exist, according to multiple references. Since the Pennsylvania school incident, Snurf itself is hard to find on the Internet, although it's been sold at least since 2005.
But other products listing the same ingredients -- such as Snuffadelic and Red Dawn Vector Euphoria Enhancer -- are readily available.
The "herbal" moniker may make teens think the drugs are safe or even healthful, warns Windle, leader of a landmark, 20-year study of the long-term effects of teen substance abuse.
"They say it is not illegal and that it's an herb, so adolescents may think it is actually healthy for you," Windle says. "This is a clever marketing gimmick to sell it online. You remove any guilt these adolescents may have about taking a drug."
Moreover, Windle says that since these drugs are not illegal, teens often feel that they are more acceptable to peers and even to parents than are illegal drugs such as marijuana.
Yet both the desired effects and the side effects can be devastating. At extreme doses, Levine says, DXM causes the same kinds of dissociative symptoms -- memory loss, depression, anxiety, detachment from self, sense of unreality, blurred sense of identity -- seen with ketamine, a very dangerous drug of abuse known as "special K."