There are plenty of reasons for parents to be concerned about their teenagers abusing over-the-counter cough medicines containing dextromethorphan: Some 5 percent of teens report abusing these medicines; they are inexpensive, easy to obtain, and potentially deadly if combined with other drugs and alcohol. Here’s another yet reason for concern: I believe DXM abuse can be a precursor to abuse of street drugs and even an indicator of street-drug addiction.

In my work as the chief executive officer of a drug treatment facility specializing in rehab for teenagers, I’ve heard plenty of stories about DXM abuse. These children typically fall into one of two groups. The first is young people looking to find out what it is like to get high; the second is those teens addicted to street drugs who go back to DXM when their drugs of choice are unavailable. These addicts may even use DXM to mitigate the effects of withdrawal.

All too often, DXM abusers move on to street drugs. They seem more likely to choose those that have suppressive effects on the body, such as painkillers, marijuana, Xanax and Valium.  These have effects more closely resembling the hallucinogenic high that comes from abusing DXM.

We know that people become addicted to substances because they like the way they feel when they are under the influence. Young people certainly are not exempt from these effects, so drug abuse can and does begin at a very early age. At New Beginnings Recovery Center we’ve seen children who began smoking marijuana, for instance, at the age of 8. DXM is especially risky because it is easily available in almost every home, and relatively low in cost.

My advice to parents is not only to watch those medicine bottles. It’s to watch for changes in your children. Look for changes in attitude, behavior, interest in activities, weight, sleep patterns, school performance, in the child’s circle of friends. If you discover evidence of drug abuse involving DXM, it simply cannot be rationalized. Drug abuse is drug abuse. If this abuse is having an adverse effect on the life of the child or those around him or her, he or she may be a candidate for teen drug treatment. Make no mistake, there are clear links between DXM and street drugs, and these ties are yet another reason for parents to remain vigilant.

Johnny Patout, chief executive officer of New Beginnings Recovery Center of Seaside Healthcare in Opelousas, La., has been working in the field of addiction for nearly three decades. A Licensed Clinical Social Worker, Johnny has provided training for substance abuse counselors and is a sought-after public speaker. Himself a recovering drug addict, Johnny draws on his education, training, and past experiences to help other addicts toward recovery.