Cold and Flu Season: Take Only as Prescribed

The flu never rests. There are influenza viruses that circulate year-long in the United States, but there is a peak season. Typically cases rise in October, but the Centers for Disease Control and Prevention (CDC) has been keeping track for decades, and data shows February tends to be the big month for bugs. Out of 36 years of keeping track, February had the most flu cases for 15 of them, followed by December, with seven seasons, and then January and March, with six seasons apiece. In addition to flu, rhinoviruses — better known as the common cold — and other bugs tend to circulate each year too. This year, scientists are studying the progress of the 2019 novel coronavirus (2019-nCoV) suspected to originate in Wuhan, China, to determine exactly how it has spread. It’s thought to spread when people cough or sneeze, so covering mouths and mouths during coughing and sneezing spells, washing hands frequently, and wearing a face mask can all be helpful habits to adopt if you or anyone around you is showing signs of flu symptoms, which include:

Fever or feeling feverish/chills (not everyone comes down with a fever)
Coughing
Sore throat
Runny or stuffy nose
Body aches
Headaches
Tiredness
Vomiting and diarrhea (more common in children)

A cold differs from the flu in that cold symptoms tend to set in gradually, fevers are rare, sneezing is more common, and a mild to moderate cough can occur. Headaches, body aches, fevers, fatigue, and chills occur much more often with flu. Cold and flu season also means many trips to the doctor and drugstore for cough and cold medicine. Millions of Americans take cough and cold medicines every year, and generally it’s safe — when taken as instructed — to use such medications to provide relief for stuffy noses and nagging coughs. It also can be easy to abuse them, especially since so much is available over the counter. Too large a dose, however, or when taken when there are no cold or flu symptoms, can be problematic.

Dextromethorphan (DXM) is used as a cough suppressant in many over-the-counter (OTC) medications, but it works on the same brain receptors that hallucinogens do. Overdoing DXM can result in hallucinations, nausea, elevated blood pressure, or a lack of coordination. Too much can also make a person experience a weird feeling, like they are detached from their body.
Promethazine-codeine is a prescription cough medicine that contains the opioid codeine. Opioids tend to suppress coughs, but take too much and heartbeat and breathing levels can slow to dangerous levels.

Sometimes people mix the opioid-promethazine with soda pop and candies such as Skittles or Jolly Ranchers. Such concoctions are mainly a sweet drink and some kind of candy. The end result goes by several slang names, such as sizzurp, lean, or purple drank. Purple drank/lean/sizzurp is rumored to have started in the 1970s or 1980s, but rappers and other singers have sung about it in recent years, including Justin Bieber, singing “love is like appreciation mixed in a double cup of Sprite.” Double cups keep the drink cold and the cup from sweating. It’s not clear how often the stuff is abused. Some estimate 2 to 3% of teens overdo it, and others suggest 10% imbibe. The codeine in the mixture can affect breathing, and the promethazine can cause drowsiness. Dextromethorphan is sometimes used instead. Besides hallucinations, sizzurp can cause drowsiness, itchy skin, seizures, and dizziness. Mixing it with other substances, such as alcohol, adds to the danger, including breathing troubles, poor judgment, and delayed reaction times. If someone takes too much cough medicine, it’s best to call 911. Naltrexone may be administered if a person has ingested opioids and it can reverse an overdose, but professional help is still strongly urged. Cold and cough medicines do carry a real risk of addiction. Opioids, taken too long, can lead to a drug tolerance. Any form of drug abuse can be dangerous. Dextromethorphan and promethazine-codeine should only be used to treat cough and cold symptoms. If dosing turns into a habit, it may be best to seek treatment for addiction. Sources huffingtonpost.ca – Bieber Compares Love to Cough Syrup-Laced ‘Sizzurp’ in New Song ‘We Were Born for This’ teens.drugabuse.gov – Can You Get Addicted to Cough and Cold Medicines? teens.drugabuse.gov – Cough and Cold Medicine (DXM and Codeine Syrup) cdc.gov – The Flu Season cdc.gov – Flu Symptoms & Complications healthline.com – Lean, Sizzurp, Purple Drank — What’s It All Mean? usatoday.com – Sizzurp: What You Need to Know about Cough Syrup High

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