BAMBERG, Germany - Parents and guardians of pre-teens and teenagers have a growing threat to contend with; one that can be found in the homes and medicine cabinets of most community members.

Known as Skittles, Tussin, Triple C, Robo and other names, run of the mill cough and cold medicines containing Dextromethorphan (DXM) are being abused by middle and high school-aged youth, and the numbers are on the rise.

The abuse of cough medicine and other legal substances by adolescents is an increasingly prevalent concern on across the United States. Warner Barracks community leaders hope to increase awareness of the issue and activate parents to further ensure prevention of this growing problem.

The Problem
According to the Center for Disease Control, "Prescription and OTC [over-the-counter] medications are widely available, free or inexpensive, and falsely believed to be safer than illicit drugs. Misuse of prescription and OTC medications can cause serious health effects, addiction, and death."

Vice Principal of Bamberg Middle High School Deena Brown has worked as an educator for 13 years and has spent 10 of those years in the Department of Defense Education Activity school system. She and other BMHS employees' concern for their students has prompted her to speak on the issue and let community members know the impact it is having.

The CDC states that the highest concentration of OTC users range from ages 12-25. The Drug Enforcement Agency claims that about 75 percent of DXM abuse cases are in adolescents ages 9-17, with a median age of 16.

"Students are starting very young," Brown said. "Parents have a certain stereotypical image of the type of child who's doing this, and there really isn't one. There is no mask, no stereotype for the child that is actually abusing these drugs. It could be your straight-A student, it could be your student that is an altar boy, it could be your student in the youth group...I think the transition into the actual (DXM) tablets has been the shocking piece."

Since products containing DXM are legal, Brown said the abuse of them is often not taken as seriously by the abuser. The side effects, including organ damage, addiction and death, are very serious.

"It's starting to reach epidemic proportionswith our youth," Brown said. "We're starting to see the repercussions of that."

In February Maj. Seamus Garrett, U.S. Army Garrison Bamberg provost marshall, said an assault on school grounds, inside a classroom, evolved into a much larger investigation after some students brought to light the distribution of substances containing DXM to minors.

The incident led to a series of interviews about the assault, Garret said, which led to the issue of minors abusing DXM products.

The MPs expanded the investigation to accommodate all the suspicious activity reported and a series of criminal occurrences, which had culminated in the sexual assault of a female student, were discovered.

The interviews revealed that an 18-year old was purchasing DXM products on post and then selling them to minors. Those involved would gather in the 5th floor attic of a stairwell building and take high concentrations of the drugs as well as consuming alcohol.

The effect of the cough and cold medicine on different kids varies," Garrett said. "If you look at the DEA website, it can cause anything from a mild high all the way up to death and it just depends on who you are. The mixing with alcohol was the second thing and then in that inebriated state, there was evidence of sexual activity up in that room."

While the nature of criminal charges against a minor on a military installation differ from those in a civilian community, there are still a number of viable punishments that can be enacted- ultimately the barring of the individual, regardless of age, from post.

Action taken against the accused could fall anywhere from community service, to removal.

"The garrison commander has the ability to remove that individual from the installation and that can cause exceptional hardship," Garrett said. "He can decide to EROD (Early Return of Dependant) you back to the United States and that's it. It's a hardship on the family and the family gets split up."

The investigation came to a close in March, and resulted in the charging and removal of several kids from post, Garrett said.

Addressing the Issue
The question of responsibility is complex and multi-faceted.

The CDC states that, "Behaviors of young people are influenced at the individual, peer, family, school, community, and societal levels. Because many societal factors contribute to adolescent health, safety, and well-being, a collaborative effort engaging multi-ple partners and sectors if necessary."

Brown feels that tackling the problem head on and putting time and energy toward a successful awareness campaign, are key to lowering the numbers.

"What we've actually taken is the awareness approach," Brown said. "Our school nurse has been doing mini-sessions with each class to talk about what these things are and what can happen to you, the impact. WeAca,!A,ve actually worked harder on educating, not only the students but our staff on what to look for, what types of behaviors to expect."

The school has an Alcohol and Substance Abuse Counselor, behavioral health specialist and an Military and Family Life Consultant on hand as well.

"Now that the awareness has increased I think we will start to see a decrease in the usage and also an awareness in educating our youth about the impact that this has on the body; the lasting consequences of abusing these types of products," Brown said.

Outside of the school, several organizations are actively contributing to what Brown calls the "three-pronged approach of home, school and community." These organizations include the commissary, the JFK Teen Center and garrison officials such as the MPs and members of the Command Group who have come to speak to students.

Internal resources include the school's weekly bulletin, newsletter and support programs for students with a deployed parent. Middle school students are invited to take part in lunchtime meetings and older students can speak with the counselor on staff as well as become involved in the Student 2 Student program, an initiative to provide peer support to students in transition.

"We'd welcome any additional ideas or support so that we can actually be there and be that bridge for our students," Brown said. "This should be a safe haven for them."

Brown said that the school has an open line of communication with the MPs and the Command Group, to further educate Bamberg youths through discussion and awareness of the legal ramifications of involvement with abuse of DXM and other substances. Units can also make an impact by putting out information to the parents and commanders so that it trickles down and people are more aware.

The commissary has also implemented a red flag system to monitor the age of any individual purchasing medications containing DXM.

The system, implemented in the middle of 2008, prompts the cashier as soon as the product is scanned to verify that the customer is over 18, said Peter Hartley, Bamberg Commissary front-end manager.

"The cashier cannot proceed with the rest of the order until they have verified in the system that the customer is of age," Hartley said. "The registers will ask the cashiers for a quantity input. This allows the cashier to be aware of large purchases and if need be to report suspicious purchases to their supervisor."

Another form of increased awareness will be headed by the MPs, who just rolled out there seasonal bike patrol this month.

"There is increased visibility," Garrett said. "ItAca,!A,s easier to get around to certain areas and we can hit every single part of every housing area on post within one eight-hour shift."

Though it's difficult to recognize what type of student will abuse drugs, Brown said external factors like peer pressure, personality and home life play a large role in drug use in her opinion.

"I've observed certain students that I know are struggling with these challenges," she said. "I also know that within their family dynamics there are some other things that are going on with them. Some students have more addictive personalities, whether they're in middle school or high school; those students who have additional emotional stressors...are looking for escape."

Brown said there are currently some middle school students receiving assistance in con-quering addictions to these substances.

"I think as the stressors have impacted our students, they've included high populations of deployments where oftentimes parental supervision is limited," Brown said. "There's a little bit more freedom because the concept of safety is there."

While working through the recent investigation, Garrett found parents to be supportive in some cases.

"Some believed that there was no way that their child would be involved in something like this and then some just didn't understand the context of the problem," Garrett said. "If you do look in your kid's room and you're looking for pot and you don't notice that you're missing cough and cold medicine out of your medicine cabinet, then you're not seeing the whole picture."

Though the confined nature of an overseas military facility and the stress of high deployments and single parents homes weigh in, a civilian communities in the United States are suffering from this same issue. Parents should be aware of it no matter where they are stationed. Military facilities also have the unique opportunity to draw on multiple resources to address and rehabilitate the problem.

The Bamberg community is pulling together to do just that.

"It's something that we always take seriously and all of us need to be on board," Brown said. "The motto is one vision, one mission, one community. That's our purpose."