Doctors and experts have grown alarmed about the sudden increase in emergency room visits among teens and 20-somethings who have seemingly overdosed on pharmaceutical medications.

The Metropolitan Police Department conducted three roundups late at night on weekends between Dec. 2 and 17 in the area known as “Toyoko” in Kabukicho in Tokyo’s Shinjuku Ward.

A total of 29 boys and girls between the ages of 12 and 19, including an elementary school student, were detained in accordance with the Tokyo metropolitan government’s Ordinance Regarding the Healthy Development of Youths.

Of the 29, 20 were residents from outside Tokyo, coming from the Kanto region and the prefectures of Ishikawa, Kyoto, Okayama and Hiroshima.

Several were found in possession of multiple over-the-counter drugs, which police believe they intended to abuse.

Police have confirmed illegal trafficking of cough medicines and other drugs for illicit purposes in the Toyoko area, which surrounds the Shinjuku Toho Building, a landmark commercial complex that has a movie theater, a hotel and restaurants and is known for the distinctive Godzilla-head sculpture that looms over it.

EMERGENCY ROOM VISITS ON THE RISE

In a joint survey, the Fire and Disaster Management Agency of the internal affairs ministry, together with the health ministry, found that emergency room visits likely caused by pharmaceutical drug overdoses are rapidly increasing among people in their teens and 20s.

Last year, compared to 2020, the number increased by 1.5 times for teenagers and 1.2 times for people in their 20s, and this year as well, the numbers (recorded up until the end of June) are increasing at a faster pace than last year.

This increase in overdoses is believed to be due to an increase in the abuse of easily available over-the-counter drugs.

Fifty-two fire departments, representative of each prefecture, responded to the survey.

A total of 10,682 people were transported to emergency rooms for suspected drug overdoses in 2022, an 11 percent increase from 2020. Women accounted for 75 percent of these patients.

Breaking down the suspected overdose patients in 2022 by age group, 1,494 were teenagers, up 47 percent from 2020. This year, the number had reached 846 by the end of June.

In 2022, 3,295 patients were in their 20s, a 21 percent increase, and 1,820 were in their 30s, a 2 percent rise.

The survey did not distinguish between prescription drugs and over-the-counter medications.

REGULATIONS TIGHTENED

Physician-prescribed sleeping pills and anti-anxiety medications have been commonly abused by adults.

On the other hand, over-the-counter medicines such as cough and cold remedies have recently become popular among young people.

In response, the health ministry’s study group approved a measure to strengthen regulations on the sale of over-the-counter medications containing ingredients designated as “drugs with a risk of abuse” on Dec. 18.

Under the measure, the sale of regulated medications to customers under the age of 20 will be limited to one small unit of the product only, either in person or online via a video image and voice request.

Discussions will begin next year to revise the system.

However, only six ingredients, such as codeine, have been designated as drugs of potential abuse. Dextromethorphan (DXM) and acetaminophen are not included.

In reality, though, there have been a number of overdose cases linked to unregulated ingredients, resulting in deaths.

THREE-DAY COMA

In March, a woman in her 20s was brought to the emergency room of Yokohama City Minato Red Cross Hospital. She was in a deep coma, her pupils dilated and her entire body was in a state of convulsions. The staff members were tense, fearing that the patient might be brain dead.

Emergency crews found a total of 1,430 empty pill packets in the woman’s home. Most of the pills, 1,352, were over-the-counter cough medicines containing the ingredient DXM.

Three days later, the woman regained consciousness and said that she had bought the large quantity of pills “at one pharmacy and took them all at once.”

DXM acts on the central nervous system to relieve coughing. It went on the market in August 2021. It comes in a small, easy-to-swallow tablet about 5 millimeters in diameter and 2 mm thick.

DOCTORS AND COMMUNITY ACTIVISTS ALARMED

In the span of a year and two months until May this year, 26 people from ages 15 to 33 were rushed to the emergency room of the National Center for Global Health and Medicine in Shinjuku Ward with acute poisoning from DXM.

Last winter, a 21-year-old man died at Kouseiren Takaoka Hospital in Takaoka, Toyama Prefecture, after overdosing on this drug, apparently purchased at multiple local pharmacies.

Doctors who saw these patients said, “Many people overdose on this drug because it is easier to obtain than illegal drugs,” urging the authorities to establish a system and environment to make these medications more difficult to abuse.

The abuse of over-the-counter drugs among young people is a serious problem.

According to a survey conducted in fiscal 2021 by the health ministry's research group, in which about 45,000 high school students nationwide responded, 1 in 60, or 1.6 percent, had abused over-the-counter drugs in the past year to “change their mood.”

Masanori Amano, who heads a public interest incorporated association called Nippon Kakekomidera, which offers support to troubled youth in the Kabukicho district, said the 1-in-60 figure “sounds about right, reflecting what has been going on in the Toyoko area.”

“They are taking drugs with surprising ease, just like adults drinking alcohol,” he said.

Amano pointed out that tightening the regulations will not be enough to solve the problem.

“Even if you regulate sales, there are loopholes, and the children who want (drugs) will try to get them any way they can.”

Amano added, "Children who are taken to the emergency room because of an overdose may be cured physically, but they are not cared for emotionally. Adults should be involved in providing care and education to prevent overdoses."

(This article was written by Akiyoshi Abe, Kazuhiro Fujitani, Shoko Mifune and Junji Murakami.)