BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1853
                                                                  Page  1

          Date of Hearing:   April 21, 2004

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                   Judy Chu, Chair

                  AB 1853 (Simitian) - As Amended:  March 31, 2004 

          Policy Committee:                              HealthVote:11-4

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill prohibits the sale, without a prescription, of a  
          nonprescription drug containing dextromethorphan (a cough  
          suppressant in some over-the-counter cough medicines) to a  
          minor.  Specifically, this bill:

          1)Makes it an infraction, punishable by a fine of up to $250,  
            for any person, in an over-the-counter sale, to willfully and  
            knowingly deliver to a person under the age of 18 years a  
            drug, material, compound, mixture, preparation, or substance  
            containing any quantity of dextromethorphan unless the person  
            has a prescription.  

          2)Requires it be prima facie evidence of a violation of #1)  
            above if the person making the sale does not require and  
            obtain proof of age (as defined) from the purchaser, unless  
            from the purchaser's outward appearance the person making the  
            sale would reasonably presume the purchaser to be 25 years of  
            age or older. 

          3)Requires there be an affirmative defense to a violation of #1)  
            above if the defendant proves, by a preponderance of the  
            evidence, all of the following:

             a)   The person making the sale required and obtained proof  
               of age from the purchaser;
             b)   The purchaser falsely represented his or her age by the  
               use of a false, forged, or altered document; 
             c)   The appearance of the purchaser would lead an ordinary  
               and prudent person to believe that the purchaser was at  
               least 18 years of age; and
             d)   The sale was made in good faith and in reliance upon the  








                                                                  AB 1853
                                                                  Page  2

               appearance and representation of proof of age of the  
               purchaser. 

          4)Prohibits a retail clerk who fails to request identification  
            from being guilty of an infraction, subject to any civil  
            penalties, or subject to any disciplinary action or discharge  
            by his or her employer, unless the retail clerk is a willful  
            and knowing participant in an criminal conspiracy to violate  
            the provisions of this bill.

           FISCAL EFFECT  

          1)Unknown minor local costs for increased local prosecutions,  
            offset by minor fine revenue. 

          2)Unknown sales tax revenue loss, likely offset in whole or part  
            by reduced health care costs paid for by publicly-funded  
            health care programs.  There is no data on the prevalence of  
            individuals under age 18 purchasing OTC products containing  
            dextromethorphan or the publicly funded health care costs  
            incurred in treating such individuals.
           
          COMMENTS  

           1)Purpose  .  According to the author, minors purchase and consume  
            large quantities of these products (which are also referred to  
            as the street names DXM, robo, skittles, Vitamin D, ex, and  
            tussin) to produce intoxication, hallucinations and overall  
            disturbances in thinking, senses, and memory.  When used in  
            the doses recommended on cough syrup and tablet packaging,  
            dextromethorphan is a very effective cough suppressant.  When  
            taken at much higher doses, however, it acts as a  
            disassociative anesthetic, similar to PCP and ketamine.  At  
            high doses, dextromethorphan is also a central nervous system  
            depressant.  Although ingesting too much cold medicine can be  
            just as hazardous as drinking too much alcohol, it is legal  
            for young people to obtain.  The author asserts that easy  
            access to these products for kids should be restricted. 

           2)Background  .  According to the National Library of Medicine,  
            dextromethorphan is found in close to 200 brand name  
            over-the-counter products, such as Coricidin HBP, Alka-Selzer  
            Plus, Children's Tylenol, DayQuil, Vicks 44, Robitussin,  
            Sucrets, Hold DM, and St. Joseph Cough Suppressant and is  
            typically used to relieve a nonproductive cough caused by a  








                                                                  AB 1853
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            cold, the flu, or other conditions.  Sales to minors of  
            products containing dextromethorphan are not tracked by the  
            Board of Equalization, so estimates of sales tax revenue loss  
            from reduced sales are unknown.  

          Statistics from the California Poison Control System (CPCS) data  
            collection system indicate telephone consultations provided  
            for patients aged 6-17 with an exposure attributed to abuse of  
            a dextromethorphan product increased from 24 in 1999 to 284 in  
            2003, an increase of 1083%.  CPCS receives approximately  
            325,000 calls annually.

           3)Opposition  .  The California Retailer Association asserts that  
            the majority of young persons making purchases of these  
            products for legitimate, legal use in alleviating symptoms  
            will be penalized for the poor decisions of a small number of  
            young people, and the prohibition of sales to minors will open  
            up a whole new area for private attorneys to sue and/or  
            extract settlements.  

          The Consumer Healthcare Products Association contends that  
            dextromethorphan is the most widely used nonprescription cough  
            suppressant, and this bill limits a consumer's ability to  
            purchase many common and cold remedies.  Finally, the  
            California Grocers Association argues that the recent  
            amendments removing responsibility from the retail clerk make  
            it nearly impossible to uphold this law.


           Analysis Prepared by  :    Scott Bain / APPR. / (916) 319-2081