BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 514|
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                                 THIRD READING


          Bill No:  SB 514
          Author:   Simitian (D)
          Amended:  5/10/11
          Vote:     21

           
           SENATE PUBLIC SAFETY COMMITTEE  :  6-0, 5/3/11
          AYES:  Hancock, Calderon, Harman, Liu, Price, Steinberg
          NO VOTE RECORDED:  Anderson

           SENATE APPROPRIATIONS COMMITTEE  :  6-0, 5/23/11
          AYES:  Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
          NO VOTE RECORDED:  Walters, Emmerson, Runner


           SUBJECT  :    Dextromethorphan:  sale to minors prohibited

           SOURCE  :     Author


           DIGEST  :    This bill (1) enacts a new crime, punishable as 
          an infraction, for any person, retailer, corporation or 
          retailer to willfully and knowingly provide dimenhydrinate 
          or dextromethorphan (DXM) to a minor in an over-the-counter 
          sale without a prescription, as specified; (2) presumes 
          that any transaction in which the defendant failed to check 
          the identification of a person who did not appear to be at 
          least 25 years of age violates this new crime; (3) allows 
          an affirmative defense where the seller demanded and 
          reasonably relied on apparently valid proof of the 
          purchaser's age, as specified; (4) provides that a retail 
          clerk is not criminally or civilly liable unless the clerk 
          was a willful participant in an ongoing criminal conspiracy 
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          to violate this new crime; and (5) requires a seller of 
          over-the-counter DXM to use, if feasible, a cash register 
          equipped with an age verification feature, as specified.

           ANALYSIS  :    Existing law specifies that an infraction is 
          not punishable by imprisonment.  A person charged with an 
          infraction is not allowed a jury trial.  Indigent 
          infraction defendants are not entitled to counsel at public 
          expense.  (Penal Code Section 19.6.)

          This bill makes it an infraction for any person, 
          corporation or retailer to sell a substance containing 
          dimenhydrinate or DXM, as defined, over-the-counter without 
          a prescription to a person under the age of 18.

          This bill provides that a violation is presumed if the 
          seller does not obtain proof of age, as defined, unless the 
          purchaser appears to be over the age of 25.

          This bill provides that "proof of age" means a photo 
          identification that includes the person's name, description 
          and picture that was issued by a government entity, as 
          specified. 

          This bill includes the following affirmative defense:

                 The seller required and obtained identification 
               from the purchaser establishing that he/she was an 
               adult proof of majority from the purchaser.
                 The seller reasonably relied on the identification.

          This bill provides that a retail clerk who fails to require 
          and obtain proof of age from a DXM purchaser shall not be 
          guilty of an infraction or subject to a civil penalty.

          This bill provides that a clerk's immunity from liability 
          does not apply if the clerk is participating in an ongoing 
          criminal conspiracy to violate the prohibition created by 
          this bill.

          This bill provides that a seller of DXM shall use, if 
          feasible, a cash register with a feature directing the 
          person selling the product to obtain proof that purchaser 
          is at least 18 years of age.

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          DXM is the active ingredient found in many over-the-counter 
          cough and cold medications.  DXM is found in more than 140 
          brand-name products such as Coricidin, Robitussin, and 
          NyQuil, and are sold over-the-counter in grocery stores, 
          pharmacies, and other retail outlets. Individuals who abuse 
          DXM in excessive amounts refer to DXM as robo-tripping, 
          skittling, dex, or candy.  While safe when taken at the 
          recommended dosage, products containing DXM can produce 
          "hallucinations and dissociative, outofbody experiences 
          when taken in larger amounts.  The California Poison 
          Control System reports that DXM has been the most commonly 
          abused substance reported in abuse calls received over the 
          past decade from patients aged 6-17 years.

          This bill prohibits the sale of a non-prescription drug 
          containing DXM to a minor.  Any person, corporation, or 
          retail distributor that knowingly supplies, delivers, or 
          gives possession of any product containing DXM to a minor 
          is guilty of an infraction punishable by a fine of up to 
          $250.  The creation of a new crime will result in 
          non-reimbursable local enforcement costs offset to a minor 
          degree by fine revenue.

           Comments
           
          Statistics from the CPCS indicate that of the 228 cases of 
          DXM abuse reported by minors in 2010:

                 71 percent were treated in an emergency room.
                 4 percent were admitted to the hospital intensive 
               care unit.
                 4 percent were admitted to the hospital in a 
               non-critical care unit.
                 6 percent refused referral to a hospital.
                 2 percent were treated at home. 
                 13 percent were lost to follow up.

          It should be noted that calls to the CPCS do not constitute 
          the universe of DXM abuse cases.  There are likely a number 
          of minors who abuse DXM but do not come to the attention of 
          the CPCS.  Based on this information, to the extent the 
          prohibition of sales of DXM to minors results in fewer 
          cases of abuse and subsequent medical care, there would be 

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          potentially significant future health care cost savings.  
          The amount of publicly-funded health care costs incurred 
          for treating minors specific to DXM abuse is unknown, but 
          could be significant.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  Yes

          According to the Senate Appropriations Committee analysis:

                          Fiscal Impact (in thousands)
           Major Provisions                2011-12     2012-13    
           2013-14   Fund  
           
          Reduced health careUnknown; potentially significant        
          Fed/General/
          costs                    cost savings                  
          Local

          Sales tax loss                                    Unknown; 
          sales tax revenue loss of                         General
                              $50 per $1,000 in retail sales to 
          minors

          New infraction                                    Unknown; 
          non-reimbursable local                            Local
                              enforcement costs offset to a minor
                              degree by fine revenue

           SUPPORT  :   (Verified  5/24/11)

          American College of Emergency Physicians, State Chapter of 
          California
          California District Attorneys Association 
          California Peace Officers Association
          California Pharmacists Association 
          California State Board of Pharmacy
          California Police Chiefs Association
          Center for Healthier Communities at Rady Children's 
          Hospital, San Diego
          Consumer Healthcare Products Association
          DXM: 18 and Over-the-Counter Coalition
          Full Circle Treatment Center 
          Junior Leagues of California SPAC

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          Junior League of Palo AltoMid Peninsula
          Palo Alto Peace Officers' Association
          Palo Alto Police Department


           ARGUMENTS IN SUPPORT  :    According to the author's office, 
          ingesting too much cold medicine can be as hazardous as 
          drinking too much alcohol.  It is cheap, easy and legal for 
          children to obtain.  The California Poison Control System 
          reports that DXM abuse calls have increased more than 850 
          percent in the last ten years.  This problem is serious and 
          widespread.  One in ten teenagers say they've used DXM to 
          get high making it more popular than LSD, cocaine, ecstasy 
          or meth.  The fact that DXM is legal and readily available 
          over-the-counter, suggests to young people that DXM is 
          safe.  Indeed, that false sense of security has been 
          identified as a contributing factor in abuse.  Age specific 
          limitations will help communicate to teens and their 
          parents that there are serious consequences associated with 
          inappropriate use. 

          The DXM: 18 and Over-the-Counter Coalition argues in 
          support:

             Dextromethorphan (DXM) is an active ingredient in 
             more than 140 cough and cold medicines sold 
             over-the-counter in grocery stores, pharmacies and 
             other retail outlets.  When taken as recommended, 
             products containing DXM are safe and effective in 
             suppressing coughs.  However, 5% of American teens 
             (an estimated 400,000 in California) endanger their 
             lives by abusing DXM through consuming medicines in 
             excessive doses to get high.  Abusers, who ingest 
             8-20 times the recommended therapeutic dose, risk 
             serious complications that can include seizures, 
             brain damage, liver damage and death in addition to 
             the dangers associated with mental disassociation.

             Teens who abuse DXM believe it's a "safe high" 
             because it's legal and easily available in the same 
             stores that sell gum and soda.  Street names like 
             Skittles, Velvet and Red-Devils imply light-hearted 
             fun.  Minors are not aware that the dangers multiply 
             when DXM is abused with alcohol, prescription drugs 

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             or narcotics.  Consequently, between 2004 and 2007, 
             emergency room visits associated with DXM abuse rose 
             70%, raising concerns about public safety and 
             associated healthcare costs.  The solution is that 
             proposed by SB 514: Prohibit the sale, without a 
             prescription, of over the counter medicines 
             containing Dextromethorphan to a minor.


          RJG:do  5/24/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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