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It has been seven months since Misty Fetko last said good night to her son, Carl Hennon.

Fetko hasn't returned to work since then.

Nor has she stopped talking about the drugs that she believes killed him.

Fetko found out about her son's possible drug abuse on July 16, 2003. She said she knew something was wrong when she went in to wake him up. He wasn't curled up in his favorite blanket. Instead, she said, he looked relaxed, hands behind his head and legs crossed.

But he wasn't moving, and he wasn't breathing.

Fetko, a nurse, called for help and immediately began giving her son, her firstborn, CPR. Plain Township paramedics and New Albany Police officers arrived.

It was too late. Carl was dead.

The police report lists his death simply as a DOA -- dead on arrival.

The answer to what killed him is more complex. The Franklin County Coroner's autopsy lists the cause of death as an accidental overdose. His body contained toxic levels of fentanyl, a drug contained in pain patches available only by prescription.

New Albany Police officer Joe Duff said the police department still is investigating how Carl may have obtained the patch.

What was more disturbing to Duff, Fetko and Franklin County Coroner Brad Lewis is that Carl also had traces of dextromethorphan, an over-the-counter drug, in his body.

"DXM (dextromethorphan) is an anesthetic," Lewis said. "If you take enough of it, it produces a euphoric feel, hallucinations, depression of the central nervous system. It is becoming an increasing problem. There have been deaths in other states related solely to DXM and Coricidin (another cold medicine that contains DXM)."

Fetko said she now knows her son died in a way that is similar to someone who abuses heroin.

"It was basically like a heroin overdose," she said. "His brain stopped telling his lungs to breathe."

Lewis said this isn't the first time he has seen the body of a teenager who used dextromethorphan.

"I've seen a couple of people come in with toxic levels of DXM, which is available in multiple over-the-counter medications," he said.

Autopsy reports on Chris Miller of Baltimore (in Fairfield County) and Samantha James of Delaware County also showed levels of dextromethorphan.

According to newspaper reports, Miller was 17 and a senior at Watkins Memorial High School in Licking County when he was found dead Oct. 10, 2003, from an accidental morphine overdose. He had been injected with morphine at a party in Reynoldsburg while trying to get high, newspaper reports said. Besides finding dextromethorphan in his system, the report of the autopsy done by the Franklin County Coronor's office says his body contained acetaminophen, another ingredient in over-the-counter cold medicines.

James, a 15-year-old student at Delaware Hayes High School, was found dead Oct. 20, 2003, of an accidental overdose. Lewis participated in the autopsy done at Children's Hospital in Columbus. The autopsy report for James states, "In summary, the death of Ms. James was caused by the toxic effects of the multi-drug use that included morphine, dextromethorphan and chlorpheniramine maleate."

The report also states that James consumed alcohol mixed with cold medicine at a party. She was taken to Grady Hospital in Delaware County the night after the party with a rash on her chest and trouble breathing. She suffered heart failure at Grady and was revived before being sent to Children's Hospital for additional treatment.

She never left Children's Hospital, the autopsy report states.

"The problem with dextromethorphan is that it is an over-the-counter drug," said Bill Schmidt, assistant director of the Ohio Medical Board. "It probably is the most common drug used in cough suppressants. It probably should be a controlled substance requiring a prescription. But the problem is that it is not and there's no way to prevent teens from getting it.

"Taking enough of it can be fatal," he said. "But the problem is the people who are abusing the drugs, typically teens, often mix and match it with other things."

The other medications mixed with dextromethorphan can cause high blood pressure, strokes or even heart failure, according to Marcel Casavant, medical director of the Central Ohio Poison Center.

The pain patch that Carl used was dangerous enough. The fentanyl in the pain patch is a chemical used in anesthesia.

The patch contained a five-day dose of pain medication that Carl figured out how to access all at once, Duff said.

"The patch contains enough of an opiate to kill you or me. Someone who has not built up a tolerance could die just from putting it on," Schmidt said.

Duff has speculated that Carl used a piece of glass and put the patch inside. He then heated the glass with a lighter and inhaled the fumes from the patch.

Lewis could not say if only one of the drugs in Carl's system killed him. The coroner's report lists the final diagnosis as drug exposure, with levels of fentanyl, levorphanol and dextromethorphan in Carl's system.

"With that level of fentanyl in his system, he may have survived," Lewis said. "The dextromethorphan alone wouldn't have killed him. It may have contributed to his death in combination with the fentanyl. But with the dextromethorphan at that level in his system, he may not have died."

The levorphanol is a breakdown product of the dextromethorphan, he explained. Two other chemicals also found in his system - pheniramine and theobromine -- also are found in cold medicine.

Since Carl's death, Fetko, like any caring mother, has tried to find some reason for her son's death. But she also found some things she did not expect.

After his death, she searched his room. There were no needles, white powder or pill bottles.

Instead, Fetko said she found three empty bottles of cold medicine: one in Carl's bedroom, one in his car and one in a lawn waste bag.

Fetko said she also found that Carl had visited some Internet Web sites and had been sending hard-to-track instant messages to friends.

Fetko visited the same Web sites. One lists the over-the-counter cold medicines that contain dextrometh-orphan. There are warnings of side effects, a warning not to mix dextromethorphan with alcohol and information that body weight can be a factor in dosing.

But the site also provides trip reports from experimental users.

"They're cocktailing, dosing themselves," Fetko said of people who misuse the drugs. "They can take it at sleepovers, they can take it and go to school. The signs and symptoms are few. There is no hangover and, unless you find empty bottles ..."

Dextromethorphan abuse is hard to track.

Casavant said the center has received more calls about dextrometh-orphan abuse since 2000. That year, the center received 21 calls about dextromethorphan abuse. In 2003, the center received 61 calls.

But he qualified that by saying those calls do not track all cases of abuse. Dextromethorphan is not listed as a poison unless it is the only chemical in a person's system. The numbers he provided included all cough medicines that contain dextromethorphan -- but those numbers do not take into account calls from parents who say their children accidentally took too much of the medicine.

Casavant said deaths associated with dextromethorphan abuse are fairly uncommon, but the larger problem is that teens who are using cough medicine to get high are using it with other drugs.

Though calls in the Cincinnati area related to dextromethorphan abuse have declined, Earl Siegel of the Cincinnati Drug and Poison Control Center, said, "... we still see it as a trend. Teens are still drinking cough syrup and Sprite at parties.

"It still is going on and it still is a legal high that apparently is being spread through the Internet," he said.

Lewis warned that the abuse already is established by the time deaths begin occurring.

"Usually, we see this after the trend is in place and it already has been in the community for a little while," he said.

Ernest Boyd, executive director of the Ohio Pharmacists Association, said use of over-the-counter medication to get high is not a new idea. In the 1970s, for example, he said the drug of choice for many was Coricidin.

"Kids are extremely susceptible to the suggestions that something is going to make them wacky," he said.

He said very few pharmacies keep cough medicines behind the counter.

"It's an issue that's out there," Boyd said. "It's been abused by teens for a period of time now."

Pharmacists can reduce the number of bottles kept on the shelves and watch for youths buying large quantities of cold medicine. But Boyd said that does not prevent a teen from going to three different stores to buy three different bottles.

If a product is determined to cause deaths, a pharmacist can put a product behind the counter. But he said true enforcement must come from the Federal Drug Administration (FDA) or the Drug Enforcement Agency.

The DEA in Detroit did issue a safety warning in November 2003 to parents, schools and local communities about the increased abuse of dextromethorphan in that area.

No such warning has been issued in Ohio. But local officials say they are trying to spread the word about dextromethorphan abuse.

"We're trying to get the word out," said Tim Benedict, assistant director of the Ohio State Board of Pharmacy.

Benedict said the amount of cough medicine being stolen from pharmacies has increased and many pharmacists are putting the products behind the counter.

CVS Pharmacy, a chain that has one location in New Albany, hasn't pulled cold medicines off its shelves in the Columbus area.

Mike DeAngelis, spokesman for CVS Pharmacy, said the pharmacies can move medication behind the counter and monitor sales if asked to do so by local law enforcement agencies or community leaders.

"In very few stores we've had to do that," he said.

Fetko believes communication is the key. She said she spoke at Carl's alma mater, St. Francis DeSales High School, three times in 2003 and she plans to speak there a fourth time during a parent-to-parent workshop at 11:30 a.m. Jan. 31.

When parents see her, with a bottle of Robitussin DM, standing by a large photograph of Carl, they might not understand until she starts to speak.

Using the same words Carl may once have used, Fetko said she talks about "robotripping," which refers to the way youths walk with high levels of dextromethorphan in their systems. They call each other "dex," "tussin," and "syrup heads."

"Skittles," is another term that refers to the use of colored cold pills, as opposed to the candy of the same name.

She tells parents how close she and Carl were. The first time she found her son with marijuana, she said she disciplined him and asked him directly if he had a problem.

Fetko said many parents may think a child's occasional drug use is "just a phase they're going through or a rite of passage."

But she said it is not.

"He had curfews. We were in constant contact," she said. "Not a day went by when I didn't give him a kiss in the morning or a kiss at night. There were no red flags that went up. I didn't know how much he was using this or how often. I believe he was psychologically addicted. This is too new, nobody really knows about it. But the kids know."

The family was moving from one house in New Albany to another and Fetko was in the process of divorcing Carl's stepfather, who had been in his life since he was 18 months old.

But she said her son was not in trouble. He had a curfew, a steady job and lots of friends he had known since elementary school. He was a high school graduate who was eager to attend a summer art program at the Memphis College of Art.

He died two weeks before the program was to begin.

Duff said this type of drug abuse is difficult to track, but he knows there is a problem in New Albany.

"It's here. In 2002, we handled 36 cases involving some sort of illegal drug, narcotic or drug paraphernalia," he said. "In 2003 to date, we handled 44 cases involving (illegal drugs). The drugs confiscated include marijuana, cocaine, crack, LSD, ecstasy.

"These statistics do not include alcohol-related incidents," Duff said. "These are also only the illegal drugs found. The youth today are getting creative, such as robotripping (drinking large amounts of Robitussin cough syrup). This acts as artificial LSD."

Though Carl Hennon's death has been ruled an accident and the case closed, Duff has not stopped investigating the drug problem in the area. He questioned many of Carl's friends after the incident and hopes to determine how Carl got the pain patch that ultimately caused his death.

"You can see the fear in their eyes," he said. "They didn't believe you could die from this.

"This was not a suicide. Carl thought he was going to wake up in the morning. He made a bad choice."

"This is a really tough thing for parents," Lewis added, "because a lot of times these drugs are used together and rightfully so. There's nothing to see that would cause you to be worried or suspicious. I think it would be pretty hard to monitor. I think it would be pretty hard to tell (if there is abuse). There's always a bottle of cough medicine in the cabinet and it's hard to tell if it's the same one that's been there."

Duff recommends going through the medicine cabinet and tracking the use of cold medicines more closely because the signs and symptoms of abuse are few.

Even the Web sites that talk of getting high from dextromethorphan list symptoms that could be caused by other illnesses: "diarrhea, an upset stomach, dizziness or a rash." The only symptoms the sites list which could trigger suspicion still could be related to other problems or other drug use: "pupil dilation, robotic zombie-like walking and reduced agility."

Fetko did not see those things in her son. What she saw were his eyes "the color of dark chocolate, and a smile that could light up the darkness and melt the largest iceberg."

She remembers the "artistic, philosophical, very political, free-thinking and free-spirited intellectual" that she raised as she looks at his pictures and the artwork he created that hangs on the walls of her home.

Nothing can replace Carl Hennon, but Fetko said she hopes by talking about Carl and his death, she can prevent another child from making the same mistake.

"I hope that by telling Carl's story that I can touch at least one life, making a difference, protecting another kid and saving another parent the pain and the grief that I have experienced by saying their final goodbyes to their sweet kid," she said.

"Let other parents know that you want to know any information they may know about your kid's actions and choices with drugs, and let them know that you will do the same," she tells parents. "Don't be afraid to share this information. It could save a life.

"Know what drugs are available in your home. Many family members are being cared for at home now, which is another opportunity for drugs to be available in the household. ... Stay aware, alert and awake," Fetko said.

People seeking more information can contact Duff at the New Albany Police Department by calling (614) 855-7547. Anonymous tips can be directed to (614) 855-8584.

The Greater Columbus Poison Control Center also can provide information at (614) 228-1323.

Fetko also is offering herself as a resource. She can be reached through e-mail at Misty@projectghb.org.

<center>lwince@thisweeknews.com