Illegal drugs are not the only substances with the potential for abuse. Over-the-counter (OTC) drugs have become more popular substances of abuse than controlled substances such as cocaine. The National Institute of Drug Abuse says that only alcohol and marijuana are abused more in the United States than over-the-counter medications. OTC drugs are often perceived as safer than street and prescription drugs. They can, however, have unpredictable consequences when taken in different dosages than indicated, when combined with other substances like alcohol, or if the person does not have symptoms indicated for legitimate use.
Pain relievers, cold medicines, tranquilizers, and depressants are among many drugs that can be purchased without a prescription. While it’s up to the U.S. Food and Drug Administration to decide if a particular medication is safe to sell in this way, many OTC medications can interact with other drugs, foods, and drinks, and lead to complications in people with certain health conditions. In addition, some substances people buy over the counter can be habit-forming.
Cold Medicine: A Blessing or a Concern
A study sponsored by Drugfree.org and the Metlife Foundation in 2011 found about one in three teens knew someone who abused cough medicine for recreational purposes. Cold and cough medicines are among the most commonly abused OTC products, including those containing dextromethorphan (DXM). One can obtain DXM in tablet, gel, or syrup form. According to Foundation for a Drug-Free World, over 100 products sold in drug stores have DXM in them. These include popular cold and cough medicines, such as Robitussin and Nyquil.
Effects of abusing DXM include euphoria, visual hallucinations, and distortions of color and sound. High doses can lead to euphoria too. In powder form, the composition and dose are less certain, and the effects can range from dizziness and slurred speech to sweating, high blood pressure, and liver and brain damage. Physical dependence is possible if one abuses the substance for long enough. Withdrawal symptoms, such as depression and difficulty thinking, are possible as well.
Other Over-the-Counter Drugs of Abuse
- Caffeine pills: Medicines with caffeine are often taken for the boost of energy they can provide. Some pain relievers have caffeine in them. Also, people have been known to put a caffeine pill in an energy drink to speed up its effects. Unintended consequences can cause dehydration, panic attacks, heart issues, and gastric reflux disease associated with consuming high doses of this substance. Although caffeine isn’t addictive like cocaine or alcohol, regular consumption can lead to increased tolerance, according to the Palo Alto Medical Foundation.
- Diet pills: A person can get a buzz if they take these in high enough doses. There are stimulants in diet pills, such as bitter orange, that can also cause extreme nervousness, rapid or irregular heartbeat, heart failure, and stroke. Bitter orange can mimic ephedrine, a substance banned by the U.S. Food and Drug Administration. Other ingredients can cause digestive, sleep, kidney, and a host of other medical problems; even natural diet pills, especially ones with ephedra, can have side effects if not taken as indicated.
- Motion sickness medicine: High doses of pills with dimenhydrinate or diphenhydramine can give an individual a high. The sensation can sometimes be as intense as with a street drug. Hallucinations are also possible. Body weight and a person’s tolerance to the medication affect how the symptoms present. Many people are unaware of the damage they can do to their bodies. In high doses, Dramamine can cause a heart attack and, if abused over the long-term, may cause depression and damage to the liver and kidneys.
- Laxatives or herbal diuretics: Young adults sometimes use over-the-counter laxatives with the intention of losing weight. Herbal diuretics may dehydrate the body as badly as laxatives can. One may also lose the minerals and salts needed to maintain a healthy balance of water, which can affect muscle function and blood acidity.
- Pseudoephedrine: This nasal decongestant is one of the leading over-the-counter drugs abused by teens and young adults, per ConsumerMedSafety.org. It is an ingredient in many cold medicines and sometimes used as a stimulant. People have acquired it to lose weight and boost their energy, despite stores being legally required to keep the drug behind the pharmacy counter.
- Herbal products: These include herbal ecstasy, a legal product that combines several herbs that can bring on euphoria and heightened awareness. In addition to swallowing it, people also smoke or snort the substance. Salvia is an herbal product that can trigger hallucinations, as can nutmeg when processed into a paste and eaten.
- Pain pills: Over-the-counter pain-relieving medications are often self-administered in higher doses so they take effect sooner. Acetaminophen, a common pain reliever, can cause liver failure in high doses. Excessive doses of ibuprofen may lead to kidney failure, stomach bleeding, and heart problems.
Treating Addiction to Over-the-Counter Drugs
Information published by the Journal of the American Board of Family Medicine reveals OTC drugs, in addition to being easily purchased, may be used as substitutes for primary addictive drugs when a person no longer has access to those primary substances. Also, these medications are not easily found by routine drug tests.
The methods of treatments and medications used to treat addiction to over-the-counter drugs vary depending on the substance abused by the individual. Identifying the signs of addiction sooner can possibly avoid some of the social, physical, and mental consequences of long-term abuse. The sooner one receives help, the sooner they can be on the road to recovery. Some of the warning signs of over-the-counter drug addiction, according to North Country Prenatal/Perinatal Council, Inc., include:
- Changes in mood, behavior, and personality
- Frequent, visible use of a particular medication
- Changes in the individual’s appearance
- A constant need for money
- Family or friends noticing cash is missing
- Letting go of favorite personal activities in favor of drug abuse
- Forgetting about responsibilities
- Problems at school, work, or home
As with all addictions, the first step in treating OTC drug addiction is to make the individual aware of the problem. Sometimes, a simple conversation can be all that’s needed to push an individual toward treatment. In other instances, loved ones may need to stage a full intervention.
Once an individual agrees to get help, the treatment plan will be individualized to meet the needs of the particular client. Medical detox may be needed, depending on the drug used. Even if withdrawal symptoms aren’t intense, supportive care will be given during detox. Therapy makes up the bulk of addiction treatment, and Cognitive Behavioral Therapy is often administered to help change the thought and behavioral patterns that contribute to substance abuse.
Prevention of OTC Drug Abuse
Over-the-counter drug abuse can be prevented by only using the medicine for the symptoms or conditions it is designed to treat, in the right doses. All OTC drugs should only be taken in the manner intended; those who crush, snort, or inject the drugs are abusing them. Also, most over-the-counter medications should not be taken with alcohol. Doing so can increase the risk of adverse effects.
Experts recommend that parents talk to their teenagers about the dangers of abusing OTC medications. They can track the websites teens frequent and look out for the warning signs, such as viewing sites on cough medicine for long periods of time. Parents can also set rules for not sharing medicines, monitor pill quantities and access in their home, and discard old or unused pills.
Abuse of over-the-counter drugs remains a major concern, but awareness seems to be getting out. The University of Michigan’s Monitoring the Future study found, from 2006 to 2014, abuse of cold and cough medicines by 8th, 10th, and 12th graders decreased from 4 percent to 3.2 percent. Even so, individuals of all ages need to be aware of the potential consequences of taking over-the-counter medications in ways they were not intended.