Drug & Substance Guide
Over the Counter Drugs
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What over-the-counter drug abuse is
Over-the-counter drugs are medications sold without a prescription, and some of them contain active ingredients that make them likely to be abused.
More than 750,000 retail outlets in the United States sell them, and 8 in 10 consumers use them to relieve symptoms without seeing a doctor.
What makes them easy to misuse is not the chemistry. They are widely available, inexpensive and legal, with no age requirement and no limit on how much can be bought at once.
- What they are
- Medications sold without a prescription
- How widely sold
- More than 750,000 U.S. retail outlets
- How widely used
- 8 in 10 consumers
- Why misuse is easy
- Cheap, legal, no age limit, no purchase cap
Legal and harmless are different words. If an over-the-counter habit has got away from you, it is still treatable.
Although current national data doesn’t offer a full picture on the scope of the OTC drug abuse problem in America, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that about 3.1 million people (ages 12 to 25) used OTC cold and cough medicines to get high.2
Over the counter drugs are safe and effective when they are used properly as directed on the box, but when they are misused by taking higher or more frequent doses than necessary, they can cause physical harm, tolerance, dependence, or addiction.
What is OTC Drug Abuse?
OTC drug abuse has increased in recent years, especially among teenagers and young adults.2,3 Many people will abuse OTC drugs to self-medicate symptoms at home or to get high. Common signs of OTC drug abuse include:
- Mood swings
- Memory lapses
- Changes in appetite and sleeping patterns
- Lack of interest in hobbies and regular activities
- Empty medicine bottles in the trash
- Disappearing medication from the medicine cabinet
- Regular large purchases of OTC medications when it’s not necessary
The misuse of over the counter drugs can lead to serious physical health problems, dependence, and addiction. Although OTC drugs can be addictive, other prescription drugs and illegal substances are more potent. A person who is misusing OTC drugs may be more likely to move on to other drugs like prescription painkillers or marijuana in search of a stronger high.
What Are Some Commonly Abused Over the Counter Drugs?
Any use of an OTC medication that is outside of what is medically recommended is considered abuse. Here are some of the most commonly abused over the counter drugs in the U.S.
Cough and cold medicine (Dextromethorphan/DXM and Pseudoephedrine)
OTC cough medicines like Nyquil can produce a high and hallucinations when they are abused. Dextromethorphan (DXM) is an active ingredient found in cough medicines, which can also cause several harmful side effects when taken in large doses. High doses of DXM can cause:
- Nausea and vomiting
- Dizziness
- Hot flashes
- Sweating
- Lethargy
- Coordination problems
- Panic attacks
- Seizures
- Hallucinations
- Impaired judgment and cognition
- Hyperactivity
- Slurred speech
- Dissociation from body
- Increase blood pressure
- Rapid eye movement
- Skin rashes
- Racing heartbeat
- Euphoria
- Paranoia
- Disorientation
- Feelings of floating
- Altered perception of time4
The misuse of cough medicine is often called “robo-tripping,” “skittling” or “dexing.”
The active ingredient in many cold medicines, pseudoephedrine, can produce stimulant effects and hallucinations when it is abused.5 Pseudoephedrine can also easily be chemically converted to methamphetamine (meth) and crystal meth.6
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Anti-Diarrhea Medicine (Loperamide)
Loperamide is an active ingredient found in OTC antidiarrheal medicine as well as medications that treat symptoms like gas. Found in the brand name drug Imodium, loperamide can produce a high when it is taken in large doses and it is often commonly abused by those who are self-medicating for opioid withdrawal symptoms.7
Misusing loperamide can cause serious heart problems as well as other harmful side effects like:
- Loss of consciousness
- Rapid heartbeat
- Abnormal heart rhythms
- Cardiac arrest
Pain relievers (Acetaminophen)
Acetaminophen is the active ingredient in Tylenol and other OTC pain relievers. In fact, more than 600 OTC and prescription medications contain the active ingredient acetaminophen. Some people may abuse OTC pain relievers to manage chronic pain, but exceeding the daily dosage recommendations of acetaminophen can result in harmful side effects. Chronic abuse of this drug can cause:
- Nausea
- Vomiting
- Stomach cramps
- Swelling or pain in the upper abdomen
- Diarrhea
- Loss of appetite
- Sweating
- Confusion
- Liver damage
Motion sickness pills (Dimenhydrinate)
Dimenhydrinate, marketed as Dramamine and other brands, is a medication that is used to treat motion sickness and vertigo. People often abuse this OTC drug for its psychedelic effects and euphoric high. In very high doses, dimenhydrinate can cause side effects like:
- Hallucinations
- Nausea
- Ringing in the ears
- Irregular heartbeat
- Coma
- Seizures
- Death9
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OTC Drug Street Names
Certain slang terms or street names may be used to refer to some of the commonly abused over the counter medications listed above.
| Street Names/Slang Terms for OTC Drugs | |
| Dextromethorphan | DXM, dextro, drix, poor man’s ecstasy, red devils, robo, triple C, Tussin, X |
| Dimenhydrinate | Dime tabs, dime, substance D |
| Loperamide | Poor man’s methadone |
| Pseudoephedrine | Chalk, crank, meth, speed |
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What Are the Side Effects of OTC Drug Abuse?
There are many different types of over the counter drugs, so the side effects of abuse will vary greatly. However, most often, the side effects of OTC drug abuse include:
- Slurred speech
- Impaired motor coordination
- Impaired cognitive abilities
Chronic, long-term abuse of OTC drugs can also lead to:
- Memory loss
- Heart problems
- Kidney damage
- Liver damage
- Internal stomach bleeding
- Increased risk for stroke
- Increased risk for high blood pressure
- OTC drug addiction
- Death
What Are Signs of An OTC Drug Overdose?
Taking large doses of OTC drugs or mixing them with other over the counter medications, alcohol, prescription drugs, or illegal drugs can increase your risk of overdosing. Drug overdose symptoms may vary depending on the drugs that were consumed, but generally, OTC drug overdose symptoms will include:
- Nausea
- Vomiting
- Confusions
- Delusions
- Hallucinations
- Seizures
- Loss of consciousness
- Headache
- Impaired motor skills
- Bluish skin and fingernails
- Extreme drowsiness
- Sweating or chills
- Irregular heartbeat or blood pressure
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What Are Over-the-Counter Drug Withdrawal Symptoms?
Some over the counter drugs may also produce withdrawal symptoms if you abuse them regularly and then suddenly stop or cut back on your use. Depending on the drug that was abused, OTC drug withdrawal symptoms may include:
- Mood swings
- Anxiety
- Irritability
- Agitation
- Disorientation
Although a medical detox program may not always be necessary for OTC drug withdrawal, a period of medical monitoring may help to ensure the comfort of the person who is detoxing from over the counter drugs.
What Are Common Signs of Over-the-Counter Drug Addiction?
Not all over-the-counter drugs have the potential to cause addiction but some do. According to the National Institute on Drug Abuse, the misuse of OTC drugs like DXM and loperamide can lead to dependence and addiction.10 Most often, OTC drug addiction is caused by chronic, long-term abuse and can result in serious health problems, relationship issues, or problems at work or school. OTC drug addiction is also characterized by an inability to stop using the drug despite the negative consequences.
OTC Drug Rehab
After detox and OTC drug withdrawal, an inpatient or outpatient rehab program can also provide structure and ongoing support to help you kick your substance abuse habits for good.
While OTC drug detox helps to eliminate your physical dependence on drugs, it won’t address the underlying causes of your OTC drug addiction. OTC drug rehab, on the other hand, will provide helpful tools, behavioral therapy, and support so you can make positive life changes and overcome your addictive behaviors.
Most OTC drug rehab programs will consist of similar components. The most common components of OTC addiction treatment include:
- Educational lectures
- Behavioral therapy
- Recovery support groups
- Life skills development
Inpatient and outpatient OTC drug rehab programs provide varying levels of structure and support and there is also a difference in price, with residential treatment typically being more expensive.
Most OTC drug treatment programs accept health insurance benefits to reduce the cost of treatment. However, other payment options include:
- Financed healthcare loans
- Medical credit cards
- Personal loans from family or friends
- HSA funds
- Employee Assistance Programs (EAPs)
- Scholarships or grants
Sober Living After OTC Drug Rehab
Many people choose to enroll in a sober living or aftercare program after completing an OTC drug addiction treatment program. Sober living programs provide safe, structured, and sober housing for people in recovery. They also offer clean living spaces and access to a full kitchen, laundry facilities, bedding, and other essential living needs. These homes are generally gender-specific and also offer recovery support services, such as:
- Drug and alcohol testing
- Tiered recovery program
- Employment assistance
- Volunteer placement
- Educational planning
The cost of a sober living program will vary depending on its location, amenities, and program offerings, but residents generally pay a monthly fee, similar to paying for rent.
It may feel like you’re trapped by your addiction, but there is a way out and you can recover with the right support. Call today to speak with a Nova Recovery Center representative about your OTC drug treatment options. We accept most insurance.
Understanding Over-the-Counter (OTC) Drugs: Common Questions and Misuse Risks
What are examples of OTC stimulants?
Some over-the-counter (OTC) stimulants include caffeine pills, pseudoephedrine found in cold medicines, and certain weight-loss supplements. These drugs are easily available but may be misused for energy or appetite suppression.
What does OTC mean for drugs?
OTC stands for “over-the-counter.” It refers to medications you can buy without a doctor’s prescription, such as pain relievers, allergy medicines, cough syrups, and motion sickness pills.
Which drugs are OTC drugs?
Common OTC drugs include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), cough suppressants with dextromethorphan (DXM), antihistamines, and gastrointestinal medicines like loperamide (Imodium).
What is the most popular OTC drug?
Acetaminophen is one of the most widely used OTC drugs for pain and fever relief. Ibuprofen and cold medicines containing DXM are also highly popular.
What is the most commonly used OTC drug?
Pain relievers like acetaminophen and ibuprofen top the list of the most commonly used OTC drugs worldwide.
What OTC drugs can be misused?
Cough medicines containing DXM, antihistamines such as diphenhydramine, and anti-diarrheal drugs like loperamide are among the most misused OTC medications, often taken in high doses for hallucinogenic or sedative effects.
What drug is most commonly abused?
While illicit drugs lead in abuse overall, among OTC medications, DXM and loperamide are most frequently misused due to their psychoactive or opioid-like effects when taken in excess.
Is DXM an opioid?
No, dextromethorphan (DXM) is not an opioid. It is a cough suppressant found in many OTC cold medications. At high doses, however, it can produce dissociative effects similar to hallucinogens.
What type of drug is DXM?
DXM is classified as a cough suppressant and antitussive medication. It works on the brain to reduce the urge to cough but may cause dangerous side effects when abused.
Why is DXM legal?
DXM remains legal because it is effective for treating coughs and is safe when used as directed. Abuse occurs only when individuals consume large amounts outside recommended guidelines.
What is an example of an over-the-counter drug?
An over-the-counter drug is any medication you can buy in a store without a prescription, and the page notes the scale: more than 750,000 retail outlets in the U.S. sell them, and 8 in 10 consumers use them rather than see a doctor. Some contain active ingredients that make them more likely to be abused, and the page lists what makes that easy: they are widely available, inexpensive, legal, and carry no age requirement or purchase limit. Misuse can lead to dependence and addiction, and people who misuse OTC drugs are more likely to move on to prescription painkillers or other drugs for a stronger high.
Learn More About OTC Addiction and Abuse
- Dextromethorphan (DXM)
- Imodium
Pseudoephedrine
Pseudoephedrine is a decongestant. It shrinks blood vessels in the nose to relieve...
References
References:
- aafp.org: Afp
- monitoringthefuture.org: Monographs (PDF)
- cesar.umd.edu: DXM
- everydayhealth.com: Pseudoephedrine
- PubMed: 29684907
- https://www.knowyourotcs.org/ingredient/loperamide/
- regulations.gov: Document
- PubMed: 26985532
- NIDA: Over counter medicines
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