OTC (over-the-counter) medicines can be purchased legally without a prescription anywhere in the United States. They treat a wide variety of ailments, from the common cold to acne. Certain OTC medicines have active ingredients that hold the potential for misuse when users exceed recommended dosages. This can pose serious health problems for users, such as memory loss, kidney failure, heart problems, and even death.

This type of addiction is a lot more difficult to control, and the warning signs are not quite as pronounced as those of drugs such as alcohol or marijuana, but if you train yourself to recognize the warning signs, OTC abuse can be easy to spot. When used properly, these medicines provide relief for ailments like a cough or a headache. But they also can lead to a dangerous and deadly outcome when abused.

Several types of OTC medications can be abused such as dextromethorphan (DXM), pseudoephedrine, dimenhydrinate, and even common pain relievers such as acetaminophen. While this is a shortlist, other over-the-counter medicines can be abused.

Research has found that teens are more likely to overuse these types of drugs because they’re easy to access. While pharmacies have imposed limits and restrictions on OTC medicines to reduce destructive behaviors and chances of abuse, more awareness is needed to address the problem, including the causes behind it.

What Is OTC Drug Addiction?

According to the National Institute on Drug Abuse, over-the-counter drugs are the most commonly abused substance(s) in the United States behind alcohol and marijuana. A common misconception is that these drugs are not dangerous because they’re legal.

There is a false sense of security that comes with medicines one can buy in a pharmacy. The reality is the drugs that line the store’s shelves can be just as dangerous as any illegal drugs.

The best way to avoid over-the-counter medication abuse is to read the instructions, follow directions, and ask a pharmacist questions you may have. If you find yourself ignoring this advice, there is a possibility you could begin abusing these medicines. Any use outside of what is recommended is considered abuse.

Types Of OTC Drugs

There are several types of OTC drugs that can be abused, but the most commonly abused are:

Dextromethorphan (DXM)

Referred to as the “poor man’s psychosis,” DXM is an active ingredient cough medicine that is commonly abused and stolen from pharmacies to get high. It can cause an intense effect that is known as “robotripping.” Side effects such as nausea, vomiting, and drowsiness occur when the dosage is exceeded.


Pseudo, as it is nicknamed for short, is an active ingredient in cold medicine created to relieve symptoms associated with the common cold, such as nasal congestion and upper respiratory discomfort. This medicine is considered a stimulant, but it is widely known for shrinking swollen nasal membranes. Pseudo is a highly sought-after ingredient in the production of methamphetamine.


Dimenhydrinate is used to treat motion sickness, but has become a drug of abuse among teens. To the naked eye, this wouldn’t seem like a drug that carries the potential for misuse, but it has become a trend. While it provides adequate relief when appropriately used, dimenhydrinate can be deadly when the prescribed dose is exceeded.

OTC Drug Abuse

Over-the-counter drugs have different medical uses and effects, which can range from treating motion sickness to mild pain. Some individuals abuse OTC drugs to alleviate symptoms of anxiety or depression, which is known as self-medicating. Abusing medication, OTC or illicit, can produce euphoria and hallucinations. Any usage of OTC medications outside of what the doctor suggests or what’s on the instructions is considered abuse.

Unfortunately, someone who abuses OTC drugs is likely to move on to dangerous or illicit drugs on their search for a better high. The harmful practice can lead to a life of hardship and addiction.

Cough Medicine

Cough medicine is one of the more commonly abused substances, and it can cause hallucinations and an overwhelming high when it is abused. Cough medicine is popular because of how accessible the drugs are to young people. It is often available in medicine cabinets at home or a friends house.

The U.S. Drug Enforcement Administration (DEA) provides a list of how different doses will interact with those who abuse cough medicine, specifically DXM. The maximum daily dose is 120 milligrams, and anything beyond that can lead to dangerous side effects.

  • 100-200 milligrams produces euphoria and is mildly stimulating
  • 200-400 milligrams can cause hallucinations and a stronger euphoria
  • 300 to 600 milligrams will cause a loss of motor functions and visual distortions
  • 500 to 1,500 milligrams can cause an out-of-body experience

High Doses Of DXM Can Cause Significant Side Effects, Which Includes:

  • Blackouts
  • Slow or irregular breathing
  • Heart palpitations
  • Muscle twitching
  • High or low blood pressure
  • Increased body temperature
  • Brain damage
  • Blurred vision

Signs & Symptoms Of OTC Drug Abuse

Recreational OTC drug abuse will alter the brain’s chemistry over time. Eventually, as you’d find with all drugs, the user will start to develop a tolerance to the drug, and they require more of the substance to experience a high.

Those addicted can also develop withdrawal symptoms as a result of their use. Erratic behavior often results when someone abuses OTC drugs. Other actions that could indicate OTC addiction include:

  • Becoming withdrawn or isolated
  • Short-term memory problems
  • Changes in personality or mood
  • Slurred speech
  • A decrease in school or work performance
  • Appetite changes
  • Weight loss or weight gain

If someone you suspect of using is struggling with over-the-counter drug abuse and has any of these symptoms, you may want to consider treatment at a professional rehabilitation facility. It is imperative that OTC drug abusers are aware of how misusing these medicines can jeopardize their health. These medications are particularly hard on the liver and kidneys.

  • Changes in coordination
  • Dizziness
  • Hallucinations
  • Hair loss
  • Hot flashes
  • Blurry vision
  • Menstrual cycle irregularities

These are the hidden dangers of casual use. If the problem develops into something long-term, the risks will become even more pronounced. Long-term issues users can face include:

  • Heart problems
  • Kidney failure
  • Liver failure
  • Stroke risk

These are not the types of symptoms to be taken lightly as these can pose serious dangers in the long-term. If you or anyone you may know exhibits these warning signs, seek help immediately.

Treatment For OTC Drug Abuse

For many, getting help for OTC dependence will require going to rehab. The initial step in this process is medical detox. It is the first step in the continuum of treatment. Detox is the most intense portion of OTC drug addiction treatment. OTC drugs are not considered physically addictive. However, they do pose a psychological addiction, causing severe health problems.

Those who struggle with OTC drug addiction may engage in the use of several kinds of drugs at one time. In many cases, medical detox is recommended when more than one substance has been abused.

In any case, detox is necessary to provide stabilization during a physically and mentally difficult time. Detox rids the body of addictive substances and does it at a gradual pace, so the brain and body have time to adjust to the absence of the substances used.

Clients typically start detox with an assessment conducted by the medical staff. This process helps create a customized treatment plan. These plans may include medications to ensure your comfort during the process.

Medical professionals monitor detox clients 24 hours, seven days a week. They administer medications and ensure clients respond to treatment appropriately.

After leaving detox, clients may be placed in an inpatient or residential treatment program. To ensure full recovery is achieved, clients move into this next phase of care. Depending on the severity of the addiction, treatment can last 30 days to 90 days. This is done on a case-by-case basis.

Following inpatient/residential treatment, the person may pursue outpatient treatment or seek transitional housing, such as a sober-living home. This placement allows recovering users to transition into society in a healthy environment that promotes positivity and sobriety. Joining an alumni program connects people in recovery to supportive people who can encourage them as they rebuild their lives after addiction. Alumni programs offer outings and group activities that promote sobriety and fellowship.

The first step to a better life is accepting there is a problem, and there are trained professionals to help at every corner. If you or a loved one is abusing over-the-counter medications, sit down and talk with them about getting help now.

Over-The-Counter Drug Abuse Statistics

  • Of the 2.1 million hospital visits related to drug abuse, 27.1 percent involved the nonmedical use of pharmaceuticals (OTC medications)
  • 80,000 people visit the emergency room each year due to acetaminophen overdose; as many as 980 people die from this
  • One in  eight teenagers has abused OTC cough medicine to get high
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