Over-the-counter drugs, commonly called OTC drugs, are prevalent, easy to obtain, and easy to use. They are also easily misused and abused for those who want a quick “legal” high. But that high comes with some hazardous withdrawal symptoms that can sometimes be fatal.
OTC medications can be purchased without a prescription. They include cold and cough medicine, diet pills, diarrhea, and constipation medicine.
There are ingredients in them that can wreak real trouble for the body if taken in greater amounts than recommended.
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OTC drugs are not safer to use than prescription drugs to get high. This is a common myth.
Most Commonly Abused OTC Medicines
The top two most abused OTC drugs are DMX (dextromethorphan) and loperamide.
DXM is found in extra-strength cough medicines. It can be swallowed in its usual form (cough or cold syrup, capsules) or mixed with soda for flavor in what users call “robo-tripping” or “skittling.” There are those who inject it also, and it is usually taken at parties where marijuana and alcohol are available.
When too much is taken at once, it can have a depressant effect and sometimes a hallucinogenic effect. Users have reported a range of experiences from feeling like they are looking outside at their bodies to loss of motor control. People who abuse it might also feel agitated, paranoid, and/or aggressive.
Loperamide is an ingredient in anti-diarrheal medication that comes in tablet, capsule, or liquid forms. It is usually taken in large quantities when being abused and acts like an opioid giving the user a euphoric feeling.
Other OTC drugs that are available with some degree of ease are:
Pseudoephedrine – An ingredient in nasal decongestants sold as small tablets in blister packs. It is usually sold behind the counter in pharmacies. It is a highly sought ingredient in making meth. However, the Combat Methamphetamine Epidemic Act of 2005 banned the sale of any anti-decongestant medicine that included pseudoephedrine for that reason. The Act limits how much can be sold, requires ID to purchase it, and pharmacies must keep a log of those who buy it.
Dimenhydrinate – It is found in motion sickness OTC drugs like Dramamine™. When taken in high doses, it can cause delirium, psychotropic visions, and hallucinations. People who abuse it can also experience confusion and amnesia. Motion sickness medicine can be bought in pharmacies, grocery stores, and convenience stores. It is very easily accessible for people who need it for legitimate reasons and those who want to get high.
Diphenhydramine – This is an antihistamine found in anti-itch medicine like Benadryl and sleep aid medicine such as ZzzQuil™. Both OTC medicines are known to cause drowsiness. People who abuse medicine with this ingredient might experience mild euphoria. If someone stops taking it suddenly, they could have worsened sleeplessness, a runny nose, irritability, restlessness, abdominal cramps, sweating and/or diarrhea.
Withdrawal Symptoms from OTC Drugs
Withdrawal symptoms from OTC drugs will vary in intensity depending on the user’s age, personal health, dosage amounts taken, length of time taken, and the OTC drug taken. If someone has been abusing these medicines for a while, they might encounter these physical and psychological symptoms:
- Strong cravings for the drug
- Increased anxiety
- Mood changes
OTC Withdrawal Timeline
OTC drug withdrawal can be discomforting. How long the withdrawal symptoms last depends on how long someone was abusing them and what specific medicine was being abused. Nonetheless, here is an approximate timetable to use as a guide:
6 to 30 hours after last using: Withdrawal symptoms start after the drug was last taken. Users should expect to feel chills, be anxious, be fatigued, or have body aches. They also may have insomnia or feel depressed.
72+ hours and after: The worst of the symptoms kick in. Users can expect to experience:
- Abdominal cramping
- Dilated pupils
Keep in mind, the first week of OTC drug withdrawal will be the most difficult to get through. Once through this phase, there are positive, useful therapies that are beneficial to gaining freedom from over-the-counter drug addiction.
OTC Drug Addiction Treatment
The National Institute on Drug Abuse (NIDA) states no medication can relieve an OTC drug abuser of withdrawal symptoms. However, there are evidence-based forms of treatment that can be beneficial in understanding the thoughts and behavior toward drug use.
Cognitive Behavioral Therapy (CBT): This therapy involves exploring the motives behind drug use and abuse and provides skills to practice and take away to avoid using drugs again. It teaches clients how to deal with and manage triggers that can lead to substance use.
Motivational Interviewing: The goal of this type of therapy is to change any ambivalence toward ending drug use or possibly to more intensive treatment.
Dialectical Behavior Therapy (DBT): This therapy teaches the client the skills to regulate their emotions, tolerate stress, and negative emotions, as well as how to communicate effectively with others.
All of these therapies are beneficial and valuable for someone who has a dependence or addiction to OTC medications. While it may not seem like a big deal to take too much of an over-the-counter drug, there are physical and psychological consequences.
Parents or legal guardians of children ages 12 to 18 might want to keep OTC medication in a secure place if they feel the child is misusing or abusing store-bought medication.
Be the best version of you – start recovery today!
Be the best version of you – start recovery today!
OTC Drug Statistics
Below are some startling facts about OTC drugs in the United States.
- 1 in 11 teens has reported using OTC cough medicine to get high.
- There are more than 750,000 U.S. brick-and-mortar retail outlets that sell OTC drugs
- There are 67,000 brick-and-mortar pharmacies in the U.S.
- There are thousands of online retailers selling OTC medicines.
- 27 percent of the 2 million hospital visits from drug abuse are from OTC abuse.
National Institute on Drug Abuse. Over-The-Counter Medicines. December 2017. (Retrieved May 2019) from https://www.drugabuse.gov/publications/drugfacts/over-counter-medicines
Partnership for Drug-Free Kids. Drug Guide. (Retrieved May 2019) from https://drugfree.org/drug-guide/
U.S. Food and Drug Administration. Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine. (Retrieved May 2019) from https://www.fda.gov/drugs/information-drug-class/legal-requirements-sale-and-purchase-drug-products-containing-pseudoephedrine-ephedrine-and
Medical News Today. What to know about ZzzQuil. Jessica Caporuscio, PharmD Reviewed by Alan Carter, PharmD. May 16, 2019. from https://www.medicalnewstoday.com/articles/325190.php
Chapman, A, (September, 2006). Dialectical Behavior Therapy Current Indications and Unique Elements. US National Library of Medicine. Retrieved August, 2019 from from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/