Anyone can buy cough syrup and simple pain relievers over the counter at drugstores and pharmacies. Since these drugs are easy to obtain, users often feel that they are safer than prescription drugs.
It’s true that when these drugs are used as intended, they are considered fairly harmless. The problem lies when over-the-counter drugs are used for non-medical purposes, in an attempt to create mind-altering effects or to get “high.”
The National Institute on Drug Abuse (NIDA) reports that prescription and over-the-counter drugs, after marijuana and alcohol, are the most abused substances in America by those ages 14 and older. The most commonly abused over-the-counter drugs are likely pain relievers like ibuprofen and acetaminophen, diet pills, laxatives, energy drinks or pills, and cough medications containing dextromethorphan, or DXM. Adolescents may be the most at-risk age group for abusing over-the-counter medications, with a study performed by the University of Cincinnati finding that 10 percent of the 54,000 teens between grades 7 and 12 who were surveyed abused over-the-counter drugs.
What is Over-The-Counter Drug Abuse?
Any use of a medication or over-the-counter (OTC) drug in a manner other than the way it was specifically intended is considered abuse, including:
- Taking more than the recommended dose or taking the drug for longer than needed
- Using OTC drugs for recreational purposes
- Altering OTC drugs
- Taking OTC drugs when they are not medically necessary
Over-the-counter drugs are used to alleviate minor medical symptoms, and they are not intended to be taken in large doses or long-term. When taken in larger-than-intended quantities, some of these substances may produce euphoric or psychoactive effects. Pills may be crushed in order to snort, smoke, or inject the resulting powder, which intensifies these effects, as the drugs are sent rapidly across the blood-brain barrier instead of being slowly digested through the stomach. This manner of abuse may increase the onset of the “high,” but it can be very dangerous and may increase the odds for a toxic overdose. Cough syrups are sometimes added to alcohol, and the mixing of multiple substances can also have unintended and disastrous results.
The Centers for Disease Control and Prevention, CDC, reports that as many as 120 people die each day from a drug overdose in America, and another 6,748 seek emergency medical treatment for drug abuse daily. Teens may view OTC drugs as less harmful than street or “club” drugs and therefore less likely to have adverse consequences. Unfortunately, this is not the case, as there are many potential hazards and risks associated with abuse of over-the-counter drugs.
Potential Risks and Side Effects of Abuse
The CDC published that 81.1 percent of the drug overdose fatalities in 2013 were unintentional, and nine out of 10 poisoning deaths were related to drug abuse or misuse. An overdose occurs when drugs reach toxic levels in the bloodstream, and the body can no longer break the toxins down. Mixing different drugs, medications, or substances, including alcohol, can increase the risk for an overdose or dangerous chemical reaction in the body. Signs of an overdose will be different depending on the drug taken, but they generally include nausea and/or vomiting, disorientation, confusion, delusions, hallucinations, seizures, loss of consciousness, weak muscles, headache, impaired motor skills or loss of coordination, blue tinge to skin and fingernails, irregular heart rate or blood pressure, excessive sweating or chills, and extreme fatigue or drowsiness. An overdose is a medical emergency; if you recognize any of these signs, seek immediate medical attention.
In addition to the potential for a life-threatening overdose, over-the-counter drug abuse can create many other potential risk factors as well. Chronic abuse of pain relievers may lead to kidney or liver damage, internal stomach bleeding, or cardiac issues. When taken in excess, energy pills and drinks may cause irregularities in heart rate, severe dehydration, and gastric reflux, while diet pills may cause these side effects as well as the increased risk for stroke, heightened blood pressure, nervousness, and tremors. OTC drugs may lower inhibitions, increasing the potential for engaging in risky sexual behaviors or putting oneself in other hazardous situations, including driving while intoxicated. Short- and long-term memory and other cognitive functions may be impaired also.
According to the Drug Enforcement Agency, or DEA, nearly one out of every 10 teens has abused an over-the-counter cold or cough medicine in an attempt to get “high” in their lifetime. These OTC drugs typically contain DXM, which may produce euphoric feelings, altered perceptions, and hallucinations for up to six hours when abused. Less than desired side effects may include blurred vision, numbness of toes and fingers, slurred speech, loss of motor functions, impaired judgment, vomiting, abdominal cramps, rapid heart rate, slowed respiration, and drowsiness. There are over 100 cough and cold products containing DXM, including Robitussin and Nyquil, which can be highly addictive when abused.
Dependency and Addiction
Chronic abuse of over-the-counter medications can lead to physical and emotional dependency just as the abuse of illicit drugs and alcohol can. Addiction occurs when compulsive drug-seeking behavior and cravings take up an excessive amount of one’s life, affecting work, school, or familial obligations. Some of the warning signs may include:
- Drop in school or work performance
- Lack of interest in social or recreational activities
- Withdrawal from family and friends
- Weight fluctuation
- Lack of concern for personal hygiene
- Obsession over OTC drug of choice
- Finding empty medication bottles or stashes of medication in easy-to-access locations
- Personality shift or mood swings that are out of character
- Appearing disoriented or “out of it” often
- Jittery or seems on edge
- Disrupted sleep patterns
- Visiting websites that detail OTC drug abuse specifics, sell DXM, or promote OTC drug abuse
Another side effect of OTC drug abuse, and particularly those products containing DXM, is the onset of withdrawal when the drug is removed or leaves the body. Over time, chronic abuse of an OTC substance can lead to the body building up a tolerance to these chemicals, so it takes more frequent and higher doses of the drug in order to produce the desired effects. The brain and body become physically dependent on the presence of the drugs, and reward and motivation pathways in the brain are altered, encouraging drug abuse and bringing on drug cravings. When the drug then leaves the bloodstream in a few hours, the user may feel physically sick as well as suffer emotional distress, such as becoming anxious, irritable, agitated, and disoriented. In addition, the addict may have trouble processing and remembering things, and feel depressed. These are withdrawal symptoms; since they are uncomfortable, they often cause a desire to seek more drugs in order to find relief. Fortunately, specialized treatment is available to help curb cravings, manage withdrawal, and support a drug-free and healthy future.
Getting Help for OTC Drug Abuse
Over-the-counter drug abuse often starts small but can quickly take over and get out of control. Luckily, most of the changes that occur in the brain due to substance dependence are reversible. Psychological support that includes individual and group counseling, alternative therapies, and support groups are important aspects of a successful recovery. Behavioral therapies can help the individual to discover the reasons OTC drug abuse may have started in the first place and teach new coping mechanisms and life skills for managing stressors and potential triggers in the future, helping to diminish and prevent relapse. Family counseling brings families closer together, improving relationships and strengthening and repairing bonds. Positive support goes a long way to fostering recovery and emotional strength.
Sometimes, in order to regain physical balance, detox in a specialized and secure facility can help to manage withdrawal symptoms and drug cravings, potentially with the use of medications. A healthy diet can help restore the vitamins and minerals that may have been depleted with substance abuse. Regular exercise can help boost natural “happy cells” or endorphins, and getting enough rest and sleep promotes physical stability as well. Adolescents who are more involved in afterschool activities and community organizations, such as sports, clubs, and other positive social outlets, were found to be less likely to abuse OTC drugs, as published by U.S News Health Day.
The Recovery Village offers many levels of care from inpatient detox and rehabilitation services to outpatient treatment plans, all staffed by highly trained, compassionate professionals who are focused on creating the most comprehensive, evidence-based treatment model for your, or your loved one’s, specific needs and circumstances. Contact an admissions coordinator today for a complete and confidential assessment.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.