Abuse of Over-the-Counter Drugs

Abuse of Over-the-Counter Drugs

illicitdruguse12th_0                                            When we think about drug abuse in the era of marijuana legalization (circa February 2014), it along with illicit drugs  like cocaine or heroin may be the first things that pop into our minds. Although the abuse of these drugs is prevalent in our communities, we often forget about a group of drugs that linger on the shelves in most of the households around the world and are abused just as often if not more. Bottles and packages containing these drugs fill entire rows of super markets and local drug stores. We administer them with little thought of the word “abuse”.  These are over-the-counter (OTC) drugs and particularly cold medicines. In a Monitoring the Future Study, cough medicine ranked 5th among “past-year use of illicit drugs and pharmaceuticals among 12th graders”.1 Cough medicines moved above tranquilizers in preference of 12th graders from 2011 to 2012.1

“Prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.”-National Institute on Drug Abuse (NIDA, May 2013)

Where as teens generally get their prescription drugs from friends or relatives, OTC drugs are readily accessible in homes, local stores or on-line. Information on how to abuse OTC drugs are as equally accessible via Internet drug forums. In these drug forums, users describe their experiences, the amount they use and even what drugs to combine. Dextromethorphan (DXM), which is found in over 100 cold medications, is one of the most commonly abused OTC. Liquid formulations can be drunk alone or with a beverage. Gelcaps or pills are either swallowed, crushed and either snorted or drunk with some type of liquid.1 Other OTC drugs that are abused include allergy, sleep, and nausea medications such as diphenhydramine, pain relievers (with and without caffeine), diet pills, pseudoephedrine (also an active ingredient in many cold medications) and even herbal medications..3,4 These drugs are abused for a range of effects including stimulation, euphoria, hallucinations, anxiety and more.

“Dextromethorphan can cause impaired motor function, numbness, nausea or vomiting, and increased heart rate and blood pressure. On rare occasions, hypoxic brain damage—caused by severe respiratory depression and a lack of oxygen to the brain—has occurred due to the combination of dextromethorphan with decongestants often found in the medication.”-National Institute on Drug Abuse (NIDA)


  1. Drug Enforcement Administration. Prescription for Disaster: How Teens Abuse Medicine. August 2012. Accessed February 5, 2014.
  2. National Institute on Drug Abuse. Drug Facts: Prescription and Over-The-Counter Medications. May 2013. Accessed February 5, 2014
  3. Dinndorf et al., Risk of abuse of diphenhydramine in children and adolescents with chronic illnesses. J Pediatr. 1998 Aug;133(2):293-5.
  4. Cohen, M. 10 Over-the-Counter Medicines Abused by Teens. Philly.Com. January 14, 2013. Accessed February 5, 2014


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