Reviewed by Yehuda Roberts
March 15, 2024
Common Causes of Over the Counter Drug Abuse
Unravel the reality behind common over the counter drugs abused and learn prevention strategies.
Understanding Over-the-Counter Drug Abuse
In order to tackle the issue of drug abuse effectively, it's imperative to first understand what it entails, especially when it comes to over-the-counter (OTC) drugs.
Defining Over-the-Counter Drug Abuse
Over-the-counter drug abuse refers to the misuse or overuse of medications that are freely available for purchase without a prescription. These medications, meant for treating minor ailments, are generally safe when used as directed. However, they can become harmful and even life-threatening when taken inappropriately, in large quantities, or for non-medical purposes [1].
Common over-the-counter drugs abused include cough and cold medications, energy pills, laxatives, and motion sickness medications. The misuse of these drugs can have serious health consequences, such as dizziness, nausea, vomiting, confusion, slowed breathing, and in severe cases, even death [1].
Factors Influencing OTC Drug Abuse
Several factors contribute to the abuse of over-the-counter drugs. A common misconception, especially among teens, is that abusing over-the-counter drugs is safer than abusing illegal drugs. This can lead to the experiment and eventual misuse of these medications [1].
Certain over-the-counter medications contain ingredients that can induce psychoactive effects when misused. For instance, dextromethorphan (DXM), found in cough and cold medications, is commonly misused by individuals seeking hallucinogenic and dissociative effects.
Other factors include the easy availability of these drugs, lack of awareness about the potential harm they can cause, and the absence of stringent regulations on their purchase and use. Combined with societal pressures and personal issues, these factors can lead individuals, particularly young people, down the path of over-the-counter drug abuse.
It's crucial to raise awareness about the dangers of over-the-counter drug abuse and promote responsible use of these medications. Education, regulation, and accessible treatment options are key to tackling this growing issue.
Commonly Abused Over-the-Counter Drugs
While over-the-counter (OTC) drugs are legal and easily accessible, they are not immune to misuse and abuse. Some common OTC drugs are regularly abused due to their psychoactive effects when taken in higher-than-recommended doses. Below we delve into the misuse of Dextromethorphan (DXM), Loperamide, Pseudoephedrine, and Diphenhydramine.
Misuse of Dextromethorphan (DXM)
Dextromethorphan (DXM), an active ingredient found in cough syrups, tablets, and gel capsules, is frequently misused for its hallucinogenic and dissociative effects. Approximately 3% of high school seniors report abusing cough medicine containing DXM. It's alarming to note that DXM is sometimes combined with other drugs like alcohol and marijuana, leading to an elevated risk of addiction.
The abuse of DXM can lead to a range of health risks, from dizziness and nausea to more severe effects like seizures, psychosis, and even death in extreme cases. The misuse of DXM, like other common over the counter drugs abused, is a growing concern that needs to be addressed.
Loperamide Abuse: Risks and Consequences
Loperamide, commonly known by the brand name Imodium, is an anti-diarrheal medication. It is misused at higher-than-recommended doses by some individuals attempting to self-treat opioid withdrawal or seeking to achieve a high. This misuse has led to severe cardiac issues and deaths [2].
The misuse of loperamide can lead to a range of health problems, including constipation, stomach cramps, fainting, and in severe cases, heart problems and death. Raising awareness about the dangers of loperamide misuse is crucial in combating this form of OTC drug abuse.
Dangers of Pseudoephedrine and Diphenhydramine Misuse
Pseudoephedrine, a common component in decongestants, is another OTC drug that is often abused. Due to its stimulant properties, pseudoephedrine can produce a euphoric high when misused. Some users resort to extracting the drug from medications to use it for illicit purposes.
On the other hand, Diphenhydramine, an antihistamine found in sleep aids and allergy medications, is sometimes misused for its sedative effects or to enhance the high from other substances. Consuming high amounts can lead to serious health complications like heart problems, seizures, and mental health disorders [2].
The misuse of both pseudoephedrine and diphenhydramine underscores the dangers of abusing over-the-counter drugs. The potential side effects and health risks associated with such misuse should not be overlooked. Education and awareness are crucial in preventing the abuse of these readily accessible medications.
Impact of OTC Drug Abuse
Over-the-counter drug abuse can have significant consequences, affecting both the health of the individual and society as a whole. This section examines these impacts in detail.
Health Risks of Overusing OTC Drugs
Abusing common over the counter drugs can have severe health impacts. When taken in large quantities or combined with other medications, over-the-counter drugs can cause side effects such as dizziness, nausea, vomiting, confusion, and slowed breathing.
In some cases, the consequences can be even more severe. For instance, overdosing on over-the-counter cold medicines containing Dextromethorphan (DXM) or Loperamide can lead to life-threatening reactions or even death. Overdoses can result in slowed or stopped breathing, leading to hypoxia, which can have short- and long-term mental effects, nervous system effects, coma, brain damage, and death.
Social Impacts of OTC Drug Abuse
The misuse of and dependence on over-the-counter drugs are not only personal health issues but also serious public health matters.
The abuse and misuse of over-the-counter (OTC) medicines is a common problem, and according to PubMed Central, it is expected to escalate during the COVID-19 pandemic. Limited research has been conducted on the patterns, causes, and consequences of OTC medicine abuse and misuse during these times, but it's clear that the social impacts can be far-reaching.
These may include:
- Increased healthcare costs due to treatment of side effects and overdoses
- Increased rates of addiction and substance abuse
- Strain on relationships due to changes in behavior and potential legal issues
- Impact on employment due to impaired performance or absenteeism
- Public safety risk due to impaired judgment or behavior
Understanding the impacts of OTC drug abuse can help in developing strategies for prevention and treatment. It's crucial to remember that while over-the-counter drugs are readily available, they are not without risks and should always be used responsibly and as directed.
Dealing with Over-the-Counter Drug Abuse
Addressing the issue of over-the-counter (OTC) drug abuse requires understanding the signs and knowing the available treatments. Misuse can lead to serious health problems, including addiction, and in some cases, can be fatal.
Recognizing Signs of OTC Drug Abuse
Recognizing the signs of OTC drug abuse is the first step in dealing with the issue. Over-the-counter drugs, when misused, can cause side effects such as dizziness, nausea, vomiting, confusion, and slowed breathing. These symptoms can become more severe when OTC drugs are taken in large quantities or combined with other medications or substances like alcohol.
Some specific OTC drugs have their own signs of misuse:
- Dextromethorphan (DXM), found in cough and cold medications, is commonly misused for its hallucinogenic and dissociative effects. Some individuals may mix it with soda for flavor in a practice known as "robo-tripping" or "skittling".
- Loperamide, an anti-diarrheal medication, is misused at higher-than-recommended doses by some individuals seeking to self-treat opioid withdrawal or achieve a high. This misuse can lead to severe cardiac issues [2].
- Pseudoephedrine, found in decongestants, can be misused for its stimulant properties and euphoric high.
- Diphenhydramine, an antihistamine, is sometimes misused for its sedative effects or to enhance the high from other substances. High amounts can lead to serious health complications.
- Aspirin can be dangerous in large quantities and is sometimes abused for self-harm purposes. Overdosing on aspirin can lead to severe health issues, including organ damage.
Available Treatments for OTC Drug Abuse
The treatment for OTC drug abuse often involves behavioral therapies. Misuse of drugs like Dextromethorphan (DXM) or Loperamide can lead to addiction when continued use causes health problems and interferes with daily responsibilities. Cognitive-behavioral therapy and contingency management are recommended treatments for addiction to these common over-the-counter drugs abused.
Cognitive-behavioral therapy helps modify the patient's drug-use expectations and behaviors, and effectively manage triggers and stress. Contingency management uses a voucher-based system where patients earn points for negative drug tests, which they can exchange for items that encourage healthy living.
In severe cases, medical intervention may be necessary to manage withdrawal symptoms and other physical complications. Seeking help from healthcare professionals is crucial if one suspects OTC drug misuse or addiction.
Prevention Strategies for OTC Drug Abuse
Given the increasing problem of over-the-counter (OTC) drug abuse, particularly during challenging periods such as the COVID-19 pandemic, it's essential to consider effective prevention strategies. These strategies aim to curtail the misuse of common OTC drugs, which, as identified by PubMed, include codeine-based medicines, cough products like dextromethorphan, sedative antihistamines, decongestants, and laxatives.
Education and Awareness on OTC Drug Misuse
Educating the public about the potential risks and dangers of OTC drug abuse is a critical preventive measure. Misconceptions about the safety of these drugs often lead to their misuse and eventual abuse. Many people are unaware that these medicines, though legal and easily accessible, can cause serious health problems when used improperly.
Efforts to raise awareness should focus on the harmful effects of abusing OTC drugs and the importance of adhering to the recommended dosage. Additionally, healthcare providers should ensure clear and open communication channels with patients to combat misinformation, especially during pandemics when the utilization of OTC drugs tends to increase [5].
Regulatory Measures against OTC Drug Abuse
In addition to education and awareness, regulatory measures play a crucial role in preventing OTC drug abuse. These can include stricter policies regarding the dispensing and selling of OTC medicines and improving pharmacovigilance legislation.
In the context of the pandemic, the implementation of early warning tools can help monitor patients' OTC medicine dispensing history and detect potential abuse. Continuation and expansion of mental health services can also address underlying issues often associated with drug abuse, such as stress, fear, and mental health issues.
In essence, implementing a multifactorial strategy that addresses various aspects of prevention can significantly reduce the misuse and abuse of OTC drugs. Regular monitoring, education, and regulatory measures, combined with continued support for mental health, are key factors in managing and preventing OTC drug abuse.
References
[1]: https://www.carman.k12.mi.us/domain/93
[2]: https://americanaddictioncenters.org/over-the-counter-medications
[3]: https://nida.nih.gov/publications/drugfacts/over-counter-medicines
