Five Commonly Abused OTC Medications

Say substance abuse and many people immediately think of illicit drugs like cocaine or heroin. With increasing media attention on the rise of prescription abuse, medications like oxycodone, Xanax, or the ADHD drug Ritalin may also come to mind. These aren’t the only types of drugs with the potential for abuse, though.

Easily obtainable drugs from the aisles of your local grocery store are also substances of abuse in the wrong hands.  These drugs aren’t illegal, and they don’t require a prescription.  They’re commonly referred to as “over-the-counter” (OTC) medications, and include common remedies like allergy medications, cough syrup and sleep aids.  When taken in higher amounts or more frequently than the recommended dosage, they can lead to dependence and addiction –and the need for drug rehab treatment.

Allergy Medicines

Histamine is a natural substance that’s released when your body is exposed to allergens or some viral infections. It’s responsible for itching, sneezing, and mucus production. Antihistamines are medications used to combat these uncomfortable symptoms. Some antihistamines can be easily abused, such as diphenhydramine.  This is the ingredient found in allergy medicines such as Benadryl.

Taking high doses of antihistamines can cause a “high.”  Symptoms may include euphoria, drowsiness, delirium and auditory or visual hallucinations.  The side effects of abuse cover a range of physical symptoms, such as sleepiness, dizziness, nausea, low blood pressure and increased heart rate.

Antihistamines don’t typically cause physical dependence.  However, for some, they can create a psychological one. An addiction counselor can work with you to develop strategies for overcoming dependence on these drugs.

Cough Medicines

Dextromethorphan is a cough suppressant found in many over-the-counter cough and cold medications. Also called DXM, the ingredient is found in many familiar brand names, including Sudafed, Robitussin DM, Dayquil LiquiCaps and Vicks NyQuil. While safe when used within recommended doses, this substance is often  abused by teenagers. One survey of more than 54,000 teen students suggests up to 10% have abused OTC drugs, like DXM. In high doses, a person experiences effects ranging from mild perceptual distortions to hallucinations. Some people also experience feelings of paranoia and panic.

High doses of DXM trigger serious side effects.  These may include confusion, slurred speech, dizziness, double or blurred vision, loss of coordination, nausea, vomiting and abdominal pain. Chronic, heavy abuse may lead to brain damage.  NMDA receptor antagonist neurotoxicity – also known as Olney’s lesions – may develop, impacting the person’s emotions, learning, and memory. DXM also interacts with other medications, including antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).

Abuse can lead to an addiction that requires drug rehab treatment. Therapy typically involves psychological counseling. Cognitive behavioral therapy (CBT) is often used to help the addict identify the reasons they rely on the drug and to help develop healthier coping strategies. Since DXM use in teens is often social, the therapist may also use role-playing to help adolescents practice responses to peer pressure situations.

Motion Sickness Aids

When the nausea and dizziness of motion sickness strikes, many people reach for over-the-counter drugs such as dimenhydrinate.  This drug is often referred to by the brand name Dramamine. While it can be effective when taken appropriately, high doses of dimenhydrinate can produce hallucinations and euphoria. Other side effects of a dimenhydrinate high include heaviness in the legs, loss of coordination, irregular heartbeat, temporary memory loss and mild to intense paranoia. An overdose can trigger a heart attack and may even result in death.

If you suspect that you may be abusing Dramamine, consult an addiction specialist as soon as possible to develop a treatment strategy to help you overcome the problem.

Sleep Aids

Over-the-counter sleep aids are intended to be taken for two or three nights at a time; they’re not intended for long-term use. Yet many people battling insomnia take sleep aids in higher doses and for longer periods than recommended.

The active ingredient in many sleeping pills is an antihistamine, typically either doxylamine or diphenhydramine (the same substance found in Benadryl). With prolonged use, it’s possible to develop a tolerance for these types of sleep aids.  When this occurs, you’ll find that you need to take increasingly larger doses to feel its effects. Sleep aid abuse can also cause dependence.  This creates a vicious cycle because you won’t be able to sleep unless you take the drug.

In addition to tolerance and dependence, sleep aids have side effects that range from mild to serious.  These may include next-day drowsiness, dizziness, forgetfulness, constipation and urinary retention. Some people also report feeling clumsy or off-balance.

A few OTC sleep aids, such as NyQuil, contain alcohol as well.  This can be particularly problematic for anyone recovering from alcoholism. OTC sleep aids are also potentially dangerous because they interact with other medications, including antidepressants and drugs taken to treat Parkinson’s disease.

Over-the-counter sleep aids generally don’t require professional drug rehab treatment. However, if you’re taking these OTC drugs in higher than recommended doses, or if you take them every night, talk with your primary care physician about finding safer alternatives for overcoming insomnia.

Diet Aids

The quest to shed weight leads many people to turn to diet pills and liquids. For some, however, that use quickly turns into abuse. A person might start taking the recommended dose, only to raise the frequency and dosage to achieve faster results.  These drugs are often abused by individuals who struggle with anorexia or bulimia.

Diet supplements rely on a blend of ingredients to suppress appetite, decrease fat absorption or increase calorie burn. Some contain herbal ingredients that are not monitored by the FDA. Complications from the abuse of diet pills include heart palpitations, menstrual irregularities, vomiting, anxiety, kidney failure, cardiac arrest and death.

Diet aid abuse sometimes involves laxatives. Laxatives work by stimulating the bowels.  They are a frequent drug of abuse for individuals with eating disorders. Someone trying to lose weight might use laxatives to purge food from their bodies, especially after a binge. Over time, abuse can make it impossible for the bowels to work without the aid of laxatives.

This type of substance abuse often requires drug rehab treatment. Since diet aid abuse can be rooted in mental health conditions like depression or an eating disorder; successful treatment should include a thorough psychological evaluation to assess underlying triggers.

Because these drugs can have a serious impact on the digestive system and other core bodily functions, hospitalization may be required to stabilize the addict’s physical condition. Since diet pills are not regulated by the FDA and manufacturers aren’t required to list ingredients, complications may occur while treating the addiction.

Once the person is physically stabilized, treatment can begin. An addiction specialist or mental health professional may recommend a treatment protocol that includes a combination of individual or family counseling, group therapy sessions and nutritional counseling.

Just because a medication is available at the local drug store doesn’t mean it’s harmless. Teenagers and adults alike turn to OTC medications to get high.  Others end up abusing them in a desperate attempt to lose weight or get a better night’s sleep. Don’t hesitate to consult with your primary care physician, a mental health professional, or a drug rehab treatment counselor if you suspect that you or a loved one is abusing a seemingly innocent over-the-counter substance. They will help you find the best treatment to help you or your family member live a healthier, addiction-free life.