Many people do not consider over-the-counter drugs as dangerous or addictive, but they do in fact have a high risk of abuse. Because of their accessibility, users can abuse these drugs easier than prescription medication. According to the Drug Abuse Warning Network, in 2011, an estimated 1,244,872 emergency department visits included nonmedical uses of prescription medications, over-the-counter drugs, or other types of pharmaceutical products. The most common drugs abused among prescription and over-the-counter drugs in emergency department visits are pain relievers. Of those visits, an estimated 200,000 emergency department visits were from suicide attempts including either prescription medications or over-the-counter drugs. Over-the-counter drugs pose more of a threat than many people think, and the potential to abuse these drugs, as well as possible side effects, needs to be better understood.
What Are Over-the-Counter Drugs?
According to the Food and Drug Administration, an over-the-counter drug, or OTC drug, is defined as a nonprescription drug that is safe and effective for use by the general public, available without treatment or permission by a health professional. OTC drugs are available at a variety of stores, pharmacies, and even online, and they can be purchased off the shelf without professional recommendation.
There are over 300,000 OTC drug products on the market, but the FDA has not individually reviewed all of them. Companies can sell non-reviewed drugs because of an FDA regulation called an OTC drug monograph. An OTC drug monograph provides the type of ingredients that are potentially used to treat specific conditions or diseases without needing a prescription, and also provides dosage amount information and instruction on how to take the drug. The OTC drug monograph helps regulate what drugs are appropriate to be labeled as over-the-counter drugs depending on the ingredients.
In addition, some companies market drugs that have not been FDA-approved or that do not fit into the monograph system. Taking a drug not approved by the FDA might be problematic and should be considered unsafe and a public health concern. As a result, it is best to avoid taking an over-the-counter drug that is not FDA-approved to avoid undetermined side effects.
Over-the-counter drugs in appropriate dosages are useful in many instances. These medications are often the first defense for consumers and healthcare providers. Having access to drugs that can help treat a medical problem immediately is convenient for consumers, can lower the number of unnecessary doctor visits and associated costs, and can assist in unexpected medical symptoms. When taken as directed, these medications can be valuable to treat a variety of symptoms.
OTC drugs are available for a number of different medical conditions or problems, such as pain and aches; allergies; cough, flu, and cold symptoms; eye-related problems; ear-related problems; gastrointestinal issues, including diarrhea , nausea, gas, and upset stomach; gynecological issues; and skin problems. OTC medications include topical products for various problems and other miscellaneous items, such as bandages, hydrogen peroxide, and nicotine patches. People use these medications every day not considering any potential of harm of abuse because they are usually not considered to be as threatening as prescription drugs.
Differences between Prescription and OTC Drugs
Though both types of drugs might serve similar purposes, there are distinct differences between over-the-counter drugs and prescription drugs. OTC medications are designed to treat mild or infrequent medical problems or symptoms. For example, when only experiencing mild symptoms of allergies, a person can use an OTC drug, such as Allegra or Zyrtec.
Prescription drugs are medications that have to be prescribed by a doctor or medical professional to treat a specific condition, and they are usually higher in strength than an OTC drug. They are designed to treat more severe symptoms. If Zyrtec is not strong enough for symptoms, a patient can seek medical advice and observation to determine if a medication like Xyzal or Clarinex is more appropriate. Because they have higher potency or strength, prescription drugs can only be distributed after a medical professional assesses a condition or symptoms, and then a prescription is given. Though OTC drugs are not as strong as prescription drugs, they still have the potential to be abused and cause addiction.
Which OTC Drugs Are Abused?
As mentioned, according to the National Institute on Drug Abuse, after alcohol and marijuana, prescription and OTC medications are the most commonly abused substances in the United States for people 14 and over. Dextromethorphan, or DXM, is an over-the-counter drug used to treat cold, flu, and cough symptoms. Cough medicine is often used, in high doses, by individuals seeking to experience a “high,” particularly by teenagers and young adults as a type of party drug because it can give a euphoric feeling when taken in excess. It is also often mixed with alcohol or other substances to enhance its effects.
OTC drugs related to promoting weight loss, such as diet pills, laxative, and diuretics, are also frequently abused. These drugs can result in serious physical damage if abused, leading to side effects like dehydration, nausea, vomiting, blurred vision, dizziness, fatigue, muscle cramping, increased heart rate, disorientation, numbness in the toes and fingers, and confusion. Other commonly overused OTC drugs include acetaminophen (pain reliever), Benadryl (antihistamine for allergies and allergic reactions), sleeping pills, ephedrine, asthma inhalers, and antacids.
According to data from the Drug Abuse Warning Network, people in the following groups tend to abuse prescription and over-the-counter medications the most:
- Opiate users
- Young people
- Women (tranquilizers and sedatives)
- Those suffering from suicidal thoughts
Though these groups exhibit higher potential to abuse OTC drugs, anyone can fall victim to abuse. It is important to watch for specific signs if you think someone may be abusing OTC drugs.
Signs and Effects of Abuse
- Empty medicine bottles
- Missing medicine bottles
- Purchasing large amounts of OTC drugs
- Loss of interest in hobbies that used to be enjoyed
- Unexplained excessive spending
- Being hostile or angry
- Unwillingness to cooperate
OTC drugs are considered to be abused when taken for reasons other than what is listed on the label or in excess. Because they are easily available for purchase, and because they sometimes go unnoticed in drug tests, it is easy for OTC drug abuse or addiction to go undetected.
When abused, OTC drugs can cause problems in the brain similar to what illegal drugs cause. It is also possible for users to overdose on OTC drugs. Though they are lower in strength, if a user takes enough of a substance, it could have similar effects as prescription drug abuse.
In addition, OTC drugs can be abused by mixing different medications together. Medications have different active ingredients, and combining certain medications can enhance the effects of the drugs. Though the resulting feeling may be pleasurable, the damaging effects of the experience can be harmful to the user.
It is important to consider any potential risks associated with using an OTC drug. Many different medical conditions can be negatively impacted by certain drugs. Some of the medical conditions that could be considered high risk for taking OTC drugs are diabetes, asthma, glaucoma, gout, heart disease, asthma, high blood pressure, kidney problems, bleeding disorders, Parkinson’s disease, immune system problems, and thyroid issues. It is also possible for users to be allergic to different ingredients in the drugs. If a person has any of these conditions, they should speak with their doctor before taking any OTC drug that might cause complications with their condition.
Abusing OTC drugs can cause severe changes in a person’s judgment. It can also lead to severe medical problems, and it could even lead to death. Some potential side effects of abusing OTC drugs are dizziness, bleeding in the gastrointestinal tract, nausea, kidney problems, severe dehydration, hair loss, urinary tract infections, insomnia, blurred vision, change in menstrual cycles, anxiety, vomiting, diarrhea, heart attack, and stroke. If overdose is suspected, prompt medical attention is essential to avoid long-term health complications.
Treatment for Abuse
Treatment for over-the-counter drug abuse depends on the type of drug taken. Quitting any drug, even OTC drugs, cold turkey has the potential for negative effects. Certain drugs of abuse are more likely to result in physical withdrawal symptoms; however, psychological withdrawal symptoms may be present for any drug of abuse. As a result, medical detox is often recommended. In addition, withdrawal is likely to be more severe in cases of polydrug addiction, as is often the case with OTC drug abuse.
Withdrawal symptoms may include diarrhea, sweating, headache, nausea, hallucinations, vomiting, trembling, depression, and anxiety. With medical detox, clients have access to 24-hour medical support and psychological help to cope with any problems that arise.
Detox is only the first step in substance abuse treatment. It should always be followed with comprehensive therapy to address the reasons behind the substance abuse. Aftercare, to support clients once structured treatment is complete, should also be part of the overall recovery plan.
Users should always read the labels in their entirety before taking an over-the-counter drug, and only take these medications as directed. If there are any questions about a drug, medical professionals, such as doctors and pharmacists, are available to answer these questions. If you are unsure if an OTC drug is appropriate for you, consult with your doctor before beginning use.
If you are worried that you, or someone you know, are abusing an OTC drug, professional help is available. With the right care, you can leave substance abuse in the past for good and embrace a better future.