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BSD7 hosted a presentation on OTC Drug Use in May, 2022. You can access the slide deck and video of this presentation here.
What is OTC Drug Abuse?
Over the Counter (OTC) drugs have various medical uses and effects, treating mild pain to motion sickness. Some abuse OTC drugs to self-medicate for mental illnesses like anxiety and depression. Abusing these medications can also give users a euphoric “high” or hallucinations. Any use outside of what’s recommended is considered abuse.
The OTC medications with the most potential for abuse include:
dextromethorphan (Balminil DM®, Benylin DM®, Bronchophan®, Buckleys D®, Calylin #1®, Delsym®, Koffex DM®, Novahistex DM®, Robitussin Lingering Cold Long-Acting Cough®)
pseudoephedrine (Sudafed®, Nexafed®, Zephrex-D®)
antihistamines (Astelin®, Claritin®, Zyrtec®, Clarinex®, Allegra®)
sleep aids (Tylenol Pm®, Aleve Pm®, Benedryl®, Unisom®, ZzzQuil®)
caffeine (No Doz®, Vivarin®, Stay Awake®, Lucidex®, Cafcit®)
ephedrine (Bronkaid®, Primatene®, Rezipres®, Akovaz®, Corphedra®)
antitussives and expectorants (Triaminic Cold and Cough®, Robitussin Cough®, Vicks 44 Cough and Cold®, Mucinex®, Robitussin Chest Congestion®)
dimenhydrinate (Dramamine®, Antivert®)
laxatives (MiraLAX (Pro)®, Clenpiq (Pro)®, Phillips' Milk of Magnesia Generic, Prepopik (Pro)®, Correctol®, Dulcolax®)
anabolic steroids (Dostalon®, Roxilon®, Mentabolan®, Ultradol®)
Cough Medicines
OTC cough medicine abuse is taking large doses of cough medicine to get high. The "high" is caused by dexotromethorphan, which is often abbreviated DXM, a common active ingredient found in many cough medicines. This sort of abuse-- whether it is called cough medicine abuse or dextromethorphan or DXM abuse-- can be dangerous
Slang Terms for Dextropethorphan: DXM, Dex, Robo, Skittles, Syrup, Triple-C, Tussin
Brand Names: Alka-Seltzer Plus Cough & Cold®, Balminil DM®, Benylin DM®, Bronchophan®, Buckleys D®, Calylin #1®, Delsym®, Koffex DM®, Novahistex DM®, Robitussin Lingering Cold Long-Acting Cough®
Cough medicines are popular among young people, as they are often readily accessible in medicine cabinets at home or at a friend’s house.
***Approximately 3.1 million young people aged 12 to 25 have used a nonprescription cough and cold medication to get high***
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The maximum recommended daily dose of DXM is 120 mg; beyond that, intoxication and dangerous side effects begin to appear. High doses of DXM can cause:
Breathing problems
Blacking out
Muscle twitching
Extreme drowsiness
Heart palpitations
Changes in blood pressure
Elevated body temperature
Vomiting
Rapid heart rate
Blurred vision
Muscle twitching
Brain damage
Cold Medicines
Pseudoephedrine is a stimulant and the active ingredient in many cold medicines. It is used to relieve nasal and sinus congestion from colds or allergies and may also relieve congestion. In rare cases, may abuse pseudoephedrine for hallucinations or an intense “body high.”
Brand Names: Sudafed®, Nexafed®, Zephrex-D®
Pseudoephedrine is also used to create illicit drugs like methamphetamine. Abusing pseudoephedrine can cause:
Irregular heartbeat
Shortness of breath
High blood pressure
Dizziness
Seizures
Motion Sickness Pills
Dimenhydrinate is used to treat motion sickness and vertigo. The drug is often abused for its psychedelic properties. The drug is considered a deliriant when taken in high doses (between 200-1200 mg depending on body weight).
Brand Names: Dramamine®, Driminate®
In high doses, the drug can cause:
Hallucinations
Ringing in the ears
Nausea
Irregular heartbeat
Seizures
Coma and even death
What Parents Can Do to Prevent OTC Drug Abuse
Talk to Your Teens
Be clear that you do not want your child taking medicine without your knowledge.
Do not encourage medication as the answer to all ailments and conscientiously model appropriate use of OTC medications.
Teach your teens and younger children to respect medicines. Medicines are important tools in healthcare, but they must be used according to directions.
make sure your child understands that abusing medicines-- just as abusing illegal drugs-- can be very dangerous.
Act with speed and confidence if you ever find unexplained empty containers of OTC medicine.
Safeguard Medications
Know what medicines are in your home and notice if they go missing.
Be aware of what products in your home may present a risk of potential abuse and consider keeping these medicines in a secure location.
Do not buy OTC medications in bulk.
Recognize the Signs
Change in friends
Change in eating or sleeping patterns
Changes in physical appearance and hygiene
Declining grades
Empty drug or medicine containers
Loss of interest in hobbies or favorite activities
Hostile and uncooperative attitude
Unexplained disappearance of household money
Unexplained appearance of medicines (e.g. got them from a friend).
Parents should know that it is a misconception that only "off-track" teenagers with inattentive or dysfunctional parents misuse medications. "Good kids" can make risky decisions and "good parents" can be totally unaware. Know the facts, talk openly, never assume, and seek outside help if your child continues to abuse medications.
The WebMD pill identifier tool allows you to search for and identify a pill based on its appearance. If you find a pill you don't recognize in your child's possession, this is a good way to find out what it is.
Top: Phenylephrine HCL
Bottom: Coricidin HBP Cough and Cold
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