OTC Drug Abuse

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.

A Helpful Tool: WebMD Pill Identifier

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