What is an Over the Counter (OTC) Drug?
An over the counter (OTC) drug is a medication that can be obtained without a prescription from a medical professional.
Some examples of OTC drugs include cough medicine and pain relievers such as OTC ibuprofen (Advil). Some are used to relieve itches, aches, and pains. Over-the-counter drugs may prevent or cure conditions such as athlete’s foot or tooth decay.
The U.S. Food and Drug Administration (FDA) decides whether a medicine is safe and effective enough to sell over the counter. Since 1999 the FDA has set a uniform design and content requirements for labels on OTC drug products.
Types of Abused OTC Drugs
The most common types of abused OTC drugs are dextromethorphan (DXM) in cough medicines, pseudoephedrine in cold medicines, dimenhydrinate in motion sickness medications, and ibuprofen (Advil) or acetaminophen (Tylenol) in pain relievers.
Here is more information about these over-the-counter medicines.
Cough medicines are popular among young people. They can cause hallucinations and a “high” feeling if used in larger doses than recommended and are easy to find in home medicine cabinets. These OTC medicines containing DXM can also cause an overdose.
Pseudoephedrine, a stimulant, and the active ingredient in many cold medicines, is used to relieve nasal and sinus congestion from colds or allergies. In certain situations, when abused, pseudoephedrine can cause hallucinations or an intense “body high.”
Motion Sickness Pills
Dimenhydrinate, an antihistamine, is used to prevent and to treat nausea, motion sickness, and vertigo. The drug is often abused for its psychedelic properties. In high doses, this OTC medicine can cause nausea, ringing in the ears, hallucinations, irregular heartbeat, coma, seizures, and even death.
Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks.
Each pain reliever taken will affect each person differently. For example, ibuprofen may work to relieve a headache for one person, while acetaminophen works better for another.
A Warning from the Drug Enforcement Administration
Just because a drug can be sold over the counter, does not mean it is harmless. The Drug Enforcement Administration warns of several instances in which their use can be dangerous.
For example, the cough suppressant dextromethorphan (DXM) is found in more than 120 OTC cold medications by itself or in combination with other drugs. Abusing these drugs means the user is abusing DXM.
Over the counter medications are also among the most common substances–along with alcohol and marijuana– found in drivers operating under the influence of drugs.
Adverse Effects from OTC Drugs
If you use over the counter medications, you may experience negative side effects and symptoms. Some of the most common side effects include:
- High blood pressure
- Irregular heartbeat
- Breathing problems
- Mood changes
Allergic reactions to over-the-counter medicines are rare but happen. Signs of an allergic reaction include rash, hives, itching, and breathing problems.
Pharmacists can help with understanding drug facts and the health risks of mixing medicines. They are prepared to discuss interactions between a prescribed medicine or OTC drug.
It is a good idea to keep a list of all medications you are taking so you can check for combinations that may adversely affect your health. Also, read drug facts labels and avoid taking different medicines that contain the same active ingredients.
Who are Most at Risk for Experiencing Adverse Effects to OTC drugs?
The very young, older adults, and those taking more than one type of medicine have a higher risk for adverse effects with OTC drugs
Healthy adults who use OTC medicines properly have a low risk of adverse effects.
Regardless of age, the following health conditions create a higher risk for side effects:
- Bleeding disorders
- Thyroid problems
- Blood clotting disorders
- Parkinson’s disease
- Kidney problems
- Breathing problems
- High blood pressure
- Psychiatric problems
- Immune system problems
- Enlarged prostate glands
- Heart disease
- Liver problems
Before Taking an OTC Medicine
If you plan to take an OTC medication, ask yourself these questions:
- What are the possible interactions with other medicines I take?
- Is my symptom a side effect or a serious allergic reaction to the medicine I am taking?
- Should I take my medicines on an empty stomach or with food?
- What symptoms should I be aware of that could cause an adverse reaction to my OTC medicine?
- Does my doctor know about the supplements or vitamins or OTC medicines that I take regularly?
If you have any concerns about taking over-the-counter medications, discuss them with your family physician or pharmacist.
Can OTC Medications be Abused?
Yes, over the counter medications can be abused. Using these drugs to achieve a euphoric feeling, and not for what the drug was intended for, is a sign of a drug problem.
The abuse of over the counter (OTC) medications is particularly problematic because many of them are easily obtained.
OTC Drug Statistics
- DXM is an active ingredient in more than 125 over-the-counter products.
- Close to 750,000 retail outlets sell OTC medicine.
- One in eight teenagers admit to abusing OTC cough medicine.
- 5 percent of 8th graders abuse some form of cold/cough medicine, according to the National Institute on Drug Abuse
- Around 80,000 people visit emergency rooms each year due to acetaminophen drug overdose.
- In 2005, the FDA issued a warning about dextromethorphan abuse after a series of drug abuse incidents.
- 3.1 million young people aged 12 to 25 have used a nonprescription cough and cold medication to get high.
OTC Drugs that were Prescription Medicines
Some over the counter medications were once prescription drugs. As time and use proved their worth and safety to The U S Food and Drug Administration, their classification was changed.
For example, the antihistamine diphenhydramine (Benadryl) started as a prescription medication in 1946, but in the 1980s was approved as an over-the-counter drug in the US.
That does not mean diphenhydramine does not have a higher risk for adverse effects if misused. There have been reports in recent years of teenagers overdosing on the drug as the result of a so-called Benadryl Challenge on the Internet.
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We further believe that once an individual develops the disease of chemical dependency, recovery can only occur if total abstinence is maintained from all mood/mind-altering chemicals unless competently prescribed. Continuing care follow-up and involvement in a 12-Step support program are essential to recovery.
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Dextromethorphan (DXM), a drug found in many over the-counter medications, is psychoactive when ingested in greater-than-recommended doses.
Abuse of cough medicines is popular among young people, according to the National Institute on Drug Abuse. These over-the-counter medications cause a “high” feeling and are easy to find at home.
Many cold medications include pseudoephedrine, a stimulant which, when abused, can cause hallucinations or an intense feeling of euphoria.
Motion Sickness Pills
In high doses, motion sickness pills containing dimenhydrinate, an antihistamine, can cause nausea, ringing in the ears, hallucinations, irregular heartbeat, coma, seizures, and even death.