Over-the-Counter Highs

Legal, over-the-counter (OTC) drugs (i.e., no prescription is needed) can sometimes be manipulated to induce a “high.” This form of drug abuse is most often associated with adolescents and teens. The youthful demographic is drawn to over-the-counter drugs, in part, because of their easy access; they can be found in drug stores and oftentimes in their parents’ medicine cabinets. However, the adaptability of these over-the-counter drugs to abuse is not unknown to adults, particularly those who have an existing substance abuse disorder (for instance, cases of alcoholics drinking mouthwash such as Listerine due to its alcohol content).

The following over-the-counter drugs are considered to induce a high in users:

  • Diethyl ether
  • Kratom
  • Robitussin (dextromethorphan)
  • Benadryl (diphenhydramine)
  • Unisom (doxylamine)
  • Dramamine (dimenhydrinate)
  • Tramadol
  • Benzedrex (propylhexedrine)
  • Kava
  • Afrin (oxymetazoline)
Alcohol Addiction

As an indication of the variety of these drugs and the ingenuity of users, note that these drugs include an anesthetic (diethyl ether), cough suppressants (Robitussin), sleep agents (Unisom), pain reliever (tramadol), natural herbs (kava, kratom), allergy reliever (Benadryl), motion sickness (Dramamine), and nasal decongestants (Benzedrex and Afrin). Each of these drugs carries different side effects and psychoactive or sedative effects that may be altered when combined with other over-the-counter drugs, alcohol, street drugs, or prescription drugs.

Teens and Over-the-Counter Drug Abuse

As Michael R. Cohen, President of the Institute for Safe Medication Practices discusses in The Inquirer, a Philadelphia-based paper, abuse of over-the-counter drugs most commonly affects teens aged 13 to 16. To illuminate why teens and some adults abuse these drugs, consider the side effects by drug type:

  • Dextromethorphan/cough suppressant. According to Cohen, one in every 10 teens has abused a cough suppressant. High doses of these drugs reportedly produce a feeling of euphoria, changes in perceptions of color and sound, hallucinations, and an “out-of-body” type of experience. These effects can last up to six hours.
  • Diet pills. When consumed in high enough doses, over-the-counter diet agents can reportedly induce a mild buzz in users.
  • Motion sickness relievers. When taken in large doses, medications that contain dimenhydrinate (Dramamine) or diphenhydramine (Benadryl) can induce feelings of being high and result in hallucinations.
  • Nasal decongestant/pseudoephedrine. Found in numerous cold medications, this stimulant is reportedly abused for the upbeat and alert feeling it confers.

Misuse of over-the-counter drugs often stems from a host of personal, family, and even societal factors. Partnership for Drug-Free Kids has characterized the problem of teen abuse of prescription and over-the-counter drug abuse as an “entrenched behavior” (i.e., drug use has hardened into the bedrock of adolescent and teen culture, making it all the more challenging to root out). Teen abuse of over-the-counter drugs is a public health problem inside of an even bigger public health problem.

According to the National Institute on Drug Abuse (NIDA), after marijuana and alcohol, prescription and over-the-counter medications are the most commonly abused drugs in the 14-and-older age group (this data is current as of 2014). The popularity of the dangerous practice of over-the-counter drug abuse invites the question, why are teens taking these drugs?

The short answer would seem to be that teens take over-the-counter medications to get high. But that’s not the end of the story, nor does it provide sufficient insight into more complex dimensions of this problem. Today’s teens are said to be a part of the “Rx Generation.” They may be abusing drugs not only to get high, but also because they believe using drugs is an acceptable recreational activity and/or coping strategy.

America has witnessed an unexpected expansion of the drug epidemic. Whereas the focus of public education and prevention efforts used to be on street drugs, prescription painkillers have developed into a formidable public health enemy. There is a nationwide misconception that prescription drugs are safer than street drugs, which gives some users false confidence in the use of pharmaceutically manufactured prescription drugs. This same thinking trickles down into perceptions of over-the-counter drugs.

While it is true that over-the-counter drugs are usually safe when used in compliance with package warnings and directions, abusing these drugs heightens their risks. As NIDA discusses, when over-the-counter drugs are abused, they can become addictive and expose the abuser to a host of dangerous side effects, including overdose. As NIDA points out, one of the greatest risks over-the-counter drugs present is their use in combination with alcohol and other drugs. Teens who abuse over-the-counter drugs, especially as part of poly-drug use (i.e., using more than one drug simultaneously, including alcohol), are entering dangerous, unchartered territory. Such combinations of abuse can prove fatal.

Side Effects of OTC Drugs

As discussed, there are numerous types of over-the-counter drugs that are abused. While these drugs may have some overlapping side effects, each drug has its own specific types of effects. For an indication as to the potential hazards of abusing over-the-counter drugs, consider the example of cough suppressant abuse.

According to Kid’s Health, prior to the 1970s, over-the-counter cough suppressants contained codeine; manufacturers subsequently changed the formulation to dextromethorphan to curb abuse. Products that contain dextromethorphan usually include “DM,” “cough suppressant,” or “Tuss” in the title. Dextromethorphan is considered safe when taken in doses of 15 to 30 mg, but cough suppressant abusers, intent on getting psychoactive effects, may consume as much as 360 mg and more. Side effects of large doses of dextromethorphan include but are not limited to:

  • Confusion, dizziness, and paranoia
  • Seizures
  • Excessive sweating
  • Headache and impaired judgment
  • Numbing of fingers and toes
  • Brain damage
  • Loss of consciousness
  • Death

Even the most vigilant parents cannot be expected to be walking encyclopedias of side effects of the various over-the-counter medications. As there are many different over-the-counter drugs of abuse, and in view of adolescents’ and teens’ ability to find new low-cost highs, looking out for side effects of these drugs is likely not a feasible prevention measure alone. As Kids Health recommends, parents and concerned adults can take the following measures to help prevent teen abuse of over-the-counter drugs:

  • Medicine cabinet safety. Lock the cabinet, and even still, use a marker or other indicator of the current drug volume (e.g., write on the cover the number of pills, mark the liquid line in the bottle, etc.).
  • Buy only what you need. As a rule of thumb, avoid over-stocking, even if the cabinet is locked.
  • Use your eyes wisely. Not all over-the-counter medications come in the expected packaging, especially when ordered over the Internet. Keep your eyes peeled for strange-looking tablets, or any drugs that look out of place.
  • Monitor the Internet. Today, teens and adolescents are savvy enough to buy over-the-counter drugs online. Check search histories, or maintain awareness of any unfamiliar websites selling over-the-counter drugs or sending marketing emails.

In addition, parents may consider keeping their debit and credit cards in a private place and monitoring purchases listed on their accounts. Further, although adolescents and teens (at least those who do not work) have limited access to cash, it may be a good practice to advise family and friends not to give cash gifts or gift cards directly to the teen.

Treatment for OTC Abuse

As TIME discusses, it is critical for parents not only to find a drug treatment program, but also to find the right program. To that end, TIME touts the guidance offered by the Partnership for Drug-Free Kids in a free e-book entitled “Treatment.” According to TIME, the right treatment program is most likely to be one that is based on scientifically tested and proven treatment models, and that avoids harsh and confrontational treatment approaches.

Based on the guidance in the Partnership’s free e-book, TIME highlights the following advice for parents and loved ones concerned about teen drug abuse and considering rehab services:

  • Get a good assessment. It is essential to get an accurate picture of the extent of the drug problem from a well-qualified and experienced addiction specialist. Approximately half of all teens with a substance abuse problem also have a co-occurring mental disorder, which, if present, will need to be diagnosed and simultaneously treated.
  • Location. Although the most appropriate rehab service may be away from home, in general, a treatment center that is close to home and part of the local community may be the best choice (provided there is no compromise to quality of treatment).
  • Demographic of other patients. Youth may be safer in treatment with other youth. Exposing youth to adults, who may present sexual issues and/or more complicated drug profiles, can present challenges that are best to soundly plan around. Likewise, gender-specific treatment can be more effective in some instances.
  • Staff training. It is best to select rehab services that include staff members with education, training, or experience in working with the specific issues related to over-the-counter drug abuse.

At Axis, we provide our clients with the most cutting-edge treatment therapies across multiple facilities. Our goal is to provide expert rehab care tuned to the specific needs of each client. Our dedicated, impeccably qualified team of addiction specialists works together to plan an appropriate course of treatment that is provided to our clients in comfortable, state-of-the art surroundings. Call now to learn more.