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How Much Is Too Much: OTC Meds?

January 5, 2024

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The Meadows

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By Melissa Riddle Chalos

Over-the-counter medications are so commonplace in our lives, using them seems as natural as wearing socks or brushing teeth. But each one requires responsible, informed consumption to avoid serious health risks. 

What is OTC Medicine?

Over-the-counter (OTC) medications are those that can be sold directly to consumers without a doctor’s prescription. Everyday medications like ibuprofen, Benadryl, Tylenol, antihistamines, antidiarrheal pills, and decongestants are designed to be short-term treatments for temporary conditions and the symptoms of each. OTC medications are fairly affordable and available just about everywhere; best of all, they will likely alleviate a majority of what ails you. 

But sometimes we can get so comfortable relying on medication for a certain issue, that we get careless about how, when, and how much we use. Featured on SNL, comedian Nate Bargatze poked fun at his dad’s decades-long use of nasal decongestant Afrin despite its recommended usage being no longer than three days. Taking that little pink Benadryl pill to help you sleep at night might work short-term, but, long-term use can negatively impact alertness, memory, and learning, and may put seniors at risk for dementia, says TIME.

Just because we’re comfortable with OTC medications doesn’t mean there aren’t risks involved when taking them.

In other words, just because we’re comfortable with OTC medications doesn’t mean there aren’t risks involved when taking them. In fact, because these meds are so widely available, they are often ripe for misuse and abuse.

How Can an OTC Drug Be Abused?

Sometimes, certain nonprescription medications become such a part of our daily routine that we end up taking them like vitamins or supplements. As we use them to deal with daily pressure, aches, pain, constipation, anxiety, and other physical or mental stressors, we stop reading the labels because we think we know what, and how much, we need. 

Sometimes, certain nonprescription medications become such a part of our daily routine that we end up taking them like vitamins or supplements. We stop reading the labels because we think we know what, and how much, we need.

While generally considered safe, misusing over-the-counter (OTC) medications is quite easy to do, but it can have serious consequences. Here are three signs of misuse:

1. Exceeding Recommended Dosages: Each OTC drug comes with specific instructions on how much to take and how often. Exceeding these guidelines can lead to negative effects and potential harm to your health.

2. Using OTC Medications for Non-Approved Purposes: For example, using a cough syrup that contains dextromethorphan (DXM) to achieve a euphoric or hallucinogenic effect rather than to alleviate cough symptoms is considered misuse.

3. Ignoring Contraindications and Interactions: If you’re combining medications — or taking OTC cold and flu meds while on a high blood pressure prescription, for example — without checking for potential interactions, you are certainly at risk of misuse.

Most Abused OTC Meds

When carelessness progresses over into intentionally misusing OTC medications, that’s when misuse becomes abuse. What are some commonly abused OTC medications? The National Institute on Drug Abuse (NIDA) shares the following:

• Dextromethorphan (DXM): Found in many cough and cold medications, DXM is a cough suppressant. Some people misuse large quantities, often mixing it with soda for flavor (which is known as “robo-tripping” or “skittling”) to experience dissociative and euphoric effects. This can lead to increased heart rate, elevated blood pressure, and even hallucinations.

• Loperamide: Loperamide is an antidiarrheal medication commonly used to treat diarrhea. In large doses, it can act on opioid receptors and produce effects similar to opioids. Some individuals misuse loperamide in an attempt to self-treat opioid withdrawal or to achieve a mild euphoria. However, taking too much loperamide can lead to serious heart-related issues, overdose, and addiction.

• Pseudoephedrine: Pseudoephedrine is a decongestant found in many cold and allergy medications. It can be misused to produce stimulant effects similar to those of amphetamines. Pseudoephedrine is a precursor for the illegal production of methamphetamine, so its sale is often restricted.

How to Prevent OTC Drug Abuse

These and other nonprescription drugs can be misused to the point of abuse. Often, patients don’t discuss with their physicians what OTC medications they take on a regular basis. By omitting this information, we lose out on valuable information that could prevent potential harm in the short-term and in the future. Reducing the risk of over-the-counter (OTC) drug misuse or abuse involves responsible and informed use.

How can we prevent OTC drug abuse?

  • Avoid Self-Diagnosis: Both self-diagnosing and self-medicating can be risky. If symptoms persist or worsen, seek professional medical advice instead of trying to manage the condition on your own.
  • Know Your Medications: Be aware of the active ingredients in the medications you are taking, especially if you are using multiple products simultaneously to avoid unintentional double dosing.
  • Limit Use of Combination Medications: Combination medications that treat multiple symptoms may contain ingredients you don’t need. Use single ingredient medications when possible, to better control your intake.
  • Educate Yourself: Stay informed about the medications you are taking, potential side effects, and any updates or recalls related to OTC drugs. Knowledge empowers you to make informed decisions.
  • Dispose of Unused Medications: Properly dispose of any unused or expired medications to prevent accidental use or misuse by others.

By practicing responsible medication use, staying informed, and seeking professional guidance when needed, you can significantly reduce your risk of over-the-counter drug misuse or abuse. If you suspect any issues, talk to a healthcare professional right away.

Are OTC Drugs Addictive?

Habit-forming behaviors often begin at home, with the opening of the medicine cabinet, with something as seemingly harmless as a cough medicine. Sometimes, there is a tipping point, when you or someone you love begins misusing OTC medications, either consuming too much, too often, or to achieve a recreational high.

Much like legal, medically prescribed marijuana, OTC medications like DMX, pseudoephedrine, and loperamide all hold the potential for misuse, overdose, and addiction. NIDA warns that some of these chemical substances can cause opioid-like effects, such as hypoxia, which can be deadly. All of them have the potential to inflict physical, psychological, and even legal trouble from abuse.

Find Addiction Help at The Meadows

At The Meadows, we specialize in helping you cut through the confusion and deal with the root causes of your mental health and substance use disorders. We work with you to get to the why of what you are struggling with, so we can provide solutions that help you achieve long-term healing and recovery. 

Using our Meadows Model and a wide range of therapeutic approaches, our caring professionals will customize a treatment plan that is unique to you and will address your specific needs. Whether it’s you or a loved one who needs help, we are here to guide you on a true path to wellness. Reach out today to learn more.