Understanding OTC (Over-The-Counter) Drugs

Over-the-counter (OTC) drugs are medications available without a prescription at drugstores or supermarkets.

OTC drugs are typically safe if used at recommended doses. Like illegal and prescription drugs, they can also be abused. Although less potent than other substances, OTC drugs still pose a risk for developing an addiction.

Abusing OTC drugs can lead to health problems including memory loss, kidney failure, heart problems, and death.

Some commonly abused OTC medications include:

  • Cough medicines (dextromethorphan, or DXM)
  • Cold medicines (pseudoephedrine)
  • Motion sickness pills (dimenhydrinate)

If you or someone you love is struggling with an OTC drug addiction, call a treatment provider for rehab-related help.

OTC Drug Abuse

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.

Someone abusing OTC drugs might move on to more dangerous or illicit drugs in search of a better high.

Cough Medicines (Dextromethorphan, or DXM)

Cough medicines can cause hallucinations and a potent high when abused. Cough medicines are popular among young people, as they’re often readily accessible in medicine cabinets at home or at a friend’s house. The Drug Enforcement Administration (DEA) lists different dose-dependent plateaus, as experienced by people who abuse DXM. The maximum recommended daily dose of DXM is 120 mg; beyond that, intoxication and dangerous side effects begin to appear.

  • A dose of 100-200 mg induces mild stimulation and euphoria.
  • A dose of 200-400 mg leads to stronger euphoria and hallucinations.
  • A dose of 300-600 mg causes loss of motor coordination and visual distortions.
  • A dose of 500-1500 mg leads to out-of-body sensations.

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

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Cold Medicines (Pseudoephedrine)

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.”

Pseudoephedrine is also used to create illicit drugs like methamphetamine. Abusing pseudoephedrine can cause irregular heartbeat, shortness of breath, high blood pressure, dizziness and seizures.

Motion Sickness Pills (Dimenhydrinate)

Dimenhydrinate is used to treat motion sickness and vertigo. In high doses, the drug can cause hallucinations, ringing in the ears, nausea, irregular heartbeat, seizures, coma and even death. 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).

OTC Drug Addiction

Recreational OTC drug use can also change the brain’s chemistry over time. Eventually the user builds a tolerance to the drugs, needing more of the substance to get the previous effects. Those addicted to OTC drugs maybe also develop withdrawal symptoms when they stop using.

Common symptoms of OTC drug withdrawal include:

  • Confusion
  • Irritability
  • Agitation
  • Anxiety
  • Mood changes

Learning to spot an OTC drug addiction can be difficult. OTC drugs like Tylenol and various cough medicines don’t carry the same dangerous image as illicit drugs like heroin. People don’t always see them as addictive, so many loved ones of people addicted to OTC drugs don’t know to look for signs of a growing problem.

Some of the signs of an OTC drug addiction include continuing to use the drugs despite known consequences and spending an excessive amount of time or money using or getting them. There are 11 key criteria to diagnose an addiction to any drug.

OTC Drug Abuse Statistics


FDA warning

In 2005, the FDA issued a warning about dextromethorphan abuse after a series of incidents caused by the drug.



Approximately 3.1 million young people aged 12 to 25 have used a nonprescription cough and cold medication to get high.



About 4% of 12th graders have abused some form of cough medicine.

OTC Drug Addiction Treatment

Those suffering from OTC drug addiction have many treatment options. Individual and group therapies, mental health counseling, and psychotherapies like Cognitive Behavioral Therapy (CBT) are all effective treatment methods.

Inpatient and outpatient rehab programs allow those recovering from OTC drug addiction the resources to get and stay sober. Enrolling in a drug rehab program can significantly reduce the odds of relapse.

Get The Resources To Beat Addiction

Overcoming an OTC drug addiction can be difficult, but it is far from impossible. Inpatient drug treatment programs give recovering addicts 24-hour medical care, while those in outpatient programs can visit specified medical centers while keeping their home lives intact. Attending a 12-step group like Narcotics Anonymous can provide community and support to help with lasting recovery. If you or someone you care about is struggling with an addiction to OTC drugs like dextromethorphan, contact a treatment provider to discuss available treatment options.