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Long-Term Effects of Over-the-Counter Drug Abuse

over-the-counter drugsOver-the-counter medications, also called OTC drugs, include all medications purchased for any malady. However, a number of over-the-counter medications are also abused by those looking for a cheap and easily accessible high, often young adults. Many users believe that the drugs are safer than abusing street drugs since they are sold legally and used for medical treatment. However, over-the-counter medications are only safe when taken as suggested, and large doses can cause intoxication as well as toxicity. They can also cause a number of acute health effects and long-term negative effects as well.

One of the biggest problems with over-the-counter drug abuse is accessibility. They are legal for all to purchase, and they are sold on the shelves at:

  • Drug stores
  • Grocery stores
  • Convenience stores
  • Online stores

Only certain OTC medications are restricted in any way, and in most cases, patrons can grab as many boxes or bottles of their medication of choice as are available on the shelves. Depending upon the drug of choice, users may ingest an entire bottle of cough syrup – to two – or take an entire box of pills. Though the intended use is to treat symptoms related to cough, cold and flu, the active ingredient can often create hallucinogenic or stimulant effects in users who take large doses. In other cases, the intended use of the OTC medication may be to ease discomfort or promote overall health, but when taken in large doses, they can have the exact opposite effect.

If you are concerned about your loved one’s use of over-the-counter medications and would like to limit the long-term effects that can occur with chronic use, contact us at The Orchid to learn more about the treatment options and services we offer that can help your family member turn over a new leaf.

OTC Drug Abuse: Types of Medications

Different types of over-the-counter medications are commonly abused by those who are trying to get high, and different types create different long-term effects. The California Department of Alcohol and Drug Programs (CDADP) reports that the most commonly abused types of OTC medications include dextromethorphan (DXM), found in cough medication, and stimulant substances like ephedrine and pseudoephedrine, found in other cold medications. Each creates very different acute and long-term effects in users.

However, a wide range of over-the-counter medications are abused and taken in large doses, either in hopes of enhancing their intended purpose or to achieve another result. Some examples include laxatives, emetics, diuretics and more. Additionally, herbal supplements and remedies also have the capacity to be abused when taken in large amounts for the purposes of getting high.

Dextromethorphan (DXM)

Cough MedicineDextromethorphan is an ingredient in a number of medications designed to treat issues like sinus pressure, headache, and congestion related to the cold or flu. However, most of the medications that people take that highlight DXM as a main ingredient also include other ingredients that can be dangerous when taken in large amounts. The acute effects of DXM include:

  • Dizziness
  • Seeing “trails”
  • Slurred speech
  • Lack of coordination
  • Fatigue
  • Confusion or feeling disoriented
  • Increased heart rate

Some users also get physically ill and complain of stomach cramping, nausea, and vomiting while others report that they feel a tingling in their fingers and toes. In the worst cases, users can overdose, taking so much that death is the result. Additionally, high doses of DXM can cause the user to experience hallucinations. Not uncommon is the experience of being so high that accidents happen and inadvertently result in the death of the user or someone else.

The long-term effects of chronic use of DXM will vary depending upon how often the user abuses the drug, the dose they take, the use of other drugs of abuse including alcohol, and the existence of co-occurring mental health issues. In general, the long-term effects risked by chronic use of the drug include:

  • The risk of overdose with each use
  • A buildup of DXM in the body caused by taking low doses repeatedly in a short period of time
  • Suppression of the central nervous system that can result in an inability to breathe or a slowing of the heart rate


A number of cold and flu medications include a stimulant drug like pseudoephedrine that provides the user with a boost to help them get through the work day while dealing with cold and flu symptoms that can cause drowsiness and fatigue. Some of these medications are used in the making of street drugs like crystal meth and regulated by the government. Most establishments put a card on the cold medications shelf that indicates the name of the drug and direct consumers to take the card to the pharmacy in order to get the medication. This precaution is taken in order to limit theft of the drug as well as to limit the number of boxes purchased at one time.

  • Anxiety
  • Shakes or tremors
  • Paranoia
  • Irritability
  • Insomnia
  • Abnormal heartbeat
  • Nausea and vomiting
  • Psychosis
  • Seizures
  • Heart attack

Overdose is always an issue when taking too much of a stimulant medication. It can cause a heart attack depending upon the amount taken, the underlying medical conditions of the patient, and the frequency of use.

When chronic use of stimulant over-the-counter medications becomes an issue, the long-term effects of the drug can include effects that continue long after the medication wears off, including:

  • Irregular menses in women
  • Decreased libido
  • Extreme mood swings
  • Agitation
  • Chronic constipation
  • Impaired vision
  • Addiction
  • High blood pressure
  • Coma
  • Death

Weight Loss Medications

The range of pills and supplements dedicated to aiding in weight loss are at risk for abuse as well, especially by young women with eating disorders. Even in small amounts, these drugs can be dangerous, and it is never recommended that they be taken for long periods of time. The National Center on Addiction and Substance Use at Columbia University reports that chronic use of the following weight loss aids sold over the counter can result in a slew of consequences:

  • Laxatives
  • Diuretics
  • Emetics
  • Diet pills

Many young adults take laxatives with the intent of “purging” calories they have eaten before they are absorbed into the body. The fact is that this method does not work. Laxatives only serve to empty the waste created by food previously processed in the body. It does not affect food in the stomach. Long-term use of large amounts of laxatives can result in serious issues of the gastrointestinal system. Some patients are unable to move their bowels without them and must undergo surgery in order to fix the damage.

Diuretics are marketed as weight loss tools but only serve to help the patient lose excess water weight. Emetics are used to cause vomiting and used, like laxatives, by some with eating disorders to purge the body of unwanted calories after a binge eating session. Taking either of these medications for too long can result in dehydration, an issue that, according to BBC Health, can cause a number of long-term and deadly health issues, including:

  • Joint pain
  • Migraines
  • Chronic fatigue syndrome
  • Kidney and liver damage and/or failure
  • Reduced lymph circulation
  • Death

How Over-the-Counter Medications Are Abused

The Partnership for a Drug-Free Americareports a wide range of methods and ways in which people abuse over-the-counter medications, including:

  • Taking them for a purpose other than their intended use (e.g., to get high or to achieve an unhealthy weight loss goal)
  • If in pill form, crushing the pills in order to release all the medication at once when swallowed, snorted or injected
  • Taking the medications in large doses
  • Combining large doses of the medication with other illicit substances including alcohol, marijuana and others

It’s not uncommon for those who abuse OTC medications to also abuse other illicit substances. For example, use of a combination of crystal meth or cocaine in addition to over-the-counter weight loss medications is common in those who are dually diagnosed with an eating disorder and a drug abuse problem. It’s also not uncommon for those who abuse OTC cough and flu medications recreationally to combine the substance with the use of marijuana and/or alcohol in a social setting. The combination of these drugs can increase the severity of the symptoms listed above, increase the chance of overdose or accident, and worsen the long-term effects of chronic drug abuse.

Treatment for Over-the-Counter Drug Abuse

Just as there are comprehensive and evidence-based therapeutic treatment options available to those who struggle with dependence upon alcohol, prescription painkillers, and other illicit substances, there is also a wide range of treatment services available for those who struggle with abuse of over-the-counter medications.

At The Orchid, we can discuss your loved one’s needs in treatment and help you to identify the best course of action for rehabilitation. Call the phone number listed above today to speak to a counselor about your family member and help them begin the healing process now.

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