The Dangers of Misusing Over the Counter (OTC) Medications and Supplements

1 May, 2022
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If you have experienced any mild medical issue, you probably took an over-the-counter (OTC) medication to treat it rather than going to the doctor. OTC medications are available without a prescription, making them convenient and cheaper than prescription medications. In addition, OTC medications are generally safe and effective when used properly. Unfortunately, some people may assume that these medications are harmless because they do not require a prescription. However, these medications can cause serious harm if misused, but treatment is available to help people who misuse or abuse OTC medications.

Commonly Misused OTC Medications

Many different OTC medications have the potential for misuse. Some commonly misused OTC medications are:

  • Sleep aids
  • Dextromethorphan (DXM)
  • Laxatives
  • Antihistamines
  • Decongestants
  • Anti-diarrheals

Dextromethorphan and loperamide have the most potential for misuse and abuse. Dextromethorphan is a cough suppressant found in many OTC cold medicines. It can be swallowed in its original form or mixed with soda. It is called “robo-tripping” or “skittling ” when mixed with soda.” In addition, Dextromethorphan can be misused in combination with other drugs such as marijuana or alcohol. Some people even inject it.

Loperamide is an anti-diarrheal found in liquid, tablet, or capsule form. People who abuse and misuse loperamide swallow large amounts of the medication.

How Do Dextromethorphan and Loperamide Work? 

Dextromethorphan is an opioid that does not act on opioid receptors in the brain, and it has no pain reduction effects. However, Dextromethorphan does have a depressant effect and sometimes a hallucinogenic effect when taken in large quantities. When large amounts are taken repeatedly to experience these effects, it can lead to addiction.

Loperamide is also an opioid, but it is designed not to enter the brain. However, when combined with other drugs and taken in large amounts, Loperamide can act similar to other opioids.

Effects of Dextromethorphan and Loperamide Misuse and Abuse

Extended abuse and misuse can lead to:

  • Extreme panic
  • Hallucinations
  • Anxiety
  • Aggression
  • Paranoia
  • Vision changes
  • Slurred speech
  • Poor motor control
  • Addiction
  • Overdose

One major risk is liver damage when large amounts of dextromethorphan products containing acetaminophen are ingested.

Loperamide misuse and abuse can cause:

  • Constipation
  • Fainting
  • Stomach pain
  • Addiction
  • Overdose

Antihistamine Misuse and Abuse Can Have Deadly Consequences

The rise of Tik-Tok has led to many “challenges.” Many are harmless and fun, but the misuse of the antihistamine Benadryl (diphenhydramine) for the “Benadryl Challenge” can lead to serious, life-threatening dangers. The FDA states that taking more than the recommended dose of Benadryl can cause:

  • Serious cardiac complications
  • Coma
  • Seizures
  • Blurred vision
  • Urinary retention
  • Death

Benadryl has a sedative effect that can feel similar to being intoxicated in larger doses. However, taking large amounts will more likely cause uncomfortable side effects or harm than a euphoric high.

It is also important to remember that Benadryl’s sedative effects make it dangerous to use with alcohol, opioids and opiates, and other central nervous system depressants.

Laxative Misuse

When we think of laxative misuse, we often think of people with eating disorders misusing laxatives to lose weight. People with eating disorders do make up the largest group, but there are three other groups of people who often misuse laxatives:

  • Middle-age people use laxatives for constipation but continue to use them for long periods.
  • People who participate in sports with a set weight limit
  • Individuals who may have a factitious disorder

There are several types of laxatives, but the most commonly misused is the stimulant type. This is possibly due to how quickly they work. Stimulant misuse can be extremely dangerous and life-threatening as it can cause acid/base and electrolyte imbalance.

Attempts to Sleep Well Can Lead to Misuse of OTC Sleep Aids

Most people have experienced some nights of tossing and turning all night and waking up tired the next morning. As a result, people who frequently have difficulty falling asleep may turn to OTC sleep medications and become dependent.

Many of these OTC sleep aids contain diphenhydramine. We have already looked at some of the dangers of diphenhydramine misuse to try to experience a high. However, it can also be misused as a sleep aid. People sometimes take doses that are too large or take the medication for longer periods of time than intended. This can lead to dependence and some evidence shows that prolonged use of diphenhydramine can increase a person’s risk of developing dementia. Older people are susceptible to the effects of diphenhydramine. When given diphenhydramine, older people may experience confusion, urinary retention, and unsteady gait.

Melatonin is sold as a non-FDA-approved nutritional supplement. Occasional use and doses of 1mg-3mg are considered safe. However, misusing this supplement by taking larger doses can cause unpleasant effects, including:

  • Tremors
  • Irritability
  • Nausea
  • Dizziness
  • Headaches
  • Anxiety
  • Depression

Decongestant Misuse Can Have Deadly Consequences

For years people have known about the dangers of misusing pseudoephedrine to make methamphetamine, and as a result, pseudoephedrine is more tightly regulated and sold behind the counter. Recently there have been reports of propylhexedrine misuse and abuse with severe health complications and sometimes death.

Propylhexedrine is a nasal decongestant in nasal sprays. In Europe, it is also used as an anorectic in weight loss medications. How does someone misuse or abuse nasal spray? Most people who misuse or abuse propylhexedrine do so by injecting it or taking it orally. Misuse and abuse can cause:

  • Seizures
  • Pulmonary hypertension
  • Tachycardia
  • Hypertension
  • Stroke
  • Agitation

Getting Help Is Important

Deciding to seek help for abuse or misuse of OTC medications can be a big step toward a healthier life. Often people who take this step need help and support from friends, families, and professionals. Help is available at Sober Life in downtown San Diego, California.

OTC medications make managing your healthcare easier, more convenient, and cost-effective. However, it is important to remember these medications can still be dangerous and can lead to misuse or abuse if not taken as directed and for the intended purpose. If you or a loved one are struggling with abuse or misuse of OTC medications, Sober Life offers a variety of outpatient programs to help. We offer a partial hospitalization program (PHP), intensive outpatient program (IOP), and an outpatient program at our modern, vibrant facility, or you can choose our virtual outpatient program. At Sober Life, you can work on your recovery in a program that fits into your lifestyle.  You will receive evidence-based treatment that promotes resilience and independence. Call Sober Life at (619) 542-9542 to learn more about our services and why we are San Diego’s go-to treatment center for substance use disorder and mental health recovery.  

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