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Over-The-Counter Drugs: Mind-Altering OTC Medications

Last Updated: June 30, 2021

Authored by Isaak Stotts, LP

The US Food and Drug Administration (US FDA) has approved a number of over-the-counter drugs (OTC) based on their safety profile. Therefore, it means OTC drugs do not pose significant health risks.
As a result, one can take them without the direct supervision of a healthcare professional. Nonetheless, there are certain over-the-counter drugs that have mind-altering effects and can result in substantial abuse.

Over-The-Counter Drugs Overview

Over-the-counter drugs are medications users can purchase without a doctor’s prescription. Hence, they are also called non-prescription drugs.
When someone takes OTC drugs following the instructions on the product labels, the chances of abuse are very low. However, with irrational use, the chance they end up abusing them and finally becoming addicted is very high.

Which Over-The-Counter Drugs Are Abused To Get High

In the US, more than 80 drugs have been approved for use without a prescription. For example, common OTC drugs include cold tablets, cough syrups, motion-sickness pills, allergy drugs and certain pain medications.

Non-prescription pain medications such as Tylenol, Advil, Aleve and other similar drugs don’t really get one high. Still, people might abuse them unknowingly.

A number of prescription and OTC drugs can give an indivdual a high. However, not all these will lead to a drug addiction. The following list contains some common over-the-counter drugs that can get a person high:

  • Cough medications: Dextromethorphan, found in cough preparations is an OTC medication that they abuse a lot. It works by changing the activity of cough center in the brain. It targets brain function. As a result, taking a large amount can cause euphoric feelings or even hallucinations. Incidentally, as the mind gets used to the euphoric feelings, user may abuse it to keep a constant high.
  • Cold medications: Pseudoephedrine is a component of cold preparations. It helps to relieve nasal congestion by constricting the blood vessels in the nasal mucous membrane. It works as a stimulant. As a result, it can cause excitation and elevated blood pressure, people may abuse these pills to get high.
  • Allergy medications: OTC allergy medications like cetirizine and chlorpheniramine may be used alone or with other drugs to treat allergy symptoms. Allergy medications are also used to prevent motion sickness. Therefore, these drugs are known to cause drowsiness and reduce attention. Consequently, many people take them in larger quantities or more frequently to get the relaxed feeling.
  • Caffeine preparations: Caffeine is a central nervous system (CNS) stimulant found in tea and coffee. Additionally, they use a combination of caffeine and pain medication like acetaminophen or aspirin to treat pain, migraine, and fever. Companies also market it as a weight loss supplement. In fact, moderate consumption of caffeine increases alertness and may also improve concentration. For this reason, coffee and tea are the most widely consumed beverages. However, consuming high amounts can cause restlessness, loss of sleep and increased heart rate.
  • Nasal inhaler: They often use OTC nasal inhaler containing the drug Propylhexedrine recreationally to get high. The use of this inhaler on the label is to reduce nasal congestion and promote airflow. Similarly, nasal inhalers produce amphetamine-like CNS stimulation. Therefore, using this drug on a regular basis may lead to addiction.

Why OTC Medications Sometimes Are More Likely to Be Abused?

OTC drugs abuseFirstly, it is the easy access. One can buy these medications without a prescription. Next, is the natural route of intake. They are easy to take as most of them are available in the form of tablets, syrups or other oral preparations.
Lastly, abusers may have multiple drugs in a single dose. In fact, a single OTC pill may contain two or more active drugs. It might be cold tablets which contain both pseudoephedrine and allergy medications. Both of these components have potential to get an individual high.

Signs of OTC Drug Abuse

There are no definite signs that could guarantee abuse of OTC drugs. However, making note of subtle signs could save a person from a greater loss in the future:

  • Changes in behavior: Drug abuse affects the brain and behavior. One might see their loved-one showing behavioral changes such as increased nervousness or aggressiveness without any relatable cause. As a result, they could suspect a case of drug abuse.
  • Lack of or decreasing communication: A drug abuser generally prefers solitude and seems detached from the surrounding. Therefore, this could be an early warning sign that the loved-one is falling into the abyss of drug addiction.
  • Deteriorating health: Drug abuse makes a person less concerned about health and hygiene. Moreover, the lack of nutrition and disturbances in sleep and mounting stress also affect their health.
  • Loss of medications from the box: People should take note of any missing medication in the medicine cabinet. A single event could be attributed to some On the other hand, a repetitive loss could mean something more serious.
  • Decreased performance in school or office: This usually doesn’t directly indicate a drug abuse. However, if their performance drops significantly and one cannot find reasons behind it, it might be drug abuse.

In conclusion, Over-the-counter drugs don’t produce highs comparable to prescriptions medications such as Morphine, Codeine, Hydrocodone, and others. Nevertheless, continuous abuse of OTC medications could be an early indicator of future drug addiction.
Watch for any sign of OTC drug abuse in the loved-ones. Regrettably, teens are more likely to start with OTC drug abuse. Later, they might move to higher levels in search of a more powerful high. Therefore, if a person is a parent to teenagers, they should be vigilant.

Page Sources

  1. Aronson J. K. Over-the-counter medicines. British Journal of Clinical Pharmacology. 2004; 58(3):231–234. doi:10.1111/j..2004.02191.x.
  2. Sansgiry S. S., Bhansali A. H., Bapat S. S., Xu Q. Abuse of over-the-counter medicines: a pharmacist's perspective. Integrated Pharmacy Research and Practice. 2016; 6:1–6. doi:10.2147/IPRP.S103494.
  3. Medline Plus. Over-the-counter medicines. 2019.

Published on: April 5th, 2017

Updated on: June 30th, 2021

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.


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