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Over-The-Counter Drug Abuse

Teens can all-too-easily get their hands on over-the-counter drugs at the grocery store or in the medicine cabinet at home. These drugs may seem harmless, but many teens are learning of their addictive properties the hard way. Get your teen help right away if you suspect they're abusing over-the-counter drugs.

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13 min read

Are Teens Abusing Over-the-Counter Drugs?

OTC drug abuse is not only common, but it’s also been a trendy way for teens to get high in recent years. Abuse of these drugs is most common in teens aged 13–16. When taken in high doses, several of these drugs induce symptoms of a “buzz” not unlike certain illicit drugs. This can include hallucinations, euphoria, intense relaxation or heavy jolts of energy.

In the place of alcohol or heavier drugs — or even in addition to these things — thousands of teens abuse OTC drugs with friends and at parties. Typically, they will take far more than the recommended dose — sometimes even as much as 30–40 times the recommended dose. They may do it for the pleasurable effects or as a way to escape their stresses — just as with any harmful substance. Whatever the cause may be, the truth remains that these legal medications are being misused, and with frequently undesirable results.

In a study of clients at a California drug court, 16.2% admitted to abusing OTC medications. In 2006, more than 3 million people in the U.S. aged 12–25 admitted to using OTC cold medicine to get high.

Popularity of Cough Syrup

Cough syrup abuse is a trend that’s hit the mainstream. Particularly in the hip-hop community, celebrities have been spotted casually drinking cough syrup, and it’s even referenced in a number of hit songs. Slang terms for cough syrup among those using it recreationally include:

  • syrup
  • sip-sip
  • dex
  • drex
  • rojo
  • orange crush
  • tussin
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By drinking an entire bottle of Robitussin or a similar DXM-containing medicine, teens report an intense high and hallucinations. This is called “robo tripping” or “robotripping” among teens, and the sensation can be addictive.

In addition to hallucinations, overuse of DXM cough syrup also causes dizziness, vomiting, confusion, rapid heartbeat and even numbness in the extremities. Among the patients rushed to the hospital for DXM, 48% are aged 12–20.

A number of stories have also mentioned “sizzurp,” “lean” or “purple drank,” a concoction made from codeine-based cough syrup and soda. This mixture creates a heavy sedation and euphoric feeling, and was referenced in a number of rap songs during the 2000s. Rapper Pimp C of the group UGK mentioned this drink in their hit song “Sippin on Sizzurp.” Pimp C died in 2007, reportedly from an overdose related to codeine cough syrup.

“I tried it one night, and the one time I tried it, I instantly got hooked,” “Over-confidence, hallucinations, get very jittery, very antsy. I hear things and I see things. I have nightmares. I see aliens. I see demons.”

Samantha HodgeRecovering robotripping addict

Following repeated reports of addiction and death involving sizzurp, the sale of codeine has been increasingly enforced, sold by prescription-only or banned entirely in various states.

Defining Over-The-Counter Drugs

You probably have one or several of these in your house right now. Over-the-counter or OTC drugs are designed to fight the common cold, sneezing, sore throat, nasal congestion and similar ailments that we encounter all the time. They’re sold at pharmacies, gas stations and grocery stores — more than 750,000 outlets in the U.S. alone — without the need for a prescription (hence the name “over-the-counter”). For minor ailments, 81% of adults use OTC medications as their first response, and 7 out of 10 parents have given their child an OTC drug late at night for help with a cold. Nearly 3 billion retail trips are made each year to buy OTC drugs.

Over-the-counter medications commonly contain dextromethorphan (DXM) or ephedrine as their active ingredient, both of which have harmful properties if used heavily. The OTC drug market has evolved constantly over the years. In the past century, drugs like opium, heroin and cocaine were sold as over-the-counter medicines, before studies revealed how dangerous they actually were. Most recently, the drug codeine — once a popular cough suppressant — saw a change in legality due to reports of codeine addiction, overdoses and deaths. The drug is still sold with a prescription in some countries, but is banned altogether in others.

Over-the-Counter Drugs That Get You High

pharmacist hand holding medicine bottle in pharmacy store

Cough syrup and cold medicine typically come to mind when discussing OTC drugs. There are hundreds of OTC drugs, though — across 80 different drug classes — and cough medicine only accounts for a portion. If you take the time to explore the medicine aisle, you’ll discover many types of legal drugs, each with their own specific and intended purpose. These different medicines each come with a unique set of risks as well, especially when they’re used improperly to achieve a high.

Teens and even preteens are talking to each other about getting high on OTC drugs, whether in the hallways at school or in online forums like Reddit. It’s fast becoming a ritual at high school parties, alongside their first experiences with alcohol or other drugs. However they get into it, around 1 in 8 teens have reported getting high on over-the-counter cough medicine, with countless others misusing other types of OTC drugs. Because of how common and accepted these drugs are, there seems to be an impression that getting high on these is safer. This couldn’t be further from the truth, however.

Commonly used (and abused) OTC drugs include:

  • Cold or cough medicine – many contain dextromethorphan or chlorpheniramine, an ingredient designed to help with runny noses
  • Pain relievers – such as ibuprofen and acetaminophen — popular brands include Tylenol and Advil
  • Caffeine medicines – offer concentrated bursts of caffeine for people seeking instant energy — popular brands include NoDoz or 5-hour ENERGY
  • Diet pills – stimulants marketed as easy ways to boost metabolism and lose weight, which have come under heavy scrutiny in recent years for dangerous ingredients
  • Laxatives and diuretics – designed to promote digestion for those having trouble, but often misused as an easy (and ill-advised) way to lose weight
  • Motion sickness pills – can help alleviate sickness during travel or at amusement parks — popular brands include Benadryl and Dramamine

Other potent and potentially harmful legal medicines include “herbals,” mixes of natural and synthetic ingredients that teens commonly use to achieve a buzz. Herbal ecstasy and synthetic marijuana are both over-the-counter products that have caused a wave of hospital visits after being ingested by teens. The legality of the products has been in flux for the last decade, although kids may be able to access them in small convenience stores with looser policies.

Limits and Restrictions

OTC drugs will typically list a daily upper limit on their packaging (e.g. 4 grams or 4g), and taking any amount higher than this limit can be dangerous. Combining multiple OTC medications with the same active ingredients adds additional dangers (for instance, mixing Advil and Motrin, which both contain ibuprofen). A teen desperate for a buzz may grab a handful of everyday pills like these. Any pleasurable feelings that come about will be quickly followed by painful and potentially serious side effects.

In general, over-the-counter drugs vary in their legality depending on the region. Certain OTC drugs are only sold to people 18 and older, and you may have trouble finding some of these drugs in certain areas of the country. But even the most common of these and easily accessible of these (cold medicines and painkillers) can be extremely dangerous when abused — taken improperly and in high doses.

Can Teens Access These Drugs?

If they’re in your home, your kids can find them. You might keep cold medicine or ibuprofen in your kitchen, bathroom, purse or car — easily in reach for a curious teen. Studies show that 49% of parents admit anybody can access their medicine cabinets. As more and more parents learn of the dangers, they are getting better about keeping OTC drugs out of reach — in locked drawers or hidden compartments — and doing so is highly recommended.

But there’s only so much you can do. Although laws change constantly, and stores are increasingly putting age limits on over-the-counter drugs, it’s not hard for teens to find at least some of these medications in convenience stores. They can also access these drugs from friends.

Are OTC Medications Addictive?

Misusing over-the-counter drugs can lead to addiction wherein the person needs the drug to get through their day and can’t function properly without it. This addiction may be more psychological than physical — where the addict craves it out of habit and due to a mental fixation — but certain drugs have seen cases of serious addiction and withdrawal, a physical aching and pain when the body doesn’t receive a fix.

Dextromethorphan in particular may cause addiction and withdrawal, the symptoms of which can include depression and difficulty processing thoughts. Codeine addiction made headlines in the 2000s for affecting thousands and killing many. This epidemic caused legislators to make codeine a prescription-only drug, but it’s still available over the counter in some countries.

What Are Side Effects of Over-The-Counter Drug Abuse?

The ramifications of OTC drug abuse can range from mild to severe, depending on several factors. These include the type of drug, the amount taken, the size and weight of the person taking it and if it’s being combined with any other substances. If your teen mixes over-the-counter drugs with alcohol or illicit drugs, this can greatly increase the risk of serious side effects, such as overdose and organ damage. Driving a car while taking OTC drugs can also be extremely dangerous, as many of these drugs make you drowsy.

Short-Term Effects

OTC drugs, particularly those with chemicals like DXM or ephedrine, have many short-term side effects. The appearance and intensity of side effects increases as the dosage increases. These effects can include:

  • Lightheadedness
  • Drowsiness
  • Nausea or vomiting
  • Impaired judgment
  • Loss of muscle movement
  • Blurred vision
  • Change in heart rate
  • Slowed breathing

Long-Term Effects

Used for a prolonged period of time, over-the-counter medications are capable of severe side effects on par with those of harder drugs. Even if your teen uses these drugs as intended, you should ensure they don’t take them longer than needed. Long-term risks can include:

  • Tolerance (needing more of the drug to feel the effects)
  • Thinned blood
  • High blood pressure
  • Heart attack or stroke
  • Liver or kidney damage
  • Stomach bleeding
  • Ulcers
  • Seizures
  • Memory loss

Effects on the Brain

Many popular over-the-counter drugs block acetylcholine, a neurotransmitter that helps neurons communicate with each other. Acetylcholine also helps promote learning and plays a role in memory. Some patients report memory loss from OTC drug abuse in as little as 60 days.

In addition to memory loss, the impact on the brain caused by heavy misuse of OTC drugs is comparable to that of harder, illicit drugs. DXM affects the same cell receptors as hallucinogenic drugs like PCP and ketamine. Used heavily, medications with DXM can cause physical distortion and hallucinations in the brain. These effects can sometimes last for prolonged periods of time, even when the drugs have worn off.

Getting high on OTC drugs also impacts the dopamine levels in the brain. Production of dopamine is crucial to regulating sensations of happiness and pleasure in a person. When the brain comes to expect the dopamine high caused by DXM or other ingredients, it can lead to addiction and the inability to stop pursuing the drugs, despite the destructive consequences such as poor physical health or troubled relationships.

Other Effects

OTC drugs grow significantly more dangerous when combined with other substances. Mixing Tylenol with multi-symptom cold medicines can do immense damage to the liver, that can require a transplant and potentially even be fatal. Any combination of anti-inflammatories (e.g. ibuprofen, naproxen, aspirin) boosts the risk of side effects, such as nausea and gastrointestinal bleeding.

Women who take OTC drugs during the first 20 weeks of pregnancy are more than twice as likely to have a miscarriage as those who don’t.

If your teen misuses OTC medications, the undesirable effects can spread quickly and violently. Aside from their health, teens risk failing out of school, getting in trouble with the law or burning through their resources to feed their addiction. In turn, this can lead them to even steal money for their next fix. In some cases, an addiction to OTC drugs could just be the beginning of your son or daughter’s problems, as they develop other dangerous substance dependencies.

Identifying An Over-The-Counter Drug Abuse Problem

As a parent, it’s tough to draw the line when it comes to OTC medications. They’re a fixture in countless households — roughly 85% of U.S. parents give their kids OTC drugs for sickness before seeking professional care. But you need to know the difference between responsibly taking these medicines and abusing them. By identifying the signs of a problem, you can make the call to approach your teen and put an end to their habit.

Keep an eye out for worrisome changes to their behavior, mood or routine. Teens abusing over-the-counter drugs are likely to miss school or see their grades decline. They might also be increasingly suspicious with their plans or whereabouts, along with the friends they’re hanging out with, and lose interest in their regular hobbies or in family obligations. Over time you may also notice their appearance, hygiene and overall health declining, along with their eating and sleeping habits.

Physical evidence of their habit might include empty bottles or boxes of medicine, loose pills, or medicine containers missing from your own medicine cabinet.

While it’s important not to jump to conclusions, don’t allow the signs to fly under the radar. At the first hint of a problem, monitor your teen’s activity more closely and research the symptoms you observe. If you believe they have a problem with OTC drugs, it’s time to step in and put a stop to it.

Is Drug Rehab The Next Step?

If your teen exhibits signs of OTC drug abuse or addiction, speak with a trusted family doctor or substance abuse counselor right away. They can help you determine how to approach the situation. Don’t make the mistake of thinking that this problem will solve itself eventually — addiction is rarely resolved without professional intervention.

Depending upon the severity of your child’s substance problem, rehab may be necessary. Powerful or long-standing addictions usually require either inpatient or outpatient rehab. Treatment advisors can help you determine the option that will set your child on the most effective course for recovery.

We at TeenRehabCenter.org are here to do everything we can to help you through this difficult time. Our compassionate addiction advisors are well-versed in teen substance issues, and can help guide your family towards recovery. It is free to call us, and there are no obligations whatsoever. Take the first step towards freedom for your child and family — just pick up the phone.

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