Over-the-counter (OTC) medicines are products used to relieve various medical symptoms. Consumers can buy them directly from a pharmacy without a doctor’s prescription. OTC medicines typically treat coughs and colds, allergies, diarrhea and constipation. They may also treat acne, muscle aches, abdominal pain, menstrual pain and headaches. Consumers can easily find them at drugstores, supermarkets and convenience stores.

Despite the term ‘over-the-counter’, OTC medicines typically appear on the shelf in self-service areas. Some require a pharmacist’s assistance because the medicine contains an ingredient that can be misused. Consumers should treat OTC medicines with caution. Although many are safe to use as directed, some can lead to serious health consequences when abused.

What are commonly abused OTC medicines?

The most commonly abused OTC medicines fall into one of the following types: Dextromethorphan (DXM), caffeine pills, laxatives, pseudoephedrine, and motion sickness pills. The drugs in these categories either have psychoactive properties, which users take to achieve a “high” or mind-altering state, or they can lead to dependence, prompting consumers to take larger and larger doses of the drug to produce the desired effect. Below, we’ll take a deeper look at each category:

Dextromethorphan (DXM)

Dextromethorphan, or DXM, is an active ingredient found in many OTC cough syrups, such as NyQuil. When taken in larger doses than recommended, it can produce psychoactive effects. A psychoactive drug changes how the brain functions, resulting in alterations in perception, mood, consciousness, cognition, or behavior. Users may abuse DXM for its mildly stimulating, hallucinogenic properties.

According to the Center for Substance Abuse Research (CESAR), recreational users commonly abuse DXM with alcohol and MDMA, also known as Ecstasy. These users may experience negative side effects, including:

  • Dizziness
  • Hallucinations
  • Coordination problems
  • Impaired judgment
  • Nausea
  • Vomiting
  • Slurred speech
  • Stomach pain

More seriously, some users may experience seizures and dissociative states. Long-term abuse of DXM products containing acetaminophen can cause liver damage.

Caffeine Pills

OTC caffeine pills, including pain relievers with caffeine, may be abused for the buzz or burst of energy that they provide to consumers. Examples of OTC caffeine pills are NoDoz and Jet-Alert. When combined high-caffeine energy drinks, the effects of these pills are amplified. Caffeine pills are safe to take in moderation, but can be fatal when taken in large doses.

Side effects of misusing caffeine pills include increased thirst, irregular or rapid heartbeat, vomiting, dizziness, fever, hallucinations, muscle twitching, convulsions, confusion and breathing problems.


Pseudoephedrine is the active ingredient in cold medicines and nasal decongestants. It is used to relieve symptoms related to colds, allergies or hay fever. The medicine can also be taken as a stimulant to cause an excitable, euphoric feeling. Its chemical makeup is similar to amphetamines, a key ingredient in the illegal drug methamphetamine, also known as meth. Hence, unlike other OTC medicines, it is harder to obtain pseudoephedrine, due to a federal law requiring it to be kept behind the pharmacy counter. Such medicines require photo identification prior to purchase, and quantities are limited.

In addition to relieving cold symptoms, people have taken pseudoephedrine to lose weight. Athletes have misused the medicine to increase their state of awareness to get them “pumped up” before a competition. Some of the negative side effects of abusing pseudoephedrine are weakness, dizziness, stomach pain, nausea, vomiting, breathing problems, irregular heartbeat.

Motion Sickness Pills

Most motion sickness medications, such as Dramamine, are safe and therapeutic when taken as directed. In large doses, however, motion sickness pills containing dimenhydrinate or diphenhydramine can cause hallucinogenic experiences similar to those of street drugs such as LSD and mushrooms, including mild euphoria, relaxation and disorientation. The dosage needed to cause such effects varies according to body weight and tolerance. Other side effects include weakness, dizziness, stomach pain, nausea, vomiting, breathing problems and irregular heartbeat. Extremely high dosage abuse can lead to coma, heart attacks and death.

Abuse of Dramamine can also lead to long-term health problems such as urine retention, liver and kidney damage, depression and memory loss.  

Who Is At Risk of Developing An Addiction?

Teens between the ages of 13 and 16 are the most at risk of abusing OTC medicines. Such medicines are easily obtainable at local pharmacies and supermarkets off the shelves. With their inexpensive prices, OTC medicines serve as a cheap way to get “high.”  

But teenagers aren’t the only ones at risk. Those looking for a cheap and easy way to have such psychoactive experiences can also develop an addiction. Adults have also abused OTC medicines, particularly in combination with other medicines, alcohol, and illegal drugs.

Treatment for OTC Medicine Addiction

There are no medications to specifically treat people with OTC medicine addictions. As with most addictions, behavioral therapies, such as cognitive behavioral therapy and other forms of psychotherapy might be helpful.

In cognitive-behavioral therapy, a cornerstone of our treatment programs at Sprout Health Group, a client learns how to effectively manage triggers and stress while changing their drug-use expectations and behaviors. Sprout’s treatment approach starts with an assessment to address any co-occurring disorders, such as depression, which can affect long-term recovery. We then develop an individualized plan that guides you every step of the way toward a life free from addiction, from detox to aftercare.

Call us today to speak with an experienced wellness professional about the best treatment options for you.