OTC Medication and Addiction

Is it Possible to Become Addicted to Legal OTC Medications?

At our Thailand rehab facility, we get a lot of questions from loved ones asking us about addiction, mental health, support groups and recovery. One popular question is whether or not it is possible to abuse or become addicted to legal OTC medications like ibuprofen (Motrin), acetaminophen, (Tylenol) Dextromethorphan/DXM (Robitussin) or pseudoephedrine (Sudafed). These common OTC medications are in most first aid cabinets and are taken to relieve fevers, headaches, muscle aches or nagging allergies. However, because of the lax feel of these medications, they often become overused. While they are legal, they can have serious side effects when they are not taken properly.

Can an addiction to legal OTC medications occur?

Many legal drugs are addictive. Substances like alcohol, opiate painkillers (prescribed) and nicotine are all legal, but heavily abused. The drugs we’ll be discussing in this article may not have an extremely high risk of addiction, but do have side effects and withdrawal symptoms.

Pseudoephedrine - You may have noticed when buying Sudafed that you are asked to show identification or sign a paper with your name stating the date of purchase. That probably led you to wonder if Sudafed is addictive. These regulations are in response to a recent spike in the abuse of this cold medicine.

Pseudoephedrine brand names include Sudafed, Robitussin, Sinutab, Theraflu and hundreds more. In general, this medication is found in cold, flu and allergy OTC brands. Some areas will require identification before purchasing the drug because there is a potential for abuse. Most common in young adults or teenagers, pseudoephedrine has a stimulant like effect when taken in large amounts. When abused this medication can cause severe headaches, nausea, vomiting, high blood pressure and anxiety. There is a risk of overdose which can cause permanent organ damage, impaired cognitive skills and even death. One of the most common concerns of pseudoephedrine is that people who abuse this medication will eventually turn to other drugs for a more intense high.

Ibuprofen - Ibuprofen is taken for a very wide range of aliments like pain, fevers, inflammation, muscle soreness, headaches and PMS. It’s not unheard of for a person to take this medication on an almost ongoing basis for one reason or another. That being said, ibuprofen can quickly become the go-to choice for any ache or pain. This can lead to the potential of a tolerance to develop. With too much use, the individual can develop side effects including dizziness, drowsiness, swelling of the eyes, face, hand or feet, fatigue or tiredness and ringing in the ears. While this medication is not physically or psychologically addictive, a person can become physically dependent on it and when they quit, there is a risk of withdrawal symptoms. These include nausea, vomiting, dizziness, confusion, anxiety and organ damage. Ibuprofen is one of the most common ways people attempt to commit suicide with; although fatalities are not common, permanent damage is, and can include kidney damage, ulcers and long term headaches.

Acetaminophen/Paracetamol - Another popular OTC medication is acetaminophen. It’s commonly taken for headaches, mild pain and muscle aches. It is available in child-friendly versions and used around the world. The chemical makeup of acetaminophen is not physically addictive, but a tolerance to the drug can occur. If use has been ongoing, there is a chance of experiencing mild withdrawal symptoms like headache, also known as rebound headaches, and cramping. When this medication is taken in very high amounts, there is a risk of overdosing.

Dextromethorphan (DXM) - Dextromethorphan is found in common expectorants and antihistamines, both used for the common cold and stuffy noses. Most people at some point have taken this medication to ease discomfort. This OTC medication is heavily abused by teens and young adults primarily because it is easy to access. Large doses can cause mild hallucinations, sensations of physical distortion and mild stimulation. Heavy abuse can lead to impaired motor function, numbness, nausea, vomiting, and high blood pressure. An overdose can cause extreme agitation, high body temperature and an excess of body acid. On rare occasions, hypoxic brain damage (lack of oxygen to the brain caused by severe respiratory depression) can occur. There is a possibility of a tolerance and potentially mild physical addiction to DXM; however, more research needs to confirm this. Withdrawal symptoms may include restlessness, insomnia, cold flashes, diarrhea and vomiting.

Abuse of OTC Medications

If you or someone you know is heavily abusing OTC medications, it is a good idea to seek the advice of professional help – no matter how serious the issue may be. Ongoing abuse can cause long lasting damage or lead to the abuse of stronger drugs.