In Washington state, substance abuse isn’t always about illicit street drugs. In fact, after marijuana, legal medications are the most commonly abused drugs, not just in Washington state, but in America. Taken properly, the medicines we buy over-the-counter are essential to our everyday help. But when they are diverted non-medically or recreationally, they can be addictive and dangerous – even deadly. Let’s take a look at some of the most-abused over-the-counter medicines:
Dextromethorphan – DXM Diversion Is Dangerous
Although it is an effective ingredient in many OTC cough and cold medicines, dextromethorphan has gained illicit popularity as an easily-obtained drug of abuse. Slang terms for dextromethorphan include – DXM, Robo, Velvet, Skittles, Triple C At high doses, “DXM” produces intoxicating effects, acting as both hallucinogenic and a stimulant. According to the Washington State Toxicology Laboratory in Seattle, there are four levels, or “plateaus”, of DXM intoxication:
- First plateau, approximately 150 mg –
- Mild intoxication
- Lightheadedness
- Euphoria
- Second plateau, approximately 400 mg –
- Intoxication
- Mild hallucinations
- Loss of concentration
- Slurred speech
- Impairment of short-term memory
- Third plateau, approximately 800 mg –
- Strong intoxication
- Hallucinations and delusions
- Disturbed thought processes
- Confusion
- Very self-absorbed
- Unpleasant demeanor
- Fourth plateau, approximately 1000 mg or more
- Vivid hallucinations
- Strong delusions
- Disassociation between the mind and the body
At such high doses, dextromethorphan presents several adverse side effects insomnia, nightmares, memory impairment, sexual dysfunction, tremors, and seizures. There is also the possibility of permanent toxic psychosis. But the biggest risk of “Robo-tripping” is when the OTC medicine used is a multi-symptom cold formula, in which case it will contain other ingredients that can cause kidney failure or death. In 2014, in order to curb the abuse of OTC cough and cold medicines by minors, Washington State Governor Jay Inslee signed into law legislation placing an age restriction on the purchase of dextromethorphan.
Pseudoephedrine Abuse Is Not Pseudo-Dangerous
Although this decongestant is controlled because it is a precursor ingredient used in the manufacture of methamphetamines, it can also be abused on its own for its stimulant properties. Some athletes will ingest pseudoephedrine in order to get “pumped” before the competition, while other people will take pseudoephedrine as an illicit weight-loss aid. At high doses, pseudoephedrine abuse can lead to heart arrhythmia, palpitations, and even heart attacks. Because of its use in the manufacture of meth, and because of its own abuse potential, there have been efforts to reclassify pseudoephedrine as a prescription-only medication.
Dramamine Is Dramatically Dangerous When Abused
Also known as “dime”, the motion sickness drug dimenhydrinate– sold as Dramamine – is a deliriant when it is taken in higher doses, 200 mg-1200 mg. At these dosages, strong auditory and visual hallucinations are common. Dramamine poisoning is possible – some of the adverse effects of abuse include:
- Temporary amnesia
- Confusion
- Loss of coordination
- Seizures
- Heart attack
- Coma
- Death
Benadryl Tablets Are Taken by the Handful
Antihistamine medications containing diphenhydramine are usually sold under the name Benadryl or Unisom and used to either relieve mild allergic symptoms, motion sickness, or as a mild sleep aid. However, when taken in very large doses, diphenhydramine tablets produce hypnotic, sedative, and hallucinogenic effects. When taken with benzodiazepine-class medications, diphenhydramine will amplify the tranquilizing effects of those other drugs. Some of the dangers of diphenhydramine abuse and overdose include:
- Fever
- Hyperthermia
- Convulsions
- Delirium
- Kidney failure
- Pancreatitis
- Cardiac arrest
- Coma
- Death
Not All Over-The-Counter Drug Abuse Is for the Purpose of Getting High
Although we usually think of drug abuse as a means of getting intoxicated or high, there are other ways to misuse over-the-counter medications. Technically, any nonmedical or non-recommended use of a medication can be considered abuse. And, just as is the case with recreational drug abuse, intentional misuse of an OTC medication can be extremely hazardous.
- Painkillers like aspirin, ibuprofen, or acetaminophen – sold as drugs such as Motrin, Advil, or Tylenol. The major risk arrives when people take more than the recommended dosage, mistakenly believing that the analgesic effect will be the better, faster, or longer-lasting.
Instead, they are doing damage to their body – Tylenol is the #1 cause of liver failure in the United States. More than 50,000 people a year go to the Emergency Room because of an overdose of acetaminophen.
- Laxatives – Although they are intended to ease the discomfort of temporary constipation, laxatives are often abused by people with eating disorders such as bulimia or anorexia. When used for too long a period by a person with an eating disorder, laxatives can contribute to that person’s death.
- Diet pills – 1 in 7 teenage girls will use over-the-counter diet pills. By the time those girls are in college, that number will rise to 1 in 5. Overuse of diet pills can result in unhealthy weight loss, malnutrition, dehydration, and an elevated risk of stroke and cardiac arrest.
- Caffeine and energy drinks – Popular with the video-game culture, these products are usually marketed as providing bursts of energy and focus. At high levels of consumption, however, the overstimulation can result in dehydration, anxiety or panic attacks, and tachycardia.
In 2016, a Seattle man blamed his stroke on a Monster energy drink. Deaths have been reported in cases where there were underlying heart conditions.
Communication and Attention are the Antidotes for OTC Drug Abuse
OTC medications are most-frequently abused by teenagers because they are usually found in their home medicine cabinets. Most of these medications are also cheap and easily-purchased, and two other favorable factors in the eyes of teenaged abusers. It is up to parents to have open and frank discussions about the dangers of substance abuse – including supposedly “safe” OTC medications. Many teenagers believe the myth that over-the-counter and prescription medications aren’t dangerous. Another smart step is to periodically perform a “Medicine Inventory” of the drugs in your home:
- Personally check the contents of every medicine package, container, or bottle WHEREVER you start – medicine cabinets, kitchen drawers, bedside tables, etc.
- Monitor pill quantities and medicine levels.
- Store OTC and prescription medications out of the easy reach of your children – where you can still get to them when you need, but where your children are unlikely to have access.
- When you have expired or leftover medicines – GET RID OF THEM. There are several drop-off locations around Seattle and throughout the State of Washington.
- Urge the parents of your child’s friends to perform their own Medicine Inventories.
If you have reason to believe that your child has been experimenting with or abusing OTC medications, then you should enlist the help of professional addiction recovery specialists. Substance abuse disorders are complicated illnesses, and you shouldn’t have to try to deal with the problem on your own.