Over-the-counter (OTC) medications are drugs that people do not need a prescription for in order to purchase. They are available at pharmacies, grocery stores, and convenience stores around the country, and typically, anyone can purchase them. According to a report compiled by the Consumer Healthcare Products Association, every $1 that consumers spend on OTC medications saves roughly $7 for the country’s healthcare system. Despite the benefits of widespread access to OTC medication, there are drawbacks as well.
When Access Leads to Abuse
Some over-the-counter medications contain active ingredients that are psychoactive in large doses. Since OTC medication is more accessible than controlled substances, people who are seeking mind-altering drugs may be inclined to abuse them. According to the National Institute on Drug Abuse(NIDA), cold medication and cough remedies that contain dextromethorphan (DXM) are the most commonly abused OTC drugs.
Dextromethorphan is a cough suppressant that can produce feelings of euphoria and disassociation. When taken in large amounts, DXM acts on the same receptors in the brain that hallucinogenic drugs like ketamine and PCP do. With continued use, an individual can develop a dependence on the drug and eventually an addiction.
When Drugs Do More Harm than Good
The U.S. Food & Drug Administration only approves substances that appear to benefit people more than they harm them; however, if the drugs are misused or abused, the risks can outweigh the benefits.
A side effect refers to an unwanted event or reaction that a substance has in addition to any of its intended therapeutic effects. All drugs have side effects, and even the side effects of over-the-counter medications can be dangerous when the drug is taken in large doses or used over an extended period of time. Side effects range from minor to life-threatening, and all OTC drugs have both short-term and long-term side effects.
For example, acetaminophen is one of the most popular over-the-counter painkillers in America. Its short-term side effects include:
- Stomach pain
Acetaminophen is a powerful analgesic and antipyretic that can also produce life-threatening complications, especially with excessive or prolonged use. Acute liver failure is one of the most dangerous side effects of taking this OTC drug. According to a review from Pharmacoepidemiology and Drug Safety, acetaminophen-associated overdoses are responsible for approximately 56,000 emergency department visits and 26,000 hospitalizations annually.
Laxatives are another example of an over-the-counter medication that can cause serious health complications through excessive or prolonged use. People often abuse laxatives in order to lose weight.
- Severe dehydration
- Laxative dependency
- Internal organ damage
- Irritable bowel syndrome
- Liver damage
- An increased risk of colon cancer
Some over-the-counter drugs have more dangerous side effects than others, but taking any substance for an extended period of time will ultimately affect the body in some way. In severe cases, such damage is irreversible.
When Medication Is Combined with Other Substances
Even people who do not misuse or abuse over-the-counter medications can still face serious complications if they mix the drugs with other substances. Sometimes, people take dangerous combinations of OTC drugs and other substances inadvertently; other times, individuals may combine substances in an effort to increase the potential effects of either or both.
According to the National Institute on Alcohol Abuse and Alcoholism, mixing different kinds of prescription and over-the-counter medications with alcohol can produce different side effects, and older people are at an especially high risk of complications arising when they do so. The body’s ability to metabolize alcohol efficiently decreases as people age, so when older people consume alcohol, it remains in their system for longer. Additionally, senior citizens are more likely to require medication that might interact with alcohol. The National Council on Patient Information and Education reports that although older adults make up 13 percent of the population, they account for 30 percent of all over-the-counter drug use.
Here are just a few possible reactions of combining OTC medications for certain disorders, symptoms, and conditions with alcohol:
- Allergy medications: dizziness, drowsiness, and increased risk of overdose
- Cough remedies: dizziness, drowsiness, and increased risk of overdose
- Heartburn and indigestion medication: sudden changes in blood pressure, rapid heart rate, and increased effects of alcohol
- Motion sickness medication: dizziness, drowsiness, and increased risk for overdose
- Pain relievers: liver damage, rapid heart rate, stomach bleeding, and ulcers
- Sleep remedies: increased drowsiness
Because medication can increase the effects of alcohol and vice versa, the most dangerous risk of combining alcohol and OTC medications is death. According to NBC News, many powerful drugs that once required a prescription are now available over the counter, and both prescription medications and illicit substances are more accessible than ever before. This has led to an increase in the number of fatal overdoses resulting from toxic combinations of alcohol, medication, and controlled substances.
OTC Drugs and Pregnancy
Much like senior citizens, pregnant women are a vulnerable population, and they must exercise caution when taking any kind of medication. Even seemingly safe over-the-counter remedies can affect the health of both mother and baby in a major way.
According to Consumer Reports, some of the most common over-the-counter medications that pregnant women should avoid include:
- Bismuth subsalicylate
Finding Help for OTC Drug Abuse
Although over-the-counter medications are incredibly potent, especially when combined with other substances, they are not nearly as powerful as illicit or prescription drugs. People who abuse OTC drugs may eventually pursue stronger substances in order to experience more powerful effects. That means one of the greatest risks of OTC drug abuse is controlled substance abuse, which has serious risks of its own; however, it is never too late to seek help. Whether individuals abuse cough medication or cocaine, they can get the help they need at an addiction treatment facility.