Is your medicine cabinet a source for teen’s to get “high?” We often think prescription medicines or illegal drugs are only used to get high. Many people mistakenly believe that over-the-counter (OTC) medicines are safe and do not cause any harm. In fact, when used as directed, they are safe and effective. But some OTC medicines—including herbals—can cause serious and potentially fatal side effects when abused.
Abuse of OTC medicines is most common among teens between the ages of 13 and 16. They know they might find a cheap high right in their family’s medicine cabinet, often without being caught. However, teens and young adults may abuse OTC medicines, especially in combination with other medicines, alcohol, and illegal drugs.
Here are the top ten OTC medicines abused by teens and young adults.
- Dextromethorphan: Dextromethorphan is primarily used to treat a cough. It is the active ingredient found in more than 100, brand and generic, OTC cough and cold medicines such as Robitussin and NyQuil. It has been reported that about one out of 10 teens has admitted to taking cough medicine to get high. Large doses can cause euphoria, distortions of color and sound, and “out of body” hallucinations that last up to 6 hours. Other dangerous side effects include impaired judgment, vomiting, loss of muscle movement, seizures, blurred vision, drowsiness, shallow breathing, and a fast heart rate. Dextromethorphan is also addictive and can cause withdrawal symptoms including depression and difficulty processing thoughts, when the abuse stops. Not much is known about long-term abuse, but cases of bone marrow and nerve cell damage, high blood pressure, heart damage, and permanent brain damage have been reported. When combined with alcohol or other drugs, large doses can lead to death.
- Pain relievers: Adults and teens have taken pain relievers, such as acetaminophen and ibuprofen, in doses higher than recommended because they want the medicine to work faster. Abusing these medicines by taking more than recommended over a long period of time can lead to serious side effects. Liver failure can occur if too much acetaminophen is taken. Stomach bleeding, kidney failure, and cardiac risks are heightened when taking large doses of ibuprofen.
- Caffeine medicines and energy drinks: OTC caffeine tablets, such as NoDoz, or energy drinks, such as “5 Hour Energy,” or pain medicines with caffeine have all been abused for the buzz or “jolt of energy” they seem to impart. Large doses of caffeine can cause serious dehydration, gastric reflux, panic attacks, and heart irregularities that have occasionally been linked to accidental deaths, particularly in those with an underlying heart condition. Taking too much of a pain reliever can also cause serious side effects as noted above.
- Diet medicines: In large doses, diet medicines can cause a mild buzz. But misuse of diet medicine can also signal a serious eating disorder. Abuse of diet medicines often starts with trying just a few in order to lose weight. But these OTC medicines can be highly addictive. Although the US Food and Drug Administration (FDA) has banned several of the most dangerous stimulants—phenylpropanolamine, ephedrine, and ephedra—commonly found in OTC diet medicines, other ingredients in these products can also be dangerous. To cite an example, bitter orange is a common ingredient that acts much like ephedrine. It can cause nervousness and tremors, rapid and irregular heartbeat, high blood pressure, stroke, heart failure, and death. Many other ingredients in diet medicines cause digestive problems, hair loss, insomnia, anxiety, irritability, extreme paranoia, blurred vision, kidney problems, and dehydration.
- Laxatives and herbal diuretics: Similar to diet medicines, some teens and young adults also abuse OTC laxatives and herbal diuretics (water pills), including uva-ursa, golden seal, dandelion root, rose hips, and others, to lose weight. Laxatives and herbal diuretics can cause serious dehydration and loss of important minerals and salts that regulate the amount of water in the body, acidity of the blood, and muscle function.
- Motion sickness medicine: Motion sickness medicines that contain dimenhydrinate (Dramamine) or diphenhydramine (Benadryl) taken in large doses can cause one to feel high and/or have hallucinations similar to street drugs. The dose needed to cause these symptoms varies widely according to the person's body weight and tolerance. For examples, some teens and adults have reported taking as many as 40 tablets of Dramamine to experience the desired high. Extremely high doses of Dramamine have caused irregular heartbeat, coma, heart attacks, and death. Long-term abuse can cause depression, liver and kidney damage, memory loss, eye pain, itchy skin, urine retention, and abdominal pain.
- Sexual performance medicines: OTC sexual performance medicines, often purchased online, are sometimes abused by teens and adults who are drinking to counteract the negative effects of alcohol on sexual performance. These medicines can cause heart problems, especially when combined with alcohol or when taken in large doses.
- Pseudoephedrine: This nasal decongestant is found in many cold medicines. The medicine has also been taken as a stimulant to cause an excitable, hyperactive feeling. Its similarity to amphetamines has made it a sought out medicine to make illegal methamphetamine. Because of that, federal law requires pseudoephedrine products to be kept behind the pharmacy counter, requiring photo identification prior to purchase and limiting the quantity that can be sold. However, people have taken pseudoephedrine to lose weight, and athletes have misused the medicine to increase their state of awareness and to get them “pumped up” before a competition. Dangerous side effects include heart palpitations, irregular heartbeat, and heart attacks. When combined with other drugs, such as prescription pain medicine, pseudoephedrine may trigger episodes of paranoid psychosis.
- Herbal ecstasy: This is a combination of inexpensive herbs that are legally sold in tablet form and swallowed, snorted, or smoked to produce euphoria, increased awareness, and enhanced sexual sensations. Marketed as a “natural” high, the main ingredient is ma huang (ephedra), an herb banned in the United States, but only as part of a dietary supplement. The product can be purchased in gas stations, health food stores, drug stores, music stores, nightclubs, and online. It is easy to overdose on the product because the dose needed for desirable effects varies widely. The adverse effects can be severe, including muscle spasms, increased blood pressure, seizures, heart attacks, strokes, and death.
- Other herbals: Other herbal products are increasingly being abused for their stimulant, hallucinogenic, and euphoric effects. Besides being legal, another draw is that many herbals are not detected during routine urine drug screens. One example is salvia, which is ingested or smoked to experience a short-lived distortion of reality and profound hallucinations. Users can experience severe anxiety, loss of body control, extreme psychosis, and violent behavior. They are also at risk for accidents and injuries that may result from an altered mental state. Some states have regulated the sale of salvia. Another example is nutmeg, which is eaten as a paste to experience giddiness, euphoria, and hallucinations. Nausea and vomiting set in within an hour and hallucinations begin within 3 hours and can last for 24 hours or more. Effects such as blurred vision, dizziness, numbness, palpitations, low blood pressure, and rapid heartbeat may occur.
One of the greatest difficulties with preventing OTC drug abuse is that few teens and young adults realize the danger. Unlike the risks associated with illegal street drugs, such as cocaine and heroin, the risks associated with OTC drug abuse are given little thought and attention. Teens and young adults who learn about the risks of drugs at home are up to 50% less likely to abuse drugs.
