The ability for individuals to access and use over-the-counter (OTC) medications (also known as nonprescription medication) to treat symptoms without a prescription offers many benefits to everyday consumers dealing with regular health concerns. Some examples of OTC medications that can be purchased without a prescription are pain relievers like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin), cough suppressants like Robitussin, antihistamines like Claritin, antacids, laxatives, and diarrhea remedies like Immodium A-D and Pepto-Bismol. These commonly purchased over-the-counter medicines treat the symptoms of many illnesses that don’t require the help of a doctor and are often used to appropriately treat symptoms such as minor aches and pains, fever, diarrhea, symptoms of the common cold, sore throat, and allergies.

However, while many OTC medications offer individuals numerous benefits, such as not needing a prescription or a consult with a physician, many over-the-counter medications offer the dangerous drawback of the potential for misuse, abuse, and addiction. While almost every OTC medicine is safe and effective when a person follows the directions on the label and uses the medication as directed by their doctor, some OTC medications are often misused and abused.

cough syrup poured on spoon - most commonly abused OTC medications concept

Here are the most commonly abused over-the-counter medications:

Below are commonly abused over-the-counter medications, starting with one of the most used medications in America.

Acetaminophen (Example: Tylenol)

Acetaminophen is commonly used to treat minor aches and pains like headaches or as a fever-reducing medication. However, the misuse or abuse of acetaminophen medication like Tylenol causes hospitalization for approximately 60,000 Americans annually. Many people abuse Tylenol in an attempt to treat chronic pain. Overdosing on these drugs can result in damages to the liver, including liver failure, increased liver enzyme levels and liver damage. Acetaminophen overdose typically occurs accidentally or during a mental health crisis when an individual is suffering from a suicide attempt.

Dextromethorphan or DXM (Example: Nyquil)

Dextromethorphan (or DXM) is a cough-suppressing ingredient found in numerous over-the-counter cold and cough medications, such as Nyquil or Robitussin. Similar to some illicit substances, DXM is a dissociative anesthetic, meaning that in larger amounts it can create hallucinogenic effects in the user, as well as produce euphoria and other mind-altering effects. Street terms for DXM include dex,  robo, skittles, and Triple C while using the medication to get high is often referred to a robotripping. DXM was/is one of the most commonly abused over the counter medicaitons. Due to this, roughly ~20 states have enacted regulations on the sale of DXM or cough syrup to minors.

Diphenhydramine (Example: Benadryl)

Diphenhydramine is a medication that reduces allergic symptoms and is found in many over-the-counter allergy remedies such as Benadryl. However, misuse and abuse of diphenhydramine can cause elevated mood, increased energy levels, and mild euphoria.

Pseudoephedrine/Phenylephrine (Example: Sudafed)

Pseudoephedrine is a decongestant medication often found in OTC medicines like Sudafed. It is often used to relieve congestion symptoms or treat symptoms of allergies. It helps to increase nasal congestion. However, the misuse and abuse of pseudoephedrine can produce stimulant-like effects and euphoria. Often, this drug was purchased by consumers in bulk that were using the ingredients to create Crystal Meth, so the drug is now closely monitored and often retail stores will only allow for a small amount to be purchased by a single individual at any one time.

Loperamide (Example: Imodium A-D)

Loperamide is a medicine used to control and offer relief from diarrhea and is the generic name for Imodium A-D. Individuals that deal with diarrhea will be able to regulate their bowel movements when taking this medication appropriately based on the recommended usage on the medication label. However, loperamide offers the risk of misuse and abuse, and when used in large amounts can produce similar effects to that of taking opioids. Therefore, due to the rising opioid crisis taking place in America over the last two decades, the numbers in individuals abusing Imodium A-D have also risen exponentially.

Diet pills/Caffeine

Diet pills and caffeine are often used by individuals attempting to lose weight or control their weight. Individuals with eating disorders will often misuse or abuse both diet pills and caffeine in order to suppress their appetite. Both also act as a central nervous system stimulant, therefore easily offering the risk of abuse or addiction. Both diet pills and caffeine offer similar effects to that of amphetamines. Ephedrine is a drug that was used in diet pills for years before being banned by the Food and Drug Administration (FDA), however, is still prevalent in many herbal over-the-counter products that are sold in stores or online but are not approved by the FDA. Similarly, caffeine is contained in drinks like soda, energy drinks or coffee, but is also available in OTC pills promoted to provide energy or help with weight loss. Both substances can be dangerous to an individual’s health and offer the risk of a regular user developing a physical dependence.

While it may seem as though many OTC medications are safe and harmless, and almost all are if used correctly by following the recommended dosage contained on the drug labels, many OTC drugs carry with them the risk of misuse, abuse, and addiction. Any physical dependence or addiction associated with these most commonly abused over-the-counter medications should be taken no less seriously than the abuse or addiction associated with more powerful prescription drugs or the use of illicit substances such as cocaine or heroin. An individual that is incapable of stopping the misuse or abuse of OTC drugs needs to seek help like anyone else dealing with a substance use disorder and should seek professional medical and clinical help in the form of detox, medical stabilization, and treatment.

Know Someone with a Substance Use Disorder? Call Innovo Detox

The most commonly abused over-the-counter medications can often be a gateway into further abuse of drugs and alcohol. If you or someone you know needs help with addiction or co-occurring disorders, please give us a call. Innovo Detox offers the latest in evidence-based medical, psychiatric, and clinical care for those in need of detox and medical stabilization in Pennsylvania and the surrounding Mid-Atlantic area. If we aren’t the best fit for you or a loved one, we will take the necessary time to work with you to find a detox, rehab, treatment center, or provider that better fits your needs. Please give us a call at (717) 619-3260 or email our team at