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Drug Information

Over the Counter

What is Over-the-Counter Medication

For the average teenager, over-the-counter (OTC) drugs are becoming increasingly mainstream when it comes to getting high. OTC drug products are widely available and can be purchased at supermarkets, drug stores, convenience stores, etc. Many OTC drugs that are designed to treat headaches, sinus pressure, or cold/flu symptoms are the ones that teens are using to get high, and contain the active ingredient dextromethorphan (DXM). There are more than 80 therapeutic categories of OTC drugs, ranging from acne drug products to weight control drug products. As with prescription drugs, the Food and Drug Administration's Center for Drug Evaluation and Research oversees OTC drugs to ensure that they are properly labeled and that their benefits outweigh their risks.1

How Do OTCs Differ from Prescription Drugs?

OTCs generally have these characteristics:

  • The potential for misuse and abuse is low
  • Consumers can use them for self-diagnosed conditions, like colds or flu
  • Labels are clearly marked with ingredients
  • You do not need a prescription or to be monitored by a doctor while using the medication.2

Examples of OTC Drugs

There are hundreds of OTC drugs currently marketed to consumers. Cold medicines such as Robitussin, Nyquil, Vicks Formula 44, and Coricidin HBP Cough and Cold tablets contain the active ingredient called DXM, which is found in more than 120 non-prescription cough and cold medications.3 DXM, when taken in high dosages, can give a "high" feeling and is frequently abused by teens today.

Is My Teen Using OTC Drugs To Get High?

A recent study found that 7 percent of 12th graders reported past year abuse of cough or cold medicines to get high.4 Another recent study estimates nearly 500,000 emergency department visits involved nonmedical use (i.e., misuse or abuse) of prescription drugs or OTC pharmaceuticals or dietary supplements. Multiple drugs were involved in more than half (57 percent) of these emergency room visits.5

Where Do Teens Get Over-the-Counter Medicines?

Teens can buy over-the-counter medicines at any supermarket, drug store, or convenience store where cough and cold medicine is sold. They can also get them from any medicine cabinet they have access to, or order over the Internet.

How Are Teens Abusing OTC Drugs?

To get high, teens may take more than the dosage outlined to treat the ailment and abuse other OTC or prescription medications at the same time. Teens may also crush pills and snort them for an intensified effect.

Could My Teen Overdose on OTC Drugs?

Yes. An overdose on OTC drugs can vary greatly depending on what drugs they mixed, the amount of the drugs they took over what time period. Some OTC drugs are weak and cause minor distress, while others are very strong and can cause more serious problems or even death.6

If you suspect your teen has overdosed on OTC drugs, take them to the emergency room immediately for proper care and treatment by a medical doctor.7

Signs and Symptoms

Depending on the type of OTC medication and additional drug pairings during use, your teen may experience:

Short-term Effects
Impaired judgment/nausea, loss of coordination, headache, vomiting, loss of consciousness, numbness of fingers and toes, abdominal pain, irregular heartbeat, aches, seizures, panic attacks, psychosis, euphoria, cold flashes, dizziness, diarrhea.8

Long-term Effects
Addiction, restlessness, insomnia, coma, death, and high blood pressure.9

Other Drug and Alcohol Interactions

ALCOHOL may intensify this effect
USE CARE when operating a car or dangerous machinery

You've probably seen these warnings on medicines you've taken. The danger is real. Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, and loss of coordination. It can put you at risk for internal bleeding, heart problems, and difficulties in breathing. Alcohol also can decrease the effectiveness of many medications or make them totally ineffective.

Some of these medications can be purchased over-the-counter - at a drugstore or grocery store - without a prescription, including herbal remedies and others you may never have suspected of reacting with alcohol. Following are some examples of harmful effects resulting from the mix of OTC drugs and alcohol.


Common medications and selected brand names

Some possible reactions with alcohol

Colds, coughs, flu, and allergies

Benadryl® (diphenhydramine); Tylenol® Cold and Flu (chlorpheniramine); Robitussin A-C® (codeine)

Drowsiness, dizziness; increased risk for overdose

Pain such as that from headache, fever, muscle ache, arthritis, inflammation

Aspirin (salicylates); Advil®, Motrin® (ibuprofen); Tylenol®, Excedrin® (acetaminophen); Aleve® (naproxen)

Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat

Sleep problems

Excedrin PM®, Sominex® (diphenhydramine)

Herbal preparations (Chamomile, Valerian, Lavender)

Drowsiness, dizziness

Increased drowsiness

Note: The above is NOT an exhaustive list. Before you take any prescription or over-the-counter medication, carefully read the label, and/or consult with your family physician or local pharmacist.

For more information about drug interaction and alcohol, visit the National Institute on Alcohol Abuse and Alcoholism.

Source: National Institute on Alcohol Abuse and Alcoholism, Harmful Interactions: Mixing Alcohol With Medicines. Reprint August 2005.

Got a Sick Kid? Don't Guess. Read the Label. http://www.fda.gov/drugs/resourcesforyou/ucm133419.htm.

Make sure you're giving your children the right medicine and the right amount.
FDA Regulatory for OTC http://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cder/ucm093452.htm

What is the OTC Drug Review Process? http://www.fda.gov/drugs/developmentapprovalprocess/smallbusinessassistance/ucm052786.htm

Common Questions and Answers:


  1. Office of Nonprescription Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration. 2006.
  2. Office of Nonprescription Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration. 2006.
  3. Over-the-Counter Drug Abuse, TeenDrugAbuse.us, Teen Help LLC.
  4. Monitoring the Future Survey, the University of Michigan, Overview of Findings. 2006.
  5. NIDA InfoFacts: Prescription Pain and Other Medications, National Institute on Drug Abuse. 2006.
  6. Drug overdose, Better Health Channel. 2006.
  7. Ibid
  8. Commonly Abused Prescription and OTC Medication, Partnership for a Drug-Free America.
Courtesy of DrugFree.org


• Reduce binge drinking and prescription drug abuse among teens.
• Reduce other high-risk behaviors and negative consequences for teens.
• Increase/build infrastructure to address substance abuse.
Mike Womack, Executive Director
P.O. Box 1412
Athens, TN. 37371-1412
MADCAT #: 423-920-6555