Most people think over-the-counter (OTC) drugs are safe because you can buy them without a prescription. But taking more than the label says, using them for fun, or mixing them with other substances can land you in the hospital-or worse. In Australia, and across the world, OTC drug misuse is rising, especially among teens and young adults. It’s not just about cough syrup anymore. It’s about pills, powders, and liquids hidden in vitamin bottles, bought from multiple pharmacies, and taken in doses 10 times higher than recommended. If you or someone you care about is showing these signs, it’s not just a phase. It’s a red flag.
You’re Taking Way More Than the Label Says
The label on your cough syrup says 10 mL every 4 to 6 hours. That’s 40 mL max in 24 hours. But if you’re taking 60, 80, or even 120 mL in a day, you’re not treating a cold-you’re chasing a high. Dextromethorphan (DXM), the main ingredient in many cold medicines, can cause hallucinations, out-of-body feelings, and numbness when taken in large amounts. At 500 mg or more, you’re entering dangerous territory. That’s about 10 bottles of typical cough syrup. The FDA now requires all DXM products to have a bold warning: “Taking more than directed may cause serious injury.” And it’s not just a formality. Emergency visits linked to DXM overdose jumped 137% in the U.S. between 2015 and 2022. In Australia, poison control centers report a steady climb in cases involving OTC cough medicines since 2020.
Your Body Is Sending Warning Signals
Your body doesn’t lie. If you’re misusing OTC drugs, it’s screaming for help. Look for these physical signs:
- Dilated or unusually small pupils
- Slurred speech, stumbling, or trouble walking
- Unexplained weight loss-12 pounds or more over a few months
- Heart racing at 120 beats per minute or higher
- High body temperature, even when you’re not sick
- Nausea, vomiting, or stomach pain that won’t go away
These aren’t random symptoms. They’re direct results of overdose. DXM can spike blood pressure to dangerous levels. If the product also contains acetaminophen (like in NyQuil or TheraFlu), taking too much can cause liver failure. The FDA reports that 32% of DXM overdose cases involve acetaminophen toxicity. That’s not a side effect-it’s a silent killer. And if you’re using loperamide (Imodium) to get high, you’re risking heart arrhythmias. Some users take 5,000 mg a day-300 times the recommended dose. That can stop your heart.
Your Behavior Has Changed-Dramatically
It’s not just about what’s happening in your body. It’s about what’s happening in your life.
- You’re hiding meds in vitamin bottles or empty snack packs
- You’re visiting three or more pharmacies in a week to avoid being flagged
- You’ve started lying about why you need medicine
- You’re spending $100 or more a month on OTC drugs with no explanation
- You’ve locked your door more often, changed phone passwords, or deleted messages
These aren’t just secretive habits. They’re signs of addiction. A study from Never Alone Rehab found that 100% of teens abusing DXM hid their drugs in vitamin containers. And 87% visited at least three pharmacies monthly. Why? Because they know it’s wrong. They’re trying to hide it from parents, teachers, even themselves.
Socially, you might notice:
- Suddenly having no friends or avoiding family gatherings
- Grades dropping fast-GPA falling from 3.4 to 2.1 in one semester
- Not caring about things you used to love
- Getting angry or paranoid for no reason
These aren’t teenage mood swings. They’re neurological changes. Chronic DXM use has been linked to an 8.3% reduction in hippocampal volume-the part of the brain that handles memory and emotion. That’s not reversible without treatment.
You’re Feeling Numb-Even When You’re Not High
One of the most dangerous signs isn’t the high. It’s what happens after. Users report emotional numbness lasting 12 to 24 hours after the drug wears off. They feel nothing. Not joy. Not sadness. Not connection. That’s not normal. That’s your brain being chemically rewired. Some users describe it as being “in a fog” all the time. Others say they can’t cry anymore, even when something tragic happens. This emotional shutdown is a precursor to depression-and in some cases, psychosis. Mayo Clinic research shows that 31% of chronic DXM users develop persistent hallucinations and paranoia that require antipsychotic medication. And once that starts, it doesn’t always go away.
You’re Mixing Drugs-And You Don’t Think It’s a Big Deal
“I just take one pill with my drink” sounds harmless. Until you realize you’re mixing DXM with alcohol, antidepressants, or even energy drinks. That’s a recipe for disaster. Alcohol + DXM = increased risk of vomiting, choking, and respiratory depression. Antidepressants + DXM = serotonin syndrome-a rare but deadly condition that causes fever, seizures, and muscle rigidity. The American Society of Addiction Medicine says 63% of OTC drug misusers develop tolerance in just 4 to 6 weeks. That means they need more and more to feel the same effect. And when they start combining substances, the danger multiplies.
What to Do If You Recognize These Signs
First, don’t panic. But don’t ignore it either. OTC drug misuse doesn’t fix itself. It gets worse. Here’s what actually works:
- Stop all use immediately. Even one more dose could trigger a bad reaction, especially if you’ve been taking high amounts.
- Call a professional. In Australia, contact Healthdirect (1800 022 222) or your GP. They can connect you to local services. SAMHSA’s National Helpline (in the U.S.) received over 14,000 calls about OTC misuse in 2022. You’re not alone.
- Get medical evaluation. A doctor can check your liver, heart, and brain function. Blood tests can detect drug levels and organ damage. Don’t wait for a crisis.
- Consider therapy. Cognitive behavioral therapy (CBT) combined with family support has a 68% success rate in helping teens stop OTC drug use within six months. That’s better than any medication.
- Secure your meds. If you live with others, lock up all OTC drugs. A Mayo Clinic study found homes with unlocked medicine cabinets had 3.2 times higher misuse rates. A simple lockbox makes a huge difference.
It’s Not Just About You
If you’re worried about a friend, sibling, or child, don’t wait for them to ask for help. Approach them calmly. Say: “I’ve noticed you’ve been acting different. I care about you. Can we talk?” Avoid accusations. Don’t say, “You’re addicted.” Say, “I’m scared for you.”
Early intervention saves lives. Research shows that if someone gets help within 72 hours of showing signs, their chance of entering treatment increases by 63%. That’s huge. And it’s possible. You don’t need to go to rehab right away. You just need to take the first step: admit something’s off. Then get help.
OTC drugs aren’t harmless. They’re powerful chemicals. And when used the wrong way, they can change your brain, damage your organs, and steal your future. But the good news? Recovery is real. People do get better. With the right support, you can too.
Can you really get addicted to cough syrup?
Yes. Dextromethorphan (DXM) can cause physical dependence and psychological addiction. Users build tolerance quickly-sometimes in just a few weeks-and need higher doses to feel the same effect. Withdrawal can include anxiety, insomnia, and cravings. It’s not just habit-forming; it rewires brain chemistry.
Is it safe to take extra OTC painkillers if I’m still in pain?
No. Taking more than the label says, even for pain, can cause serious harm. Acetaminophen overdose is the leading cause of acute liver failure in the U.S. and Australia. Ibuprofen can cause stomach bleeding or kidney damage. Always follow dosage instructions. If pain persists, see a doctor-not the medicine cabinet.
Why do teens abuse OTC drugs instead of illegal ones?
Because they’re easy to get, cheap, and don’t feel “dangerous.” Many teens believe OTC drugs are safe since they’re sold on shelves. They don’t realize that taking 10 pills at once is the same as using an illicit drug. The myth of safety makes them more vulnerable.
Can OTC drug misuse lead to using harder drugs?
Yes. Studies show 67% of people who start with OTC drug abuse move to prescription or illegal drugs within 18 months. The brain’s reward system gets rewired, making it harder to feel pleasure without chemicals. That opens the door to opioids, stimulants, or other substances.
What should I do if I find OTC drugs hidden in my child’s room?
Don’t confront them with anger. Gather the meds, call a doctor or counselor, and say: “I found these. I’m worried. Let’s talk about it.” Early intervention is key. Many teens will admit to misuse if approached with care, not punishment. Lock up all medications in your home to prevent future access.
Are there any safe ways to use OTC drugs for fun?
No. There is no safe recreational use of OTC drugs. The doses needed to get high are far beyond what’s tested or approved. Side effects are unpredictable. One person might get dizzy; another could have a seizure, heart attack, or brain damage. Even one time can be fatal.
How long does it take to recover from OTC drug misuse?
Recovery varies. Physical withdrawal from DXM lasts 5-7 days. But emotional recovery-regaining focus, mood stability, and motivation-can take months. With therapy and support, most people see major improvement within 6 months. Some brain changes, like memory issues, may need longer to heal. But recovery is possible.
Next Steps: What You Can Do Today
If you’re reading this and thinking, “That’s me,” here’s what to do right now:
- Stop taking any OTC drug not prescribed for a specific symptom.
- Call your doctor or a local health service. Don’t wait for a crisis.
- Ask someone you trust to help you lock up all OTC meds in your home.
- Write down how you’ve been feeling-physically and emotionally. That helps when talking to a professional.
If you’re worried about someone else:
- Don’t wait for them to ask for help.
- Get the facts. Know the signs.
- Speak up, gently and honestly.
- Find a counselor who specializes in substance use.
OTC drugs are not toys. They’re medicine. And when misused, they can destroy lives. But they can also be the first step toward healing-if you act before it’s too late.