Signs You’re Misusing Over-the-Counter Drugs and What to Do

It’s easy to think that because something is sold over the counter, it’s safe. But OTC drug misuse is a growing problem - and it’s not just teens. People of all ages are taking more than the label says, mixing pills, or using them for reasons far beyond what they were meant for. The results can be deadly. You might not realize you’re crossing the line until it’s too late. Here’s how to spot the signs - and what to do next.

You’re Taking More Than the Label Says

The instructions on the bottle aren’t suggestions. They’re limits. Dextromethorphan (DXM), the active ingredient in many cough syrups, is safe at 15-30 mg per dose. But people looking for a high take 100 mg, 500 mg, even 1,500 mg at once. That’s 50 times the recommended dose. At those levels, DXM doesn’t just suppress coughs - it distorts reality. Hallucinations, out-of-body experiences, loss of coordination - these aren’t side effects. They’re red flags. The FDA now requires all DXM products to have a bold warning: "Taking more than directed may cause serious injury." That’s not legal jargon. It’s a lifesaving message.

Your Body Is Sending Warning Signals

Your body doesn’t lie. If you’re misusing OTC meds, it’s screaming. Dilated or constricted pupils? Slurred speech? Unexplained weight loss - 12 pounds or more in a few months? These aren’t random symptoms. They’re documented signs of chronic misuse. Elevated body temperature? Heart rate spiking to 150 bpm? Blood pressure climbing to 160/100? These aren’t "feeling a little off." They’re medical emergencies. One study found that 32% of people abusing DXM products with acetaminophen (like Tylenol Cold) damaged their liver by exceeding 4,000 mg of acetaminophen daily. That’s just 8 extra pills. One night. And your liver doesn’t recover easily.

Your Behavior Has Changed - Dramatically

It’s not just physical. Your habits start to shift. You’re hiding bottles in vitamin containers. You’re visiting three or more pharmacies a month to avoid suspicion. You’re locking your door more, changing phone passwords, spending $100+ a month on cough syrup you can’t explain. Your grades drop. Your friends notice you’re not showing up anymore. You’re avoiding social events. You’re driving while dizzy or spaced out. That’s not just "going through a phase." That’s addiction in motion. Studies show 89% of teens who misuse OTC drugs see their GPA fall by at least 1.3 points in one semester. That’s not laziness. That’s brain chemistry being rewired.

You’re Not Getting High Anymore - You’re Just Trying to Feel Normal

This is the trap. At first, it’s curiosity. Then it’s fun. Then it’s the only way you feel okay. That’s tolerance. And it builds fast. Within 4 to 6 weeks, you need 3 to 5 times the dose to get the same effect. That’s not just dangerous - it’s a sign your brain has stopped producing natural chemicals like dopamine on its own. You’re not chasing a high anymore. You’re chasing the absence of withdrawal: anxiety, nausea, shaking, depression. The American Society of Addiction Medicine found that 63% of OTC drug misusers develop this dependence. And when you stop? The crash lasts for weeks. Some people need antidepressants just to get through it.

You’re Mixing It With Other Things

OTC drugs don’t play well with others. Mixing DXM with alcohol? That’s a recipe for respiratory failure. Combining it with antidepressants? You risk serotonin syndrome - a life-threatening spike in brain chemicals. Taking loperamide (Imodium) to get high? That’s even worse. People are swallowing up to 100 pills a day - 300 times the safe dose - to mimic opioid effects. The result? QT prolongation. That’s when your heart’s rhythm goes haywire. One study found users had heart intervals over 500 milliseconds. Normal is 350-440. At that point, your heart can stop without warning. Emergency room visits tied to OTC drug misuse jumped 137% between 2015 and 2022. That’s not coincidence. That’s escalation.

What to Do If You Recognize These Signs

If you see these signs in yourself or someone else, don’t wait. Don’t assume it’s "just a phase." Early action saves lives. The Tennessee Department of Health found that when three or more physical signs appear together - like slurred speech, dilated pupils, and high temperature - immediate intervention works 92% of the time. That means talking to someone you trust, calling a helpline, or seeing a doctor within 72 hours. Motivational interviewing - a kind of supportive counseling - increases treatment success by 63% when done quickly.

How to Get Help

You don’t have to go through this alone. SAMHSA’s National Helpline (1-800-662-HELP) received over 14,000 calls about OTC drug misuse in 2022 alone. Treatment isn’t one-size-fits-all. For DXM, detox usually takes 5 to 7 days under medical supervision. For loperamide, the FDA approved a new treatment using low-dose naltrexone in 2023, which helped 82% of patients manage withdrawal. Cognitive behavioral therapy combined with family therapy has a 68% success rate at keeping teens sober after six months. That’s better than any pill. Prevention works too. Since 2021, 32 states have launched school programs like "Know the Dose." In places where they’ve been active, first-time DXM misuse among 8th graders dropped by 29%.

Protect Yourself and Others

If you have OTC meds at home, lock them up. Studies show households without lockboxes have 3.2 times higher misuse rates. Don’t assume your teenager knows the risks. Many think cough syrup is "safe" because it’s legal. That’s the biggest myth. The truth? OTC drugs are the gateway to harder substances for 67% of users within 18 months. One in three chronic DXM users develops lasting psychosis. One in four transitions to prescription opioids. And 29% end up using heroin. This isn’t about being "bad" or "rebellious." It’s about brain chemistry being hijacked by something you thought was harmless. Don’t wait for a crisis. Talk. Act. Get help.