Abstract
In recent years, the non-medical use of prescription drugs (without a doctor’s prescription) has increased dramatically. Less attention has been paid to the intentional misuse of over-the-counter (OTC) medications. Misuse of OTC medications has negative health consequences similar to those of illicit drugs, including psychosis, tachycardia, seizures and agitation. When mixed with alcohol or other drugs, these medications can also be dangerous: OTC-related emergency room visits increased 70 % from 2004 to 2008. This study examined the intentional misuse of OTC medications, the non-medical use of prescription drugs, the use of alcohol and illicit drugs, and psychological factors in two samples of young adults (ages 18–25) from different areas of the United States (Total N = 1,197). Overall, 18.6 % of the Colorado sample and 13.0 % of the Virginia sample reported lifetime misuse of an OTC medication. Participants who reported misusing OTC medications were also significantly more likely to report using marijuana, ecstasy, cocaine, and non-medical use of prescription analgesics, stimulants, anxiolytics, and sedatives. Participants who reported misusing OTC medications were more than twice as likely to report hazardous alcohol use, relative to individuals who denied misusing OTC medications. Individuals who had misused OTC medications scored significantly higher in sensation seeking and hopelessness and reported more symptoms of depression, anxiety, and somatic distress, relative to those who denied OTC misuse. Results suggest that a considerable minority of young adults are jeopardizing their health with the misuse of OTC medications as part of a pattern of polysubstance use.
Similar content being viewed by others
References
Blanco, C., Alderson, D., Ogburn, E., et al. (2007). Changes in the prevalence of non-medical prescription drug use and drug use disorders in the United States: 1991–1992 and 2001–2002. Drug and Alcohol Dependence, 90, 252–260.
McCabe, S. E., & Teter, C. J. (2007). Drug use related problems among nonmedical users of prescription stimulants: A web-based survey of college students from a Midwestern university. Drug and Alcohol Dependence, 91, 69–76.
McCabe, S. E., West, B. T., & Wechsler, H. (2007). Trends and college-level characteristics associated with the non-medical use of prescription drugs among US college students from 1993 to 2001. Addiction, 102, 455–465.
National Center on Addiction and Substance Abuse (NCASA) at Columbia University. (2007). Wasting the best and the brightest: Substance abuse at America’s colleges and universities. [On-line]. Retrieved November 29, 2013, from http://www.casacolumbia.org/download.aspx?path=/UploadedFiles/b1kms01k.pdf.
Hall, A. J., Logan, J. E., Toblin, R. L., et al. (2008). Patterns of abuse among unintentional pharmaceutical overdose fatalities. Journal of the American Medical Association, 300, 2613–2620.
Benotsch, E. G., Martin, A., Koester, S., Cejka, A., & Luckman, D. (2011). Non-medical use of prescription drugs and HIV risk behavior in gay and bisexual men. Sexually Transmitted Diseases, 38, 105–110.
Hoyte, C. O., Albert, D., & Heard, K. J. (2013). The use of energy drinks, dietary supplements, and prescription medications by United States college students to enhance athletic performance. Journal of Community Health, 38, 575–580.
Kelly, J. C., & Parsons, J. T. (2010). Prevalence and predictors of non-medical prescription drug use among men who have sex with men. Addictive Behaviors, 35, 312–317.
Benotsch, E. G., Jeffers, A. J., Snipes, D. J., Martin, A. M., & Koester, S. (2013). The five factor model of personality and the non-medical use of prescription drugs: Associations in a young adult sample. Personality and Individual Differences, 55, 852–855.
Cooper, R. J. (2013). Over-the-counter medicine abuse—A review of the literature. Journal of Substance Use, 18, 82–107.
Substance Abuse and Mental Health Services Administration (SAMSHA; 2008). The NSDUH report: Misuse of over-the-counter cough and cold medications among persons aged 12 to 25. [On-line]. Retrieved November 29, 2013, from http://www.oas.samhsa.gov/2k8/cough/cough.pdf.
Lachover, L. (2007). Deciphering a psychosis: a case of dextromethorphan-induced symptoms. Primary Psychiatry, 14, 70–72.
Gracious, B., Abe, N., & Sundberg, J. (2010). The importance of taking a history of over-the-counter medication use: A brief review and case illustration of “PRN” antihistamine dependence in a hospitalized adolescent. Journal of Child and Adolescent Pharmacology, 20, 521–524.
Kirages, T. J., Sulé, H. P., & Mycyk, M. B. (2003). Severe manifestations of coricidin intoxication. American Journal of Emergency Medicine, 21, 473–475.
Schonfeld, L., King-Kallimanis, B. L., Duchene, D. M., et al. (2010). Screening and brief intervention for substance misuse among older adults: The Florida BRITE project. American Journal of Public Health, 100, 108–114.
Steinman, K. J. (2006). High school students’ misuse of over-the-counter drugs: A population-based study in an urban county. Journal of Adolescent Health, 38, 445–447.
Lin, K.-H., Chen, Y.-J., Wei, C.-F., et al. (2010). Prolonged withdrawal delirium in concomitant diphenhydramine and nefopam dependence: A case report. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 34, 705–706.
Bryner, J. K., Wang, U. K., Hui, J. W., Bedodo, M., MacDougall, C., & Anderson, I. B. (2006). Dextromethorphan abuse in adolescence: An increasing trend: 1999–2004. Archives of Pediatrics and Adolescent Medicine, 160, 1217–1222.
Food and Drug Administration (FDA; 2010). FDA warns against abuse of dextromethorphan (DXM). [On-Line]. Retrieved November 29, 2013, from http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM224446.pdf.
Ford, J. A. (2009). Misuse of over-the-counter cough or cold medications among adolescents: Prevalence and correlates in a national sample. Journal of Adolescent Health, 44, 505–507.
Feinberg, D. T. (2006). The cost of over-the-counter substance abuse. Journal of Child and Adolescent Psychopharmacology, 16, 801–802.
Herman-Stahl, M. A., Krebs, C. P., Kroutil, L. A., & Heller, D. C. (2007). Risk and protective factors for methamphetamine use and nonmedical use of prescription stimulants among young adults aged 18 to 25. Addictive Behaviors, 32, 1003–1015.
Arria, A. M., Caldeira, K. M., O’Grady, K. E., Vincent, K. B., Johnson, E. P., & Wish, E. D. (2008). Nonmedical use of prescription stimulants among college students: Associations with attention-deficit-hyperactivity disorder and polydrug use. Pharmacotherapy, 28, 156–169.
Sung, H.-E., Richter, L., Vaughan, R., Johnson, P. B., & Thom, B. (2005). Nonmedical use of prescription opioids among teenagers in the United States: Trends and correlates. Journal of Adolescent Health, 37, 44–51.
Arria, A. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E. D. (2008). Perceived harmfulness predicts nonmedical use of prescription drugs among college students: Interactions with sensation-seeking. Prevention Science, 9, 191–201.
Weyandt, L. L., Janusis, G., Wilson, K. G., et al. (2009). Nonmedical prescription stimulant use among a sample of college students: Relationship with psychological variables. Journal of Attention Disorders, 13, 284–296.
Zullig, K. J., & Divin, A. L. (2012). The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students. Addictive Behaviors, 37, 890–899.
Benotsch, E. G., Zimmerman, R. S., Cathers, L., McNulty, S., Pierce, J., Heck, T., et al. (2013). Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug and Alcohol Dependence, 132, 391–394.
Hall, M. T., Howard, M. O., & McCabe, S. E. (2010). Subtypes of adolescent sedative/anxiolytic misusers: A latent profile analysis. Addictive Behaviors, 35, 882–889.
Benotsch, E. G., Koester, S., Luckman, D., Martin, A., & Cejka, A. (2011). Non-medical use of prescription drugs and sexual risk behavior in young adults. Addictive Behaviors, 36, 152–155.
Benotsch, E. G., Seeley, S., Mikytuck, J., Pinkerton, S. D., Nettles, C. D., & Ragsdale, K. (2006). Substance use, medications for sexual facilitation, and sexual risk behavior among traveling men who have sex with men. Sexually Transmitted Diseases, 33, 706–711.
Bohn, M., Babor, T., & Kranzler, H. (1995). The alcohol use disorders identification test (AUDIT): Validation of a screening instrument for use in medial settings. Journal of Studies on Alcohol, 56, 423–432.
Woicik, P. A., Stewart, S. H., Pihl, R. O., & Conrod, P. J. (2009). The substance use risk profile scale: A scale measuring traits linked to reinforcement-specific substance use profiles. Addictive Behaviors, 34, 1042–1055.
Derogatis, L. R. (2001). Brief symptom inventory 18, administration and scoring manual. San Antonio, TX: Pearson.
Centers for Disease Control and Prevention. (2005). Unintentional deaths from drug poisoning by urbanization of area: New Mexico, 1994–2003. Morbidity and Mortality Weekly Report, 54, 870–873.
Gillman, P. K. (2005). Monamine oxidase inhibitors, opioid analgesics and serotonin toxicity. British Journal of Anesthesia, 95, 434–441.
Hersh, E. V., Pinto, A., & Moore, P. A. (2007). Adverse drug interactions involving prescription and over-the-counter analgesic agents. Clinical Therapy, 29, 2477–2497.
Lessenger, J. E., & Feinberg, S. D. (2008). Abuse of prescription and over-the-counter medications. Journal of the American Board of Family Medicine, 21, 45–54.
National Institute on Alcohol Abuse and Alcoholism. (NIAAA, 2007). Harmful interactions: Mixing alcohol with medicines. NIH Publication No. 03-5329. Retrieved July 12, 2012, from: http://pubs.niaaa.nih.gov/publications/medicine/medicine.htm.
Schwilke, E. W., dos Santos, M. I. S., & Logan, B. K. (2006). Changing patterns of drug and alcohol use in fatally injured drivers in Washington State. Journal of Forensic Sciences, 51, 1191–1198.
Benotsch, E. G., Martin, A. M., Koester, S., Mason, M. J., Jeffers, A. J., & Snipes, D. J. Driving under the influence of prescription drugs used non-medically: Associations in a young adult sample. Substance Abuse. doi:10.1080/08897077.2013.854287.
Lembke, A. (2012). Time to abandon the self-medication hypothesis in patients with psychiatric disorders. The American Journal of Drug and Alcohol Abuse, 38, 524–529.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Benotsch, E.G., Koester, S., Martin, A.M. et al. Intentional Misuse of Over-the-Counter Medications, Mental Health, and Polysubstance Use in Young Adults. J Community Health 39, 688–695 (2014). https://doi.org/10.1007/s10900-013-9811-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-013-9811-9