Many over-the-counter (OTC) medicines contain active ingredients that are likely to be misused, especially when consumed in dosages that exceed those recommended or in a manner that is not recommended. According to the US federal government’s website, commonly misused OTCs include dextromethorphan (DXM), an ingredient in cold and cough medicines, and loperamide, an ingredient in anti-diarrheal medicines. These medicines are sold in tablet, capsule, and liquid form. Users may combine them with other controlled substances.
In addition, medicines that were former OTCs, those containing pseudoephedrine, are now sold only behind the counter. In some states, they require a prescription or may only be purchased by those 18 and older. Excessive consumption can lead to an overdose or to addiction.
In the United States, consumption of opioids, which should be available only by prescription, is a national public health crisis. The commonly used and misused opioids are hydrocodone, oxycodone, oxymorphone, morphine, codeine, and fentanyl. They have different trademarked names depending on the manufacturer. Misuse of these substances includes overconsumption, using another person’s prescription, or taking a drug with the intent to get high. Users may crush the tablets and, after mixing the powder with water, snort or inject the solution. These drugs may be used instead of or in combination with heroin, an illegal opioid. Long-term use may create tolerance, dependence, or addiction.
The Centers for Disease Control website states that there in 2018 there were 67,367 deaths from drug overdoses in the United States, with 70% of those due to opioids. Between 1999 and 2018, the CDC calculates that
almost 450,000 people died from an overdose involving any opioid, including prescription and illicit opioids.
There has been a sharp increase since 2013, the period called the third wave, in overdose deaths from consumption of fentanyl and other synthetic opioids.