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The Most Commonly Abused Medications In America

by Landmark Recovery

October 31, 2018
A pharmacist grabbing medication off the shelf

The term “drug addiction” is typically associated with substances like heroin, methamphetamine, or cocaine. When most people picture drug addicts, they think of destitute men and women, dressed poorly, with gaunt features and unkempt faces. The truth is, however, that most drug addicts do not fall into this stereotype. In fact, the National Institute on Drug Abuse (NIDA) notes that OTC (Over-the-counter) drugs and prescription medication are actually the most commonly abused substances in the nation after alcohol and marijuana.

These drugs are abused more often because they are so accessible and many users do not realize that these medications can be addictive. This is understandable, as pharmacists and doctors are typically trusted resources when it comes to acquiring medication for some kind of disease or illness. While they appear safe, the truth is that any drug has the potential to do harm if used improperly, and many common prescription medications used for pain have the potential to become addictive. Consumers need to be aware of the major health risks associated with common OTC and prescription medications.


The Most Commonly Abused OTC Drugs

A pharmacist grabbing medication off the shelf

Because these medications can be sold without a prescription, they have a higher potential of being acquired and abused. OTC medicines are used to treat a variety of illnesses and symptoms such as cough, cold, constipation, pain, and more. The danger inherent in these medications is that they carry ingredients that can be misused at higher dosages. The most commonly misused OTC medications are:


Dextromethorphan (DXM)

DXM is a cough suppressant used in several common cold medicines. The most commonly abused sources of DXM are found in extra-strength cough syrup, tablets, and capsules. Medications that include DXM are typically abused by taking higher than the recommended dosage or mixing with soda for flavor, in what is nicknamed “skittling” or “robotripping”. DXM may also be mixed with other drugs such as marijuana or alcohol.

In one 2008 study, DXM was found in almost half of all OTC medications in the U.S., making it cheap, easy, and legal to acquire. Household names like Nyquil, Robitussin, and Theraflu are all commonly abused sources of DXM. DXM is classified as a synthetic opiate, but it does not act on the opioid receptors, although it can produce a false positive urine test for opioids. When taking in large doses, the drug produces euphoric and hallucinogenic as well as sedative effects.

DXM’s effects on the human body are not that different from alcohol and marijuana. At high enough doses, the drug can produced serious hallucinogenic effects, including physical distortion, paranoia, and anxiety. Repeated usage in order to attain a high can lead to addiction and serious consequences to the user’s life and health. In the long term, this drug can wreak havoc on the stomach and even cause liver damage. If taken in high enough doses, this drug can cause overdose wherein breathing slows or stops. An overdose on DXM can have short and long-term mental effects and damage to the nervous system. Common DXM medications include:

  • Mucinex
  • Nyquil
  • Vicks Formula 44
  • Theraflu
  • Delsym
  • Comtrex



Loperamide is an anti-diarrheal medication available in pill or liquid form that can produce similar effects to mild opioid highs. In fact, Loperamide has been dubbed the poor man’s methadone because of its ready availability and inexpensiveness. Like DXM, Loperamide is a synthetic opiate that does not attach to the opioid receptors in the brain. However, when taken in extremely high doses, the drug can act in a similar way to other opioids.

The generic form of Loperamide, Imodium, is available in most drug stores in the United States. Users may buy massive quantities of this drug at several drug stores in order to get high or to help mitigate the effects of an opioid withdrawal. As a result of this drug’s abuse, the FDA created restrictions on the packaging of loperamide to warn users of the possible addictive side effects and to limit the number of tablets in a package.

Loperamide abuse can create euphoric effects similar to opioids if taken in high enough doses. Misuses of this OTC drug can lead to fainting, stomach pain, constipation, and irregular heartbeat, as well as kidney problems. These effects become magnified if the drug is taken with other medications. In the long term, this drug can wreak havoc on the stomach and even cause liver damage. If taken in high enough doses, this drug can cause overdose wherein breathing slows or stops.

  • Anti-Diarrhea
  • Ultra A-D
  • Imodium
  • Diamode



Antihistamine abuse is a common type of OTC drug abuse that goes mostly unnoticed by the world. These types of drugs are used for treating allergic reactions, as a sleep aid, and to prevent or treat motion sickness, but the sedative side effects can become addictive for some users who struggle with insomnia or who wish to achieve a dissociative effect. Antihistamines do not cure the cold, but they do block cells from being binded to by histmianes, which produce changes in the cells that lead to sneezing, itching, and mucus production.

Antihistamine drugs typically also contain acetylcholine, which produces sedative side effects. When combined with other substances such as opioids, alcohol, or marijuana, antihistamines exaggerates the sedating effects of these drugs. Using high doses of antihistamines with alcohol can result in liver damage and produce serious health consequences in the long term. Some users can come to rely on antihistamines in order to fall asleep, but this is dangerous as prolonged use can cause serious withdrawal effects and interfere with sleep. Commonly reported side effects from antihistamine withdrawal include chest pains, insomnia, bladder pain, and kidney pain. Common medications containing antihistamines are:

  • Benadryl
  • Unisom
  • Sominex
  • Allegra
  • Clarinex
  • SimplySleep
  • ZzzQuil


While caffeine is perfectly safe in small enough doses, users can quickly grow to depend on this stimulant for getting through the day. Additionally, consuming too much caffeine too quickly can cause high blood pressure, sweating, anxiety, and even convulsions. Coffee is usually safe, but some users resort to taking caffeine pills and extremely saturated energy drinks in order get a fix of caffeine. Teens and young adults are marketed these substances in order for them to feel prepared for the high pressure environments of academia and the professional workforce.

Energy drinks such as Monster, Red Bull, Rockstar, and numerous other brands have proven that there is a large demand for high doses of caffeine in concentrated and sugary form. While relatively harmless when consumed in low enough quantities, mixing an energy drink with another drug or consuming multiple cans in a short period can be dangerous. For example, a single can of Red Bull has almost 50 grams of sugar and over 100mg of caffeine, along with taurine, guarana, and ginseng which are all additional stimulants. It is recommended that grown adults consume no more than 300 – 400 mg per day to avoid negative health consequences.

Caffeine pills are another dangerous method of caffeine consumption that can easily lead to overdose if users are not careful. A popular caffeine pill is NoDoz, which is commonly used by truckers to make long hauls across the country, but many individuals consume caffeine this way in order to meet work and school obligations. Like energy drinks, caffeine pills can offer a boost of energy when needed, but with the average dose level being 200mg, even taking more than one of these per day can result in negative consequences like elevated heart rate, anxiety, and sweating.


Diet Pills (Ephedra)

Diet pills comprise a number of prescription and OTC supplements that help users to control their weight. However, many diet pills work in similar fashion to stimulants that alter the natural way the body processes weight and suppresses the appetite. Some diet pills are even classified under the Controlled Substances Act. Common diet pills are Benzphetamine, Diethylpropion, and Mazindol to name a few.

Because of their similarity to amphetamines and other stimulants, these drugs have many similarities in terms of potential for abuse and withdrawal symptoms. Diet pills, much like amphetamines, can increase performance, increase energy, and create feelings of euphoria. As legal stimulants, they carry a higher potential for abuse than prescription medications. Becoming dependent on diet pills is not uncommon for someone with an eating disorder or other underlying mental condition. Some of the most commonly abused diet pills include:

  • Didrex
  • Tepanil
  • Tenuate
  • Mazanor
  • Apidex


The Most Commonly Abused Prescription Drugs

A doctor who can prescribe medications typing on their computer

Prescription drug abuse is one of the most serious issues facing the United States. According to the latest survey on substance use by SAMHSA, among people 12 years or older there are currently 3.3 million individuals who are currently misusing prescription pain relievers. Of these people, 6 out of 10 indicated that the main reason they misused pain relievers was to alleviate physical pain and more than half indicated that they had obtained the last pain relievers they misused from a relative or friend. It is difficult for the nation to combat this problem, as many individuals do require pain management medication in order to get through serious injuries or chronic pain. Other commonly abused drugs include CNS depressants such as benzodiazepines and stimulants such as methylphenidate and amphetamine.



Opioids are commonly abused because of the euphoric effect they produce in users. Some of the most commonly abused prescription opioids include Oxycodone (OxyContin), Codeine, Fentanyl, and Meperidine (Demerol). Synthetic opioids such as these are typically used to treat chronic or acute pain, as well as for numbing and aiding in cold treatment. These drugs, while safer than heroin, work in a similar manner with respect to the effects on opioid receptors in the brain. Addiction to opioids can produce seriously intense withdrawal symptoms such as cravings, runny nose, insomnia, chills, and more.



Benzodiazepines, or benzos, are part of the drug family falling under sedatives. All benzos are considered Schedule II-IV drugs by the DEA. Benzodiazepines produce similar calming and sedative effects to opioids, but hold significantly less risk for overdose solely by themselves. However, when combined with opioids, both become significantly more lethal. Instead of targeting the opioid receptors, Benzos target the GABA receptor molecules, which are largely concerned with cognitive processes outside of life functions. So instead of potentially shutting down your lungs (like with opioids), you run the risk of mental drowsiness, amnesia, and problems with learning and motor control.

Benzos create feelings of calmness and relaxation. At higher and higher doses, they can induce vertigo, drowsiness, and muscle incoordination. Depending on level and tolerance, benzo effects can last from an hour or two to more than a day. Other sedatives and opioids will suppress the nervous system and potentially stop your breathing, but benzos do not carry this risk. While these drugs are intended to help alleviate symptoms of anxiety, nervousness, restlessness, and insomnia, when improperly used, they can create these exact symptoms. Common Benzos include Xanax (Alprazolam), Klonopin (Clonazepam), Rohypnol (Flunitrazepam), Valium (Diazepam), Librium (Chlordiazepoxide), Ativan (Lorazepam), Dalmane, and Serax.



Stimulant drugs are used for a variety of medical and recreational purposes. Medically, stimulants are used to treat ADHD and are intended to raise alertness and attention, as well as increase blood pressure, heart rate, and breathing. Recreationally, stimulants are taken to achieve high alertness, energy, and a pleasurable sense of well being. When injected or smoked, stimulants can produce intense feelings of euphoria. Stimulants come in a variety of forms, including amphetamines, cocaine, methamphetamines, pseudoephedrine, and more. The most common individual forms of stimulants are amphetamines (Adderall, Dexedrine), and Methylphenidate (Ritalin).


In Conclusion

Drug and alcohol addictions are some of the most destructive forces in the world today. The process of healing ourselves, our families, our communities, and the world at large, starts with recognizing the danger that these substances represent. At Landmark Recovery, we believe in creating a supportive network of love and access to resources that can help you break free from the chains of addiction. Visit our website to learn more about our drug rehab and alcohol rehab centers.

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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.