Can You Be Addicted to Over-the-Counter Medications?

But this accessibility can create a false sense of security. The truth is, misusing certain OTC medications can lead to dependence, serious health complications, and withdrawal symptoms that mirror those of more recognized addictions.

_______________________________________________________

What Are Over-the-Counter Medications?

Over-the-counter medications are drugs approved for sale without a prescription. They’re regulated differently from prescription medications because they’re generally considered safe for self-administration when used as directed. Common examples include pain relievers, cold medicines, sleep aids, and allergy medications.

However, “safe when used as directed” is the key phrase here. 

Because these products are so easy to access, many people assume they carry little to no risk. That assumption can lead to unintentional misuse—small changes in dose, frequency, or purpose that quietly shift normal use into something more concerning.

_______________________________________________________

What Over-the-Counter Medicines Can Be Addictive?

While most OTC medications are safe when used as directed, certain ingredients can cause dependence, tolerance, or misuse when taken in higher-than-recommended amounts.

Dextromethorphan (DXM): Cough Syrups and Cold Medicines

DXM is found in many cough suppressants, including Robitussin, NyQuil, and generic “DM” formulas. At recommended doses, it safely suppresses coughs. At high doses, it produces euphoria and dissociative effects, which is why some people misuse it.

Signs of DXM misuse include taking multiple doses, purchasing cough medicine frequently, or using it when no illness is present. And the physical risks can be very uncomfortable and include nausea, rapid heart rate, and serotonin syndrome. 

Additionally, when cough syrups contain acetaminophen alongside DXM, liver damage becomes an additional serious concern.

Diphenhydramine: Sleep Aids and Allergy Medications

Diphenhydramine is the active ingredient in Benadryl, ZzzQuil, and Unisom SleepGels. It’s an antihistamine with sedating effects, which is why it’s commonly used as a sleep aid.

The problem is that tolerance builds quickly. Many people find themselves needing more to achieve the same drowsy effect. Long-term overuse can further lead to confusion, memory problems, and heart rhythm abnormalities.

Pseudoephedrine: Nasal Decongestants

Pseudoephedrine relieves nasal congestion but has stimulant-like effects at higher doses. This is why it’s kept behind pharmacy counters and purchases are tracked—it has a well-documented history of misuse.

Loperamide: Anti-Diarrheal Medications

Loperamide, sold as Imodium, isn’t traditionally considered addictive. However, at very high doses, it can act on opioid receptors in the body. This has led some individuals—particularly those managing opioid withdrawal on their own—to misuse it.

Consequently, loperamide misuse can cause life-threatening heart rhythm disturbances and intestinal blockage. 

Caffeine Pills: Energy Supplements

While caffeine dependence is common and often dismissed as harmless, overuse of caffeine pills can create problematic patterns. And caffeine pills, such as NoDoz and Vivarin, offer a concentrated dose of caffeine for alertness. 

Yet, when taken in the long term, withdrawal symptoms may include headaches, fatigue, and irritability. Overuse often also leads to anxiety, heart palpitations, insomnia, and digestive issues. 

For some, caffeine pills may be masking underlying exhaustion or sleep problems, which need to be addressed.

_______________________________________________________

Is It Possible to Become Addicted to Ibuprofen or Acetaminophen?

This is a common question, and the answer requires some nuance!

Ibuprofen (Advil, Motrin)

Ibuprofen is not chemically addictive. It doesn’t produce euphoria or the reward-system activation associated with addictive substances. 

However, some people develop a behavioral dependence, taking it preemptively to avoid pain or relying on it daily for chronic discomfort. As such, long-term overuse may include stomach bleeding and kidney damage.

Acetaminophen (Tylenol)

Acetaminophen is also not addictive in the traditional sense. The primary concern with acetaminophen is liver toxicity—it’s one of the leading causes of acute liver failure in the United States, often due to accidental overdose. 

Some people overuse it without realizing how quickly they’re approaching dangerous levels, especially when taking multiple products that contain it.

_______________________________________________________

Signs of OTC Medication Misuse or Dependence

Recognizing a problem is the first step toward addressing it. Warning signs include:

• Needing higher doses for the same effect
• Using medications for non-medical reasons
• Taking more than the label allows
• Hiding your use or feeling guilty about it
• Experiencing withdrawal symptoms (such as fatigue, irritability, insomnia, or cravings)

And the consequences of ongoing misuse can be serious. It may include overdosing, organ damage, cognitive impairment, dangerous interactions with alcohol or other medications, and impaired judgment that increases accident risk.

This is the importance of following dosage instructions carefully, no matter whether the medication is prescription or over-the-counter. Avoid combining medications with overlapping ingredients. Don’t rely on sleep aids every night. If symptoms persist beyond a few days, talk to a healthcare provider. And consider healthier alternatives for managing sleep, stress, and pain.

_______________________________________________________

When to Seek Help

If you’re taking more than directed, feel like you need a medication to sleep or function normally, use OTC medications to cope with stress or emotions, or experience withdrawal when you stop, it’s time to reach out for support. 

At Freedom Recovery Centers (FRC), our team is here to help guide you; you don’t need to do this alone. When you’re ready, call us at 804-635-3746.