5 Addictive Over-the-Counter Drugs

1. Dextromethorphan

Dextromethorphan (DXM) is a synthetic derivative of morphine, used to produce popular cough medicines. Taken in doses exceeding therapeutic doses, it often produces effects that are difficult to predict. Symptoms of intoxication may occur when the dose is increased to 220 mg. The body’s reaction to DXM is varied and may depend, for example, on the genetic predisposition of the experimenting person.

2. Benzydamine

This drug belongs to non-steroidal anti-inflammatory drugs. Benzydamine is mainly used externally. It has analgesic, local anesthetic, anti-inflammatory, and antiseptic effects. Unlike other NSAIDs, it is a weak inhibitor of prostaglandin synthesis [3]. Benzydamine is an increasingly popular narcotic drug. It has psychoactive effects in high doses (500 mg and above). When administered orally, it is easily absorbed from the gastrointestinal tract, reaching maximum concentration within 2–4 hours. It easily penetrates the blood-brain barrier.

Due to the high dose of benzydamine, the most popular drug used for intoxication is Tantum Rosa as a powder or vaginal douche [2]. Due to the content of excipients, this solution is often subjected to preliminary purification using home methods, e.g. using ordinary filter paper [4]. People using benzydamine for recreational purposes confirm the occurrence of various hallucinations [1]. From the descriptions they post on internet forums, it can be concluded that these are most often auditory and visual hallucinations in the form of visions, afterimages, and time-lapse visions.

3. Pseudoephedrine

It is a stereoisomer of ephedrine but has a weaker vasoconstrictor effect and a smaller effect on the central nervous system than ephedrine. Many years ago, it was observed that abuse or large doses of pseudoephedrine administered orally or intranasally can cause adverse CNS symptoms, such as insomnia, excessive agitation, hallucinations, and psychosis. Pseudoephedrine, like other psychostimulants from the amphetamine group, stimulates the sympathetic nervous system to a “fight or flight” response, constricts blood vessels, increases blood glucose levels, dilates the arteries, and accelerates breathing and heart rate.

Due to its relatively easy access and relatively low cost, pseudoephedrine is often used for intoxicating purposes. Depending on the dose, it causes euphoria, increases self-esteem, and arousal, increases motivation, and improves communication skills. It can cause psychological addiction. Pseudoephedrine is taken not only for intoxication or to improve concentration during studying but is also used to support the weight loss process. It can be used to obtain methamphetamine and methylcadinone at home.

4. Codeine

Codeine phosphate is a compound from the group of phenanthrene alkaloid derivatives, occurring naturally in opium. It is mainly used to stop dry, persistent cough. It is often abused because after an overdose it causes euphoria, a state of bliss, and relaxation. Codeine causes tolerance, as well as psychological and physical dependence. Psychological dependence can occur after a few days of use, while physical dependence develops more slowly.

5. Diphenhydramine

Diphenhydramine and dimenhydrinate are substances that have a sleep-inducing effect and reduce the symptoms associated with motion sickness. They are also sometimes used for recreational purposes, such as to induce OEV (Open Eye Visions). However, they cause side effects, such as difficulty urinating, a feeling of being dizzy, and headaches, which make young people less likely to use them. Instead of a hallucination session, a long sleep may also occur