The Rising Trends in the Misuse and Abuse of Over-the-Counter Medications: A Comprehensive Review

Abstract

Background: Over-the-counter (OTC) medications are widely perceived as safe and accessible, yet their misuse and abuse are rising concerns. While these medications are designed for common ailments, their potential for dependency and harmful effects is often underestimated. This review examines the trends in OTC medication misuse, particularly focusing on substances like dextromethorphan (DXM), diphenhydramine (DPH), and codeine.

Methods: A systematic review was conducted from 2020 to 2023, utilizing databases such as PubMed, Scopus, and Web of Science. The review analyzed existing literature on the misuse patterns of specific OTC medications, associated psychopathological effects, and molecular mechanisms that facilitate their recreational use.

Results: The findings indicate a significant prevalence of misuse among adolescents and young adults, often characterized by unconventional administration methods and concurrent use with other substances. Key substances implicated in misuse include DXM, DPH, and codeine-based cough preparations. The demographic most affected includes males with a history of substance use disorders and psychiatric conditions. The study highlights the complexities of OTC misuse, including the social acceptability of these substances compared to illicit drugs.

Conclusion: The misuse of OTC medications poses a critical public health challenge, with implications for drug-related toxicity, addiction, and mortality. The COVID-19 pandemic has exacerbated these trends, necessitating the development of targeted prevention strategies and public health interventions to mitigate misuse. Increased awareness and monitoring are essential to address the growing problem of OTC medication abuse.