What Are Over-the-Counter Drugs?

A medication that is sold directly to a customer without requiring a doctor’s prescription is called an over-the-counter drug. A medication that requires a prescription from a doctor is called a prescription drug. An over-the-counter drug is generally used to treat a condition that doesn’t need the direct supervision of a doctor, like a sore throat or a stuffy nose. An over-the-counter drug has to be proven as safe and tolerated without problems. Over-the-counter drugs are usually required to have little or no abuse potential.

After a period of time, a drug that proves itself safe and suitable for self-medication may go from being a prescription drug to an over-the-counter drug. While it’s less likely for a drug to go from being over-the-counter to prescription, some pharmacies are now putting certain over-the-counter medicines, like the ones containing pseudoephedrine that is a main ingredient in methamphetamine, into locations where customers must ask for them. This helps prevent shoplifting, as people who abuse over-the-counter drugs sometimes steal the drugs from pharmacies or other stores. The pharmacist is also able to monitor the amount of a certain type of drug someone may be buying.

So what exactly are considered over-the-counter drugs? Pain relievers, antihistamines, decongestants, cough medicine, diet pills, and sleep aids that you can buy without a prescription either in a drugstore or online are over-the-counter drugs. There are also different types of drugs that relieve the same symptoms. For example, Tylenol and Aleve are both pain relievers, but they have different chemical make-ups.

According to the National Institute on Drug Abuse (NIDA)’s Monitoring the Future survey, prescription and over-the-counter drugs are, after marijuana and alcohol, the most commonly abused substances by Americans aged 14 and older. The most commonly abused over-the-counter drugs are cough and cold remedies containing dextromethorphan. In 2022, 2.4 percent of twelfth graders had used an over-the-counter cough or cold medicine for non-medical reasons. Teen abuse of diet pills and stay-awake pills, which are stimulants, were at their lowest level ever recorded—at 1.6 percent each. Over-the-counter drug abuse is also a health concern in Canada. The 2021 Ontario Student Drug Use and Health Survey, released by the Centre for Addiction and Mental Health, found that 3.6 percent of middle and high school students had used over-the-counter cough medicine to get high. This was a drop from 10 percent of those surveyed in 2013. Another standard survey of teen drug use, the National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), no longer includes over-the-counter drug abuse from its survey.

History of Over-the-Counter Drug Abuse

Abuse of over-the-counter medications is not a new phenomenon. Laudanum was used in Europe since the 1600s, and it was brought to America by the early settlers. Laudanum was an opiate-based liquid treatment used mostly for headaches. In the 1700s, paregoric was devised as an antidiarrheal, a medication that stops diarrhea. It was also found to be an antitussive, which means a cough suppressant or a medication that stops a bad cough. In the 1800s, paregoric was abused by parents, but not in the way you might think. They were using it on their children to either calm them down when they were rowdy or to just put them to sleep. Paregoric was only regulated and classified as a controlled substance in the latter half of the twentieth century. Basically, that means it went from being over-the-counter to prescription. Part of the reason for this is that people were confusing laudanum with paregoric. Laudanum contains twenty-five times the amount of morphine than paregoric does, leading to many accidental overdoses.

One of the most popular medicinal elixirs of the mid-to-late 1800s and early 1900s is one of the most popular soft drinks of today. These elixirs were mixed up behind the counters at early drugstores. In 1866, a man named John Pemberton included cocaine, along with caffeine, as the main ingredient in his new elixir, Coca-Cola. It’s believed that because of the euphoric and energizing effects of the cocaine, Coca-Cola became the most popular soft drink in history. Cocaine was taken out of Coca-Cola in 1903. However, cocaine did not become an illegal drug until 1920, when it was outlawed by the Dangerous Drug Act of 1920.

Dexetrim, which is still available as an over-the-counter appetite suppressant, was so named because in the 1950s and ’60s, it contained Dexedrine, a stimulant. In addition to staving off hunger, housewives found that it gave them the energy to take care of everything they needed to do. Dexedrine was regulated to a prescription medication, which is being used today to treat attention deficit hyperactive disorder.