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Review ArticleClinical Review

Abuse of Prescription and Over-the-Counter Medications

James E. Lessenger and Steven D. Feinberg
The Journal of the American Board of Family Medicine January 2008, 21 (1) 45-54; DOI: https://doi.org/10.3122/jabfm.2008.01.070071
James E. Lessenger
private practice, Benicia, California (JEL)
MD
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Steven D. Feinberg
Department of Orthopaedic Surgery-Physical and Rehabilitative Medicine, Stanford University School of Medicine, California (SDF)
MD, MPH
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Article Figures & Data

Tables

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    Table 1.

    2002 Emergency Department Admissions from Use of Prescription and Over-the-Counter Medications

    Substance%Age at First UseSource of Feferral
    Opioids5526Self
    Stimulants2820Criminal justice system
    Tranquilizers, muscle relaxers1024Self
    Sedatives623Self
    OTC medications120Self
    • Data from the National Survey on Drug Use and Health.5

    • OTC, over the counter.

    • View popup
    Table 2.

    Commonly Used Prescription Drugs with Potential for Abuse

    CategoryDrugsExamples
    SedativesBarbituratesAmytal, Nebutal
    FlunitrazepamRohypnol
    Dissociative anestheticsKetamineKetalar SV
    Opioids and morphineCodeineTylenol with codeine
            derivatesFentanylDuragesic
    MorphineDuramorph
    OpiumLaudanum
    OthersOxycontin
    StimulantsAmphetaminesDexedrine
    CocaineCocaine hydrochloride
    MethamphetamineDesoxyn
    MethylphenidateRitalin
    Anabolic steroidsAnadrol
    Tranquilizers andBenzodiazepinesAtivan, Halcion
            muscle relaxersCarisoprodolSoma
    • Data from the National Institute on Drug Abuse.17

    • View popup
    Table 3.

    Abused Over-the-Counter Medications (Representative List)

    ClassMedicationMedical (Legal) UseNonmedical UsePhysical Findings of Nonmedical Use
    Dietary supplementsSupplement with piperazineAnorexiaHallucinationsAcute psychosis
    Dissociative substancesDextromethorphanCough suppressantDissociative effectPsychiatric effects
    CoricidinDecongestantEuphoriaEuphoria psychosis
    ChlorpheniramineDecongestantEuphoriaEuphoria psychosis
    DimenhydrinateAntiemeticEuphoria, hallucinationsExtreme euphoria, hallucinations
    DiphenhydramineSedationEuphoria “high”Tachycardia, euphoria, hallucinations, psychosis
    Stomach preparationsCalcium-bromide combinationsAntacid stomach medicationEuphoria, hallucinationsNeuropsychiatric symptoms
    StimulantsNicotine gumSmoking cessation“High”Agitation
    PhenylpropanolamineDecongestant“High” physical performance enhancementAgitation, rapid heartbeat
    EphedrineAnti-asthmaProlonged erection and sexual performancePriapism
    PseudoephedrineDecongestantProlonged erection and sexual performancePriapism
    MethylephedrineDecongestantProlonged erection and sexual performancePriapism
    CaffeineAwarenessPerformance enhancementAgitation, rapid heartbeat
    EphedraStimulant“High”Agitation, tachycardia, flushing
    CyclizineAntihistamineEuphoriaEuphoria
    EpinephrineBronchodilatorEuphoriaHeadache, nausea, chest pains
    LaxativesOral and rectal laxativesAnticonstipationPsychological dependenceGI disturbances
    SedativesDiphenhydramineSedationSedationSomnolence, coma
    SteroidsAndrostenedione (herbal sources)Hormone replacementExercise enhancementAcne, glandular failure, hyperaggressive behavior
    HerbalAntidepressantAntidepressantAdverse psychiatric reactionsPsychosis
    Detox cocktailDetox from drugsSerotonin syndromePsychosis

Additional Files

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  • Erratum

    The institution affiliation information in this article is incorrect. It should read:

    From private practice, Benicia, California (JEL), and the Department of Orthopaedic Surgery-Physical and Rehabilitation Medicine and the Department of Anesthesia-Pain Management Center, Stanford University School of Medicine, California.

    We apologize for the error, and we regret any confusion or inconvenience it may have caused.

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The Journal of the American Board of Family Medicine: 21 (1)
The Journal of the American Board of Family Medicine
Vol. 21, Issue 1
January-February 2008
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Abuse of Prescription and Over-the-Counter Medications
James E. Lessenger, Steven D. Feinberg
The Journal of the American Board of Family Medicine Jan 2008, 21 (1) 45-54; DOI: 10.3122/jabfm.2008.01.070071

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Abuse of Prescription and Over-the-Counter Medications
James E. Lessenger, Steven D. Feinberg
The Journal of the American Board of Family Medicine Jan 2008, 21 (1) 45-54; DOI: 10.3122/jabfm.2008.01.070071
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