Is it safe to experiment with drugs and medicines I can buy at the store?

Just because a drug or medicine is sold at your local pharmacy or supermarket, that doesn’t mean that it is safe for you to use while you are being treated for cancer. Many over-the-counter medicines can interact with cancer-fighting medications. You should always talk to your doctor or nurse before taking any sort of medication.

There is a big misunderstanding among teenagers and adults that it is safer to “abuse” medicines sold at stores than those that are illegal. Although these medicines are safer in that they are made in a controlled, safe environment, not following their dosing instructions or abusing them can have similar outcomes to those of illegal drugs and alcohol.

Cough medicine is a common household medication that is abused by teenagers. The common ingredient in many cough and cold remedies, Dextromethorphan (DXM), (a cough suppressant) is found in at least 70 over-the-counter products, including Alka-Seltzer Plus Cold & Cough Medicine, Coricidin Cough and Cold Tablets, Dimetapp DM, Robitussin cough products, Triaminic cough syrups, Tylenol Cold products, and Vicks NyQuil LiquiCaps.

Used as directed on the label, DXM products are effective at suppressing cough and are safe to use. DXM was approved by the U.S. Food and Drug Administration in 1958 and has no serious side effects when used in small doses—typically, 10 to 20 mg doses every four to six hours, or 30 mg every six to eight hours.

When taken in vastly larger quantities, however, DXM produces a distorted awareness, altered time perception and hallucinations. And if taken along with other drugs—even other over-the-counter medications like acetaminophen—the combination can cause liver damage, heart attack, stroke or death.

You may be surprised to know that the effects of DXM have been compared to PCP (phencyclidine) and the anesthetic ketamine. All three are called dissociative substances: At high doses, they give the abuser a feeling of not being in one’s own body. DXM also produces hallucinations. The effects can last up to six hours, but that can vary, depending on how much DXM is taken and what other drugs or chemicals are taken along with DXM. Other effects of DXM include:

  • Hot flashes
  • Nausea, vomiting and dizziness
  • Lack of coordination
  • Panic attack or seizures
  • Impaired judgment
  • Sweating
  • Lethargy or drowsiness—or hyperactivity
  • Slurred speech
  • High blood pressure
  • Rapid eye movement
  • Rash
  • Racing or pounding heartbeat
  • Paranoia and hallucinations
  • Feeling of floating

Regular abuse of DXM at high doses can lead to toxic psychosis, a toxic condition where the person loses contact with reality and is in a perpetual confused state.