A legal high is still a high. Addiction recovery has an invisible enemy: over-the-counter drugs. A doctor’s prescription isn’t needed to obtain a medicated state. Sometimes, an addicted individual needn’t contact a seller for substances. Every addiction recovery program is different, but each promotes safety against harmful substances sold in stores.

If you suspect a loved one is abusing substances, and if there’s no possible way they’re obtaining a fix via shady means, they may be consuming these totally legal—but still incredibly dangerous—OTC medications.

One: Ephedrine

In large doses, ephedrine and pseudoephedrine can be “cooked” into methamphetamine. While strict laws prohibit the purchase of such quantities, buyers can still obtain a legal high by taking ephedrine in large doses. For some, ephedrine abuse can start as a means to lose weight. In fact, bodybuilding forums actively promote the mixture of ephedrine, caffeine and aspirin to cut fat.  Ephedrine in large doses, purchased either as Bronkaid or Primatene in the United States, creates an amphetamine-like high. This high can result in blurred vision, dehydration, paranoia and kidney problems.

Two: Dramamine

Dramamine can be purchased as motion sickness pills. Combined with diphenhydramine, or Benadryl, Dramamine creates hallucinatory effects similar to those found in street drugs. Also legal to purchase, motion sickness pills can be incredibly dangerous when consumed recreationally. Responsible for eye pain, memory loss, kidney damage, depression and even death, Dramamine remains one of the most dangerous OTC substances one can buy.

Three: Ma Huang

Also known as ephedra, ma huang is coined as “herbal ecstasy” by OTC substance abusers. When snorted, swallowed or smoked, ma huang can increase one’s awareness, generate euphoria and increase sexual sensations. It’s even marketed as a natural high, and it can be bought in gas stations, music stores, drug stores, and nightclubs. Terrifyingly, ma huang is easy to overdose—due to its varying recreational dosage among users. Adverse ma huang effects include increased blood pressure, muscle spasms, strokes, heart attacks and seizures.

Four: Dextromethorphan

Abbreviated as “DXM,” dextromethorphan is found in cough medicines. It creates hallucinations when consumed in high dosages, and it’s one of the most abused OTC substances found in department stores. DXM is a popular recreational drug among teens, as it’s incredibly accessible, requires little identification to buy and costs little to purchase. DXM is incredibly toxic in high doses, resulting in shakiness, rapid heart rate, vomiting, shakiness, blurred vision and even brain damage. Like other OTC medications, cough syrup dosages vary greatly among users. For this reason, overdose is common.

The Dangers of OTC Addiction

In 2005, the FDA issued a dextromethorphan abuse claim due to increasing overdoses. Today, about 3.1 million adolescents between age 12 and 25 have used nonprescription drugs to get high. The purchase of these substances is completely legal. Because of this, addiction recovery centers warn against the overuse of such substances.

Furthermore, an OTC addiction is incredibly difficult to spot—as a bottle of cough syrup seems innocent. Make no mistake, however, as the substances listed above can be abused. In some cases, they’re more toxic than illegal street drugs. Parents are urged to talk about the dangers of addiction with their children. Even after rehabilitation, previously addicted individuals may seek out OTC substances as a means to “wean off” lingering urges. Of course, this weaning can quickly become an addiction. In any case, communal support is important. If you or a loved one struggles with an OTC drug addiction, contact a health and addiction recovery provider today.