Pseudoephedrine is a decongestant commonly used by people who have allergies, colds, hay fever, or sinus pressure/pain. It works by reducing inflammation in the sinus cavities to make breathing easier.
Pseudoephedrine is part of a system of products, termed over-the-counter (OTC) medications, which are often the first resort for people seeking some kind of minor relief. An estimated 81 percent of adults use OTC medicines as a first response to minor ailments, according to the Consumer Healthcare Products Association (CHPA).
Yet, as with most substances, there is a dark side to these products.
Pseudoephedrine is sometimes used by those who illegally make methamphetamine, which is why products containing this substance are not readily accessible on store shelves in many states.
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In 2005, Congress passed the “Combat Methamphetamine Epidemic Act,” which mandated the following:
- Pseudoephedrine-containing medicines were to be secured and sold from behind sales counters.
- It set daily purchase limits of 3.6 grams (approximately a 15-day supply) per day and 9 grams per 30 days.
- Established that buyers of pseudoephedrine medicines must present government-issued identification and sign a logbook that is accessible by law enforcement.
Despite these safeguards, pseudoephedrine products are still readily abused, putting users at risk for incurring significant harm and even death.
What is Pseudoephedrine?
As a decongestant medication, pseudoephedrine works by shrinking the blood vessels in nasal passages and treats nasal and sinus congestion.
The drug is an ingredient in prescription and over-the-counter (OTC) medicines such as Sudafed, Decofed, Advil Allergy Sinus, and Suphedrine.
Pseudoephedrine products come in immediate and extended-release tablets and as a liquid. It is also made available in adult and child formulations.
How Does Pseudoephedrine Work?
According to Verywell Health, pseudoephedrine stimulates the alpha and beta receptors in your body. In addition to constricting or tightening the blood vessels, this substance also stimulates the heart rate, slows down some portions of the digestive system, while stimulating others states Verywell Health.
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Health experts say that pseudoephedrine abuse and misuse is increasing, especially in teens and young adults. The abuse of OTC medicines like pseudoephedrine products is most common in teenagers between the ages of 13 and 16, reports ConsumerMedSafety.org.
Easy access to the medication may be one reason. One can go to the pharmacy and ask for it. Those who abuse pseudoephedrine usually do so because they enjoy the way they feel when taking it. As a stimulant, it boosts one’s energy, so the more you take it, the more intense that energy boost may feel. Some people also report feeling a bit euphoric. Others abuse it for its weight-loss and stimulant properties.
ConsumerMedSafety.org states that people take “pseudoephedrine to lose weight, and athletes have misused the medicine to increase their state of awareness and to get them “pumped up” before a competition.”
However, taking more than prescribed is a recipe for disaster, and serious side effects could occur.
Pseudoephedrine Side Effects
Pseudoephedrine, a stimulant, is capable of producing harmful side effects. According to MedlinePlus.gov, pseudoephedrine can produce the following effects:
Severe side effects associated with pseudoephedrine products include:
- Difficulty breathing
- Fast, pounding, or irregular heartbeat
- Stomach pain
Signs of Pseudoephedrine Abuse or Addiction
Pseudoephedrine abuse is not the same as addiction. Abuse means that you are taking excessively large doses of the drug to experience an effect, which is the aim of recreational use.
Another sign that someone is abusing this drug is if they have a large supply of cough medicine containing pseudoephedrine. Maybe the person does have some allergies, but buying cough medication in bulk isn’t common.
Abuse of any substance can quickly lead to dependence, where the user will need the drug in their system to feel normal.
That dependence can bloom into addiction when the user starts to exhibit compulsive behaviors around seeking the drug.
Still, there are specific signs and behaviors that can indicate pseudoephedrine addiction.
According to the Mayo Clinic, the symptoms and behaviors of addiction can include:
- Failing in your attempts to stop using the drug
- Experiencing withdrawal symptoms when you attempt to stop taking pseudoephedrine
- Continuing to use the drug, even though you know it’s causing problems in your life or causing you physical or psychological harm
- Over time, needing more of the drug to get the same effect
- Taking larger amounts of the drug over a longer period of time than you intended
- Making sure you maintain a supply of the drug
- Spending money on pseudoephedrine when you can’t afford it
- Not meeting obligations and work or school responsibilities
- Feeling the need to use the drug regularly — daily or even several times a day
- Having intense urges for pseudoephedrine that block out any other thoughts
- Cutting back on social or recreational activities because of pseudoephedrine use
- Driving or doing other risky activities when you’re under the influence of pseudoephedrine
- Spending a good deal of time getting pseudoephedrine, using the drug or recovering from the effects of the drug
- Doing things to get pseudoephedrine that you normally wouldn’t do, such as stealing
How Does Pseudoephedrine Interact With Other Drugs?
Being aware of how pseudoephedrine interacts with other drugs is important. When combined with certain drugs, you run the risk of experiencing paranoia or respiratory distress, depending on whether the drug is a stimulant or a depressant.
According to Everyday Health, you should avoid certain drugs, such as:
- Antidepressants, including doxepin (Sinequan), amitriptyline (Elavil), and nortriptyline (Pamelor)
- Antihypertensive drugs, including mecamylamine (Inversine), methyldopa (Aldomet), and reserpine
- Beta blockers such as nadolol (Corgard), carvedilol (Coreg), and labetalol(Normodyne)
- Digitalis (Crystodigin)
If you’re addicted pseudoephedrine, you may experience uncomfortable withdrawal symptoms when you stop taking it. The intensity and time frame to get through those withdrawal symptoms will vary depending on specific factors, such as the dosage you’ve been using, how long you have been using the drug, how frequently you’ve been using the drug, your age, physical, and mental health.
When you go through this detox under the care of substance abuse professionals, you’ll likely have an easier time. You’ll know what to expect and have the expertise of others who can steer you in the right direction. Detoxing from any drug is the first step toward a complete recovery.
Treating Pseudoephedrine Addiction
If you’ve tried to break free from this addiction but haven’t been able to, know that substance abuse professionals are ready and willing to help you.
There are various treatment options to treat addiction. For people who are heavily addicted to a drug, heading off to a residential treatment program is recommended. There, you can live at the residence and receive treatment at the same time. This can be very helpful as you only have yourself to worry about, which means you can completely focus on your recovery in your own space. Time away from family and friends can be extremely valuable.
You’ll also be under the care of substance abuse professionals around the clock. You learn a lot about the disease of addiction and likely receive individual and group counseling.
Some opt to stay in treatment for 28 days. Others stay longer, perhaps 60 or 90 days. For serious addictions, some opt to spend six months or more. According to the National Institute on Drug Abuse (NIDA), 90 days, or three months, is the minimum recommended length for effective residential treatment.
If you’re contending with a mild addiction, going to outpatient treatment may serve you well. You’ll get the same type of treatment that you would at a residential facility, with the exception that you’ll be able to stay at your house. You may attend anywhere from three to seven weekly meeting sessions, and can you go home once your sessions are over. This is a great option for those who have work or family responsibilities in which they cannot take a break.
Intensive Outpatient Programs (IOP)
A third option is geared toward those who can’t attend residential treatment, for some reason, yet need more intensive treatment than outpatient. IOP usually requires you to attend more than 12 hours per week. You’ll receive the same type of treatment as the others, allowing you to overcome this addiction and learn plenty of other valuable life skills as well.
U.S. Food and Drug Administration. Center for Drug Evaluation and Research. (n.d.). Legal Requirements for the Sale and Purchase of Drug Products. Retrieved from from https://www.fda.gov/drugs/information-drug-class/legal-requirements-sale-and-purchase-drug-products-containing-pseudoephedrine-ephedrine-and
Consumer Healthcare Products Association. (n.d.). Statistics on OTC Use. Retrieved from from https://www.chpa.org/MarketStats.aspx
Consumer Healthcare Products Association. (n.d.). Pseudoephedrine. Retrieved from from https://www.chpa.org/Meth.aspx
ConsumerMedSafety.org. (n.d.). Prevent Medication Errors - Consumer Med Safety. Retrieved from from https://www.consumermedsafety.org/medication-safety-articles/item/611-don%E2%80%99t-let-otc-medicines-in-your-cabinet-be-the-source-of-a-legal-%E2%80%9Chigh%E2%80%9D-or-other-abuse-for-teens-and-young-adults
Everyday Health. (2015, January 12). Pseudoephedrine (Sudafed) - Side Effects, Dosage, Interactions - Drugs. Retrieved from from https://www.everydayhealth.com/drugs/pseudoephedrine
Hayes, K. (2019, June 24). Uses for Pseudoephedrine and Why it Is Behind-the-Counter. Retrieved from from https://www.verywellhealth.com/what-is-pseudoephedrine-1192197
Mayo Clinic. (2017, October 26). Drug addiction (substance use disorder). Retrieved from from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
MedlinePlus.gov. (n.d.). Pseudoephedrine: MedlinePlus Drug Information. Retrieved from from https://medlineplus.gov/druginfo/meds/a682619.html
News Medical. (n.d.). Sudafed Sinus Pain Relief Tablets. Retrieved from from https://www.news-medical.net/drugs/Sudafed-Sinus-2b-Pain-Relief-Tablets.aspx