Pseudoephedrine is an ingredient in several over-the-counter (OTC) medications, but due to its potential to be used in the manufacturing of methamphetamine or crystal meth, stores have taken precautions and keep the drug behind the counter. The Combat Methamphetamine Epidemic Act of 2005 has been incorporated into the Patriot Act signed by former President Bush on March 9th, 2006.
The act was designed to limit over-the-counter sales of cold medicines that contain the active ingredient pseudoephedrine. The sales are limited to behind the counter. The law places limits on how much pseudoephedrine can be purchased each month, and it requires the individuals who buy the medication to present photo identification to buy the substance. Additionally, stores are required to keep personal information about the buyer for at least two years.
You may have heard of pseudoephedrine or over-the-counter drugs like Sudafed, but if you’ve never used it you may wonder what it is? Pseudoephedrine is a drug that occurs naturally in the plant species Ephedra sinica, known in traditional Chinese medicine as ma huang. The drug was designed as a nonprescription substance to treat colds, hay fever, and allergies.
The drug bears a strong chemical resemblance to the legal stimulant amphetamine, and the illegal stimulant methamphetamine, which is why it is used in its production leading to the ban. Unfortunately, when the substance is used in its natural form, it can lead to an overdose even in smaller doses. The amount that causes an overdose will depend on the person, but it could be deadly in some cases.
Ready to get Help?
Talk to a treatment expert
Pseudoephedrine belongs to a class of substances known as sympathomimetic amines, which get their name because they increase the average rate of activity in the sympathetic nervous system. There is a story of a seven-year-old girl who developed an episode of myoclonic movements and tremors after being medicated with a not well-quantified amount of a pseudoephedrine/antihistamine combination.
The story mentioned that there is potential toxicity of pseudoephedrine usually administered as part of cold-syrup preparations, which are used for the sympathetic treatment of upper respiratory tract cough and congestion. The products are considered safe, but the potential adverse side effects and toxic effects can occur.
Due to the increase of the sympathetic nervous system, it can involuntarily activate the “fight-or-flight” reflex in response in those who consume the substance. Pseudoephedrine also triggers changes in the sympathetic nervous system that produce effects such as nasal congestion, sinus decongestion, and an increased level of stimulation associated with alertness and heightened concentration. It can also trigger a significant reduction in normal appetite levels.
The most severe risks of pseudoephedrine use occur in those who take oral or injected preparations of the drug, not nasal preparations. Some complications of use include nausea, sweating, unusually rapid heartbeat, skin flushing, narrowing of the blood vessels that produces high blood pressure, a form of heart-related chest pain known as angina, insomnia, paranoia, mental confusion, agitation, shortness of breath and abnormal accumulation of fluid in the lungs.
Many of the symptoms are potential side effects of pseudoephedrine use, and some evidence points to continued use of the drug to increase a person’s overall risk of a stroke. As you would expect, many of these symptoms resemble the effects of both amphetamine and methamphetamine use; however, it’s necessary to note that amphetamine and methamphetamine produce much more powerful and dangerous forms of these effects.
While the effects listed above are more consistent with continued use and not generally life-threatening, some symptoms can occur when the dose is increased. While pseudoephedrine may be viewed as less harmful than other drugs based on its classification as an over-the-counter drug, that should not allow someone to consider it as a safe alternative. All drugs carry the potential for deadly effects despite their legal status. For example, alcohol is permitted to anyone over the age of 21 but is one of the most deadly substances on the planet. Pseudoephedrine should also be given the same respect. Some of the more deadly overdose effects include:
Whether or not you’ve had a seizure or seen someone have a seizure, it can be a potentially fatal phenomenon. Pseudoephedrine, as we’ve mentioned, is in many brand name over-the-counter medications including Sudafed, 12-hour Cold Maximum Strength, Biofed, Simply Stuff, Claritin-D, Cenafed, among many others. Taking an overdose of pseudoephedrine can have, among its side effects, the severe impact of a seizure or convulsion. If you suffer from a seizure, you must call 911 immediately.
Another potential effect of an overdose is pseudoephedrine is hallucinations. These may take the form of seeing things not there or hearing things that others don’t understand or having physical sensations of something that does not exist touching you. If you are experiencing any of these effects, you must contact 911 immediately before accidentally injuring yourself.
High blood pressure is a condition that many people struggle with. Using pseudoephedrine can increase these symptoms if you already have the disorder, but will also cause you to temporarily experience it if you do not. Hypertension causes the heart to work harder by pumping more blood into the body rapidly. It also has the potential to create cardiovascular problems that include stroke or heart attack. If your blood pressure spikes while using pseudoephedrine, contact your physician immediately.
The exact dosage to overdose is subjective because it varies from one person to another. One individual can take the same dose as their counterpart and feel fine, whereas their counterpart experiences an overdose. While it is difficult to pinpoint an exact amount, it is crucial to be aware of the overdose symptoms to protect yourself in the event better an overdose does occur. Being well-versed in this topic can help save your life if you consume pseudoephedrine.
There are many different pathways to treat those who are ready to give up abusing pseudoephedrine. Long-term residential treatment for pseudoephedrine abuse typically lasts 30 to 90 days depending on the severity of the addiction. It might be the most optimal course of action. The client may find residential treatment benefits them more if they’ve attempted outpatient and did not succeed. Residential treatment is also beneficial if the client is experiencing physical or mental health problems, has a poor home situation that makes abstaining from the substance difficult, or the person does not live near an outpatient clinic.
During treatment, it’s necessary to address the psychological symptoms in addition to the physical symptoms during recovery. Psychotherapy options for treating signs and symptoms include behavioral modification and holistic treatment that focuses on the entire individual rather than the single problem of addiction.
The most important thing that you could do for yourself or loved one is to ensure that the treatment process is practical and comfortable. The 12-step process works for anyone seeking a better life.
If you or someone you love is struggling with a substance use disorder that involves pseudoephedrine, there is help available to lead you out of active addiction and propel you into lasting recovery.
Learn more about addiction treatment and discreet options by speaking to an addiction treatment specialist at The Palm Beach Institute.
Brown, J. W., Dunne, J. W., Fatovich, D. M., Lee, J., & Lawn, N. D. (2011, February). Amphetamine-associated seizures: Clinical features and prognosis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21314677
Sympathomimetic Amines. (n.d.). Retrieved from https://www.sciencedirect.com/topics/neuroscience/sympathomimetic-amines
SUDAFED® Ingredients & Buying Tips. (n.d.). Retrieved from https://www.sudafed.com/know/buying-sudafed-ingredients
Side Effects of Taking Too Much Pseudoephedrine Within 24 Hours. (n.d.). Retrieved from https://www.livestrong.com/article/38048-side-effects-taking-much-pseudoephedrine/
U.S. Food and Drug Administration. Center for Drug Evaluation and Research. (n.d.). Information by Drug Class – Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine. Retrieved from https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm072423.htm