Over-the-Counter (OTC) and prescription drug abuse is a growing and dangerous problem, and as a retailer you can play a role in reducing and preventing it. For additional info and resources on this topic visit www.helpingservices.org/otc.

1. Stop Over-the-Counter (OTC)
and Prescription Drug Abuse
Photo source: www.fdalawyersblog.com
www.helpingservices.org

2. Over-the-Counter (OTC) and prescription drug abuse
are a growing and dangerous problem, as a retailer
you can play a role in reducing and preventing it.
After viewing this presentation, you will better understand:
Following this online presentation, please take the brief quiz to
receive your certificate of completion.
Thank you for taking this training and helping to prevent and reduce
over-the-counter and prescription drug abuse.
• Types of abused OTC and
prescription drugs
• Potential side effects of misuse
• Best practices to set up and monitor
medication sales in your store
• How to reduce consumer theft
• Right to refuse a sale
• Responsibility to report suspicious
activity

3. Training Overview
• What’s the problem?
• Why is OTC and prescription drug abuse
becoming more common?
• What are the impacts of misuse?
• Which drugs are abused?
• How can I reduce access and abuse?

4. What’s the problem?
Source: Centers for Disease Control and Prevention

5. The problem
The consequences of abuse of Over the Counter and
Prescription drugs include:
• Unprotected, unplanned, unwanted sexual activity
• Impaired motor vehicle driving/passengers resulting
in accidents, injuries, and death
• Poor academic and athletic performance in youth
• Impacted work performance and attendance
• Experimentation and mixing of other drugs
• Serious injury or death

6. Why is OTC and Prescription Drug Abuse
Becoming More Common?
Availability
Access
Awareness
Attitude

7. Availability
Many over-the-counter
(OTC) and prescription
drugs are readily
available.
Photo source: www.fdalawyersblog.com

8. Access
• Internet
• Friends and family
• Medicine cabinet
• Legally purchase
• Stolen from retailers
OTC medications are easy to get.

9. Awareness
Media highlights illegal
drug use more than
OTC and prescription
misuse.
All have the potential
to be dangerous and
lethal when abused.
PBS Frontline Episode

10. Attitude
1 in 5 youth said that there was “no risk”
or only “slight risk” to using OTC meds
differently than directed.
Source: Iowa Youth Survey

11. OTC and prescription drugs are
increasingly abused
because of the current
availability, access, awareness,
and attitude.

12. General Short Term Impacts of OTC Misuse
• Nausea / vomiting
• Anxiety
• Poor memory
• Poor coordination
• Numbness
• Dizziness
• Hallucinations
• Heart palpitations/failure
• Depression
• Seizures
• Blurry vision
• Nightmares
• Sleep disturbances
• Fainting

13. General Long Term Impacts of OTC Misuse
• Ruptured blood vessels
• Stroke
• Paranoia
• Seizures
• GI bleeding
• Brain damage
• Kidney complications
• Liver complications
• Heart complications
• High blood pressure
• Cancer
• Death

14. Cough Suppressants Cold Medicines
Inhalants Stimulants
Sleep Aids, Allergy Medicines and Motion Sickness Pills
Commonly Abused
Over-the-Counter Drugs

15. Cough Suppressant - DXM
• Contain Dextromethorphan (DXM) found in
over 120 common OTC drugs for colds and
the flu.
• Products such as Actifed, Comtrex,
Coricidin, Robitussin, Vicks, Pediacare,
Theraflu, and others.
• DXM is a dissociative anesthetic, meaning it
can cause hallucinations. At high doses,
may cause loss of muscle control, nausea,
loss of consciousness, seizures, stroke and
death.
Some OTC elixirs (liquid medications) have a very high alcohol content, some
times as high as 50% (100 Proof), which is just as potent as straight whiskey.

16. Cold Medicine
• Contain Pseudoephedrine, an
ingredient used to make “meth”
• Found in non-prescription cold
medicines such as Sudafed,
Aleve, Claritin-D
• In Iowa: Need a valid ID, sold
behind the counter where
quantities are limited.
• Side effects at high doses
include: low blood pressure,
chest tightness, vision changes,
seizures, irregular heartbeat and
difficulty breathing.

17. Sleep Aids, Allergy Medicines and
Motion Sickness Pills
• Contain Dimenhydrinate
• Found in Benadryl, sleep aids,
common cold products.
• Large doses may cause
euphoria, hallucinations, heart
palpitations, extreme
drowsiness, severe dizziness,
abnormal speech, flushed skin,
temporary amnesia, coma
and death

18. Stimulants
• Contains caffeine
• Energy drinks –(Monster,
RedBull, Blast), diet pills
and stay awake products
• Make the heart beat faster
and may cause stroke

19. Inhalants
• Chemical fumes /nitrous oxide
• Found in products such as
Reddi-wip, Dust Off and other
aerosols. Metalic spray paints
are preferred.
• Inhaling from a paper or plastic
bag “bagging”, and huffing
(inhaling) from a soaked rag.
• Causes hypoxia, can result in
death from the very first use

20. Misusing over-the-counter
products and prescription
drugs can be just as
dangerous as using
illegal drugs.

21. Commonly Abused Prescription Drugs
Stimulants
Central Nervous System Depressants
Opioids

22. Stimulants
• Use: treat asthma, attention
deficit/hyperactivity disorder
(ADHD) and severe obesity
• Drug names: Ritalin, Adderall,
and Dexedrine
• Side effects:
– Increases blood pressure and
heart rate, constricts blood
vessels, increases blood
glucose and breathing
– May cause heart attack or
lethal seizures

23. Central Nervous System Depressants
• Use: sedative and
tranquilizer to treat anxiety
and sleep disorders.
• Drug names: Xanax, Valium
• Sided effects include:
Suicidal thoughts,
depressed heart rate and
breathing, may even result
in death

24. Opioids
• Use: Narcotic painkillers
• Drug names: Codeine,
morphine, methadone,
hydrocodone, fentanyl
• Side effects: Affects the
brain and spinal cord,
respiratory failure, nausea
and vomiting

25. Prescription drugs can be
dangerous when taken
for non-medical reasons,
by a person other than it
is prescribed for, or in
extreme amounts.

26. What can we do?
Prepare
Be Aware
Look for Signs
1.
2.
3.

27. Prepare: Set Up Store
• Train employees to recognize/report suspicious
behavior.
• Install security cameras.
• Place products in sight of counter or near
register.
• Find out your store’s policies on sale of OTC and
prescription drugs and your right to refuse a sale.
• Make policies known to staff and customers.
Don’t have a policy? Contact Helping Services
info@helpingservices.org for assistance in policy
creation or for additional training.

28. Be Aware: At Point of Sale
Watch for suspicious behavior.
• Persons trying to steal or consume in the
store.
• Persons who are under the influence.
• Persons buying multiple products.
You have the right to refuse the sale.

29. Look for Signs
Quantity Frequency Combinations
Buying large
quantities, multiple
packs of cold pills or
several bottles of
cough medicine, at
one time.
Coming in often to
purchase similar
items (Ex: purchasing
cold medicine
several times each
week).
Buying cold or
cough medicine
with pop or alcohol.
(This masks the taste
to be able to ingest
large quantities.)

30. What else can you do?
• Keep track of inventory and notice
trends or areas of concern.
• Monitor restrooms for signs that
products are being used or consumed
in the store.
Report suspicious activity to
management and law enforcement.

31. Reduce OTC and Prescription Drug Misuse
Educate yourself and others about this issue
• Four A’s: Availability, Access, Awareness, and Attitude
• Long and short term consequences and behaviors
• Variety of products to watch for
Prepare your store and employees
• Know the signs: Consumers buying quantity, frequency,
combination
• Be aware of consumers
• Prepare: Set up store, at point of sale, after the customer
leaves
• Make sure all employees are knowledgeable about
policies around these issues.

32. Use this information to
take action to eliminate
OTC and prescription
drug misuse.
You can help prevent
risky behaviors, health
issues, and even death.

33. Take the quiz and get your
certificate of completion.

34. Thank You
Special thanks to Corporal Steve Eastvedt, from the Dubuque
Police Department, for his contribution to this training.
This training was created with funding from the Iowa Department
of Public Health through the Comprehensive Substance Abuse
Prevention grant.
www.helpingservices.org

35. Help promote proper disposal of unused
medications. Click to find the next local
Drug Take Back events and drop-off sites.
Photo: www.medicaresolutions.com/blog

36. References
• DrugFacts: Prescription and Over-The-Counter Medications. (Revised 2013, May). National Institute on Drug Abuse.
Retrieved January 16, 2014, from http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-
medications
• Drug Facts: Prescription Drugs. NIDA For Teens. Retrieved January 16, 2014, from http://teens.drugabuse.gov/drug-
facts/prescription-drugs
• Most Commonly Used OTC Drugs. Teen Drug Abuse. Retrieved January 16, 2014, from http://www.teen-drug-
abuse.org/teenoverthecounterdrugabuse/ commonly-used-otc-drugs.htm
• Dextromethorphan. Teen Drug Abuse. Retrieved January 16, 2014, from http://www.teen-drug-
abuse.org/teenoverthecounterdrugabuse/ dextroamphetamine.htm
• Shoplifiting. Reference for Business. Retrieved January 16, 2014, from http://www.referenceforbusiness.com/small/Qu-
Sm/Shoplifting.html
• ShineWideOpen. Inhalants- The Legal Killer. (2013, June 12). Bubbleews. Retrieved January 16, 2014 from
http://www.bubblews.com/news/651340-inhalants-the-legal-killer
• Over the Counter Pain Medication Problems. Doctor Saupto.com. Retrieved January 19, 2014, from
www.doctorsaputo.com/a/over-the-counter-pain-medication-problems
• Dimenhydrinate. MedlinePlus a service of the US National Library of Medicine NIH National Institutes of Health.
Retrieved January 19, 2014, from www.nlm.nih.gov/medlineplus/druginfo/meds/a607046.html
• Over-The-Counter Drugs.(2001). Encyclopedia.com. Retrieved on January 19, 2014 from
http://www.encyclopedia.com/doc/1G2-3437000061.html
• Talking About Prescription Drug Misuse [Pamphlet]. Iowa Governor’s Office of Drug Control Policy.
www.iowa.gov/odcp
• Over The Counter Drug Abuse: More Dangerous Than You Think [Pamphlet]. In the Know, Prevention and Treatment
Resource Press. www.ptrpress.com
• Talking To Kids About Prescription Drug Abuse [Pamphlet]. Iowa Governor’s Office of Drug Control Policy.
www.iowa.gov/odcp
www.helpingservices.org

37. Additional Resources
• Helping Services for Northeast Iowa
www.helpingservices.org
• Iowa Department of Public Health Bureau of Substance Abuse
www.idph.state.ia.us/bh/substance_abuse.asp
•Iowa Governor’s Office of Drug Control Policy
www.iow.gov/odcp
• Iowa Substance Abuse Information Center
www.drugfreeinfo.org
• Substance Abuse and Mental Health Services Administration
www.samhsa.gov
• The Partnership At DrugFree.Org
www.drugfree.org or 1-855-DRUGFREE
www.helpingservices.org

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