Photo/Illutration Cold medicine (Asahi Shimbun file photo)

The serious problem of the misuse of over-the-counter (OTC) drugs, such as cold medicines and cough suppressants, persists unabated.

This issue has become more serious following the lifestyle constraints imposed by the COVID-19 pandemic, particularly among teenagers. 

A national survey of high school students conducted in fiscal 2021 found that about one in 60 students had misused OTC drugs in the past year, taking them not for their intended medical purpose but for abuse.

Many of these students described themselves as "not enjoying school," "having no close friends" or "being unable to consult with parents," suggesting they were in situations of social isolation.

Surveys targeting psychiatric hospitals to understand the reality of patients with drug dependencies have shown that OTC medications have become the main cause of an increasing number of cases. In a 2022 survey, OTC drugs were the main substances misused by 65 percent of the teenagers covered by the survey.

There are also cases of people being rushed to a hospital due to an overdose of OTC medications. It is necessary to take stronger policy measures to tackle this serious threat to people’s health, such as establishing a system to prevent large-quantity purchases.

In 2014, the health ministry designated six ingredients commonly used in OTC drugs as "substances with a risk of abuse." Pharmacies are obliged to confirm the name and age of young purchasers of drugs containing these active ingredients and adhere to the principle of selling only one package per person.

However, it is still possible to purchase as much as one wants by visiting multiple stores. Among the drugs being abused, some do not necessarily contain these six ingredients and they can also be purchased online.

The health ministry is currently considering a new regulatory regime where pharmacists or registered sellers would be required to confirm the purchase history at other stores and other relevant information through face-to-face or online interactions before making a sale.

Sales of such drugs to consumers under 20 would be limited to only one small-quantity product at a time.

Yet, it is said that people intending to abuse these drugs often search for stores where sales rules are not strictly observed or visit outlets during hours when no pharmacist is present to make their purchases.

In the ministry’s meeting to discuss measures to deal with the problem, some voiced concerns about products containing lethal doses in a single box. The entire regulatory system governing sales of OTC drugs should be redesigned by taking into account various related cases and issues.

Additionally, there are ingredients other than the six designated ones that are being misused and have dependency risks. The government should embark on a major review of the list of regulated substances based on experts' opinions.

Pharmacists and others on the selling side also have important roles to play. Beyond strictly enforcing sales rules, they should provide support to prevent the abuse of OTC medicines through initiating conversations with purchasers and providing information.

Of course, even if drugs become inaccessible, people inclined to abuse OTC medicines will still be left with mental health issues and other internal factors behind their problems.

It is vital to create an environment where people around them reach out, connecting them to trustworthy adults and consultation services, and also to enhance preventive education about drug misuse.

--The Asahi Shimbun, Nov. 24

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