For many people, pseudoephedrine use starts with innocent intentions. It may have started with a cold, sinus infection or allergies, and you understandably wanted immediate relief as soon as possible. You head to the pharmacy, purchase your remedy of choice over the counter (OTC), make a cocktail of drugs purporting to bring immediate relief and, ultimately, you get the first good night’s sleep you’ve had in over a week.
The problem is, many people fail to realize that even drugs that can be obtained without a prescription come with their own set of risks. People like the way they feel when using OTC cough and cold medicines, and before you know it, the line between drug use and drug abuse becomes blurry.
The United Nations Office on Drugs and Crime estimated the worldwide production of amphetamine-type stimulants, which includes many of the cold medicines people use as well as methamphetamine, to be nearly 500 metric tons a year with 24.7 million abusers. Meanwhile, the United States government reported in 2008 that approximately 13 million people over the age of 12 have abused methamphetamine — 529,000 of which are considered regular users.
The overall percentage of drug treatment admissions in the US due to methamphetamine and amphetamine abuse tripled from 3% in 1996 to 9% in 2006. Some states have much higher percentages, such as Hawaii, where 48.2% of the people seeking help for drug or alcohol abuse in 2007 were methamphetamine users. The abuse of amphetamine type substances like pseudoephedrine, is a nationwide problem that needs to be addressed.
Understanding Pseudoephedrine Addiction
Is pseudoephedrine addictive? Absolutely. Often referred to by its brand name Sudafed, pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages to clear nasal congestion. The drug is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears.
Pseudoephedrine itself is not a highly addictive substance – it is when the drug is used improperly that addiction becomes a concern. Those who use the drug only for its intended indication at the labeled dosage should not worry about developing an addiction. As is true with most other addictive drugs, though, pseudoephedrine targets the brain’s reward system by overloading the circuit with dopamine. The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects people desire and prompts them to repeat the behavior.
Pseudoephedrine for Allergies
When you have a bad cold or congestion from allergies or hay fever, pseudoephedrine can provide relief. It narrows the blood vessels in the nasal passages, thereby, relieving congestion. It’s only a temporary remedy and will not cure the underlying condition—cold, allergies, hay fever—that created the congestion in the first place. This drug is available without a prescription under several different brand names, the most popular of which is Sudafed.
Pseudoephedrine for Colds
Pseudoephedrine is also an ingredient in many combination cold medicines that are available over the counter as well. In fact, by reading the labels, you might discover that it’s in almost all of the cold medicines in your pharmacy that claim to relieve congestion. Taking these medicines for a short period of time according to the recommended dosage should not pose any great health risk and is likely to ease your symptoms.
Pseudoephedrine: The Part of Sudafed that Could Kill You
You may have noticed, especially if you are an allergy sufferer, that many pharmacies are now keeping Sudafed behind the counter. It’s not controlled by prescription, but you do have to ask the pharmacist for it, show identification, and sign a waiver to purchase it. It’s the active ingredient, pseudoephedrine, they are tracking. Pseudoephedrine is used to make meth, a very dangerous and addictive street drug popularized most recently by the TV series, “Breaking Bad.”
If you suffer from allergies and Sudafed is your drug of choice for sinus congestion, constantly showing ID to purchase it might be annoying. In some states, you cannot stock up on Sudafed because the amount you are allowed to purchase at one time is limited. The more important consideration, however, is that you are regularly consuming the active ingredient in meth. This should certainly be a cause for concern, since bad things happen to those who take meth—from addiction, to arrest, to sudden death.
The drugstore is where many people end up crossing the line between drug use and drug abuse. It’s easy to see why people, especially invincible teenagers, end up getting addicted to pseudoephedrine. That addiction can lead to getting hooked on stronger, more dangerous drugs. Teenagers are attracted to drugs they can have easy access to. Walking into the pharmacy and legally purchasing Sudafed, or even finding some in the family medicine cabinet, is about as simple as it gets.
The Meth Connection
It’s impossible to talk about pseudoephedrine abuse and restrictions without looking at the methamphetamine crisis. “The United States government reported in 2008 that approximately 13 million people over the age of 12 have used methamphetamine.” Meth addiction is blamed for a measurable portion of all car thefts and murders, not to mention the serious health implications, including death.
There are even a number of injuries and deaths that can be attributed to the operation of meth labs. Meth production and abuse are on the rise world-wide. There are several reasons for this trend, but only one related to decongestants. Pseudoephedrine is available over-the-counter and can be used to produce meth in a home lab.
The easy answer would be to restrict the availability of pseudoephedrine, but that poses problems for law-abiding citizens who just need it to reduce their congestion. It’s the best substance on the market for those with chronic congestion conditions, like allergies. It’s also a big money-maker for pharmaceutical companies, and those companies don’t want to see their revenue reduced by declining sales.
While the federal government has moved to track the sale of pseudoephedrine and restrict the volume sold per person, there is no evidence that these tactics are cutting down on meth operations. Individual states are beginning to consider requiring a prescription for pseudoephedrine. While these legal issues play out at the state and federal level, the take-away is clear: pseudoephedrine is a dangerous substance when taken in high doses or for a long period of time. When in doubt, you should consult your physician about your use of this drug and find out if there is another drug that is safer to use to relieve your symptoms. If you have to take pseudoephedrine, follow package dosing instructions. You don’t want a sniffle to turn into a painful addiction.
Meth and Pseudoephedrine
It’s also impossible to talk about pseudoephedrine abuse and restrictions without looking at the methamphetamine crisis. Meth addiction is blamed for a measurable portion of all car thefts and murders, not to mention the serious health implications, including death.
There are even a number of injuries and deaths that can be attributed to the operation of meth labs. Meth production and abuse are on the rise world-wide. There are several reasons for this trend, but only one related to decongestants. Pseudoephedrine is available OTC, but it can be used to produce meth in a home lab.
Individuals who abuse pseudoephedrine may experience the following side effects:
- Difficulty Sleeping
- Stomach pain
- Irregular heartbeat
Pseudoephedrine use also has a number of potentially dangerous drug-to-drug interactions. For example, pseudoephedrine can interact with MAO inhibitors — which are normally used to treat depression. When combined, the two drugs can cause blood pressure to drop dangerously low. The end result of low blood pressure ranges between dizziness and fainting to death. Pseudoephedrine is also known to interact with antihypertensive drugs and beta-blockers.
Dangers of Pseudoephedrine & MAO Inhibitors
Beyond these common side effects, pseudoephedrine interactions with other medication can be serious. MAO inhibitors, typically taken as anti-depressants, cause serious reactions in people who take pseudoephedrine. The mixture of pseudoephedrine and MAO inhibitors can cause blood pressure to drop dangerously low. Low blood pressure can cause dizziness or fainting, blurred vision, fatigue, shallow breathing, and if it drops too low, death.
Pseudoephedrine Addicts: Who Are They?
Pseudoephedrine is a key ingredient in methamphetamine, and meth is a highly addictive central nervous system stimulant that can be injected, snorted, smoked or ingested orally. Long-term methamphetamine abuse can cause addiction, anxiety, insomnia, mood disturbances and violent behavior. Additionally, psychotic symptoms including paranoia, hallucinations and delusions can occur. The psychotic symptoms can even last for months or years after methamphetamine use has stopped. Beyond neurological and behavioral consequences, long-term methamphetamine abuse can cause certain physical effects. Detrimental physical effects can include weight loss and severe tooth decay (meth mouth).
The National Institute on Drug Abuse reports that, according to the 2012 National Survey on Drug Use and Health, about 1.2 million people (0.4% of the total population) reported using methamphetamine within the past year. Meanwhile, 440,000 individuals (.02% of the total population) admitted to using it within the previous month.
These statistics may seem rather large (and they are), but they also represent a decline from previous years. In 2006 731,000 (0.3%) reported past-month use. In 2012, there were 133,000 new users of methamphetamine age 12 or older — the same as the previous year but continuing a general downward trend across the past decade. The average age of new methamphetamine users in 2012 was 19.7 years old.
An alarming 50% of teens aren’t properly educated on OTC medications, potentially leading to dangerous misuse of these drugs. Ultimately, the availability of pseudoephedrine in pharmacies contributes to the prevalence of abuse among teenagers. The easy answer would be to restrict the availability of pseudoephedrine, but that poses problems for law-abiding citizens who just need it to reduce their congestion. It’s one of the best substances on the market for those with chronic congestion conditions, like allergies.
Increased awareness is needed to combat the growing pseudoephedrine abuse trend. According to a recent survey by the Community Anti-Drug Coalitions of America (CADCA) and the Consumer Healthcare Products Association (CHPA), just 8% of parents surveyed knew about nasal contestant abuse, and 75% of these parents never talked to their teenagers about such abuse. Results from another study showed that only 45% of teens believe that cough syrup abuse is risky. Pseudoephedrine abuse may lead to future addiction to stronger, more dangerous substances.
Addiction and Abuse: What Are the Signs?
The National Institute on Drug Abuse defines drug addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.”
Like any addiction, pseudoephedrine addiction reaches a point where getting your fix is all you can think about. Suddenly family, school, your job and other life activities become just a cover for getting and taking your pseudoephedrine. Signs of pseudoephedrine addiction can include:
- Increased focus on getting the medicine and taking it regularly.
- Desire to hide the fact that you’re taking medicine daily.
- Consistently staying up late and getting up early.
- Difficulty sleeping.
- Engaging in risky behaviors.
- Dramatic loss of weight.
- Lack of interest in regular activities and hobbies.
Another telltale sign of pseudoephedrine addiction is finding a large amount of cold medicine packaging among someone’s belongings. Additionally, changes in mood, finance or physical appearance may signal drug abuse as well.
Addiction and Abuse: What Are the Symptoms?
Someone who is abusing pseudoephedrine in particular may experience a wide variety of symptoms. Symptoms of pseudoephedrine addiction can take all or some of the following forms:
- Tolerance – This is defined as either the need for increasingly bigger doses of pseudoephedrine to achieve the desired high, or a diminished effect when using the same amount of pseudoephedrine.
- Dosage – The dosage, or the amount of the drug, often increases so the user can get the same high as before.
- Loss of control – This refers to a person’s inability to reduce or control his or her pseudoephedrine use.
- Time – A person who is addicted to pseudoephedrine spends a lot of time engaging in different activities to obtain pseudoephedrine.
- Change in priorities – When the need for pseudoephedrine precludes continuation of normal daily activities, such as having a job, being social with friends or being physically active, there might be an issue.
- Continued use – When pseudoephedrine use continues despite awareness of physiologic or psychological side effects, it can be indicative of an addiction.
Pseudoephedrine Addiction: How to Treat It
There are several avenues for addicts who are ready to give up abusing pseudoephedrine.
Long-term treatment in a rehab facility for pseudoephedrine addiction, which typically lasts from 30 to 90 days, might be the most appropriate course of action if:
- The addict tried outpatient treatment but it didn’t work.
- The addict is experiencing physical or mental health problems.
- The addict’s home situation makes it hard to stay away from drugs or alcohol.
- The addict doesn’t live near an outpatient treatment clinic.
Meanwhile, outpatient treatment may be the best option if:
- The addict can’t or doesn’t want to quit work or take a leave of absence.
- The addict doesn’t want to be close to loved ones.
- Inpatient treatment is too costly.
It’s important to address the psychological symptoms in addition to the physical symptoms during recovery. Psychotherapy options for treating signs and symptoms of addiction to pseudoephedrine include:
- Behavioral modification with a primary focus on empowering the individual to control the behavior.
- Cognitive therapies that focus on conscious mental processes and seek to eliminate bad thought processes.
- Holistic treatment that focuses on the entire individual rather than just the primary problem of addiction.
At 12 Keys Rehab, we believe the combination of the 12 Step Recovery model with therapies like cognitive behavioral therapy, group therapy, Eye Movement Desensitization and Reprocessing therapy and more, gives our clients the best possible advantage against addiction. 12 Step programs take advantage of a combination of the 12 step recovery model and various types of proven therapies.
When beginning the treatment program at 12 Keys, addicts will follow the 12 step methodology. Some of the central goals for this treatment model include:
- Accepting you are powerless over your addiction
- Accepting you need help to remain abstinent
- Living the 12 steps every day so you can stay sober
The most important thing you can do for your loved one is to ensure their rehabilitation process is effective and comfortable. The 12 step process works for anyone sincerely seeking a new blueprint for life that helps them live happily and productively — without the crutch of addition or destructive behaviors. In implementing the 12 Step Rehab Model, 12 Keys Rehab uses the following steps to make sure recovering pseudoephedrine addicts are primed for success:
1. Detoxing: First Stop on Road to Recovery
For many, a detox program is the first step to a successful recovery. There are various stages to detox and the length depends on specific needs. However, the average detox time is about one week. At 12 Keys, all detox programs are medically-assisted, meaning a medical professional will be by your side throughout your pseudoephedrine addiction withdrawal process.
Drug detox should, under no circumstances, be attempted at home. Withdrawal symptoms and duration vary from person to person, but they can be life-threatening. It mostly depends on how large of a dose the addict has taken and the length of addiction.
Withdrawal symptoms include cravings for the abused substance along with physical and psychological symptoms. Symptoms vary according to the drugs being abused, but generally they can include shakiness, sleepiness, hallucinations or confusion, tremors and nausea. However, not everyone experiences these symptoms. They sound scary, but they can be managed while you are in detox.
The body withdraws from pseudoephedrine during the acute stage. Medical supervision is necessary and helpful to make sure the body’s reaction to the withdrawal is well managed. Typical withdrawal symptoms include nausea, fatigue, headache or aches similar to flu symptoms. Medications can usually counteract the worst symptoms of acute detox to avoid needless suffering.
Second, as the drugs leave your system, other health issues may appear. High blood pressure, hypoglycemia, diabetes and other physical problems may arise during this emergent stage, or a mental illness such as schizophrenia, depression or anxiety can also emerge. However, mentally, you may actually feel a lot better. Many people say they feel relieved because they know they’re on the way back to health again.
Finally, for a month or two following detox, you may still feel a little uneasy. Recovering from a disease, just like getting over any other serious illness, often comes with lingering physical symptoms. A healthy diet, sufficient rest and commitment to meetings and recovery work can help mitigate this stage.
2. Repairing: Laying the Foundation for Sustained Recovery
For sustained mental recovery, former addicts at this stage of recovery should make a list of who they’ve wronged. They must also develop the willingness to apologize to these people whenever the time is right. It’s important to distinguish when it’s helpful rather than hurtful to open old wounds. This is where sharing some of your concerns with recovered addicts is helpful, and 12 Keys Rehab has many former addicts on staff who are willing and able to provide guidance.
Addiction affects everyone in an addict’s life. Involving family in the recovery process can help to mend broken relationships, share honest thoughts about addiction and work to restore trust. 12 Keys open 12 step meetings are available to anyone. Privately making amends or apologizing to each individual on your list is of paramount importance. This step should only be completed, however, when doing so won’t harm you or your affected family or friends.
3. Learning: Recognizing the Wrongs of Addictive Behavior
It’s important to understand addiction is a condition that affects not only the addict, but also family, friends and co-workers. The short- and long-term health ramifications are significant. Often, addicts think no one knows and they are only hurting themselves, but this is not true. If you are spending energy worrying about how and when you’ll get your next dose, then you are not performing your job as parent, co-worker, boss or citizen to the best of your ability.
12 Keys offers an array of recreational activities that can serve several learning purposes for recovering addicts. For instance, to heal the body, 12 Keys encourages individuals to spend time enjoying the rehab’s beautiful waterfront property, reconnecting with natural and learning to appreciate the beauty of life. 12 Keys also encourages clients to participate in yoga or meditation on their own time.
Life in rehab should not be an unpleasant experience. Instead, it should be the time for you or your loved one to learn the tools and skills necessary for living a sober life. 12 Keys counselors and specialists are uniquely qualified to understand the fears and feelings of our clients because most are recovering addicts themselves. They understand that a key component to living a real recovery means learning to enjoy once-loved activities. That is why the 12 Keys real recovery program features fun activities available to each and every client.
4. Growing: Building a Life Post-Addiction
Key to the learning and growing process is the ability for former addicts to admit mistakes as soon as they realized they’ve made them and to apologize as soon as possible. Aftercare and support is essential for lasting recovery.
For some, the growing process can be a call to action for addicts to help those around them who may be in the earlier stages of recovery. According to 12 Keys, “To help yourself, you have to continually help others by sharing your story and sharing the power of recovery.”
Growing a life beyond addiction is important to prevent relapse. Warning signs of an impending relapse may include:
- Romanticizing past drug use
- Believing you can recreationally use pseudoephedrine without falling back into addiction
- Reconnecting with friends made during addiction or sabotaging healthy relationships
- Changes in attitude and behavior
- Loss of interest in hobbies or activities
- Sudden presentation of pseudoephedrine addiction withdrawal symptoms
- Downplaying importance of addiction recovery programs
12 Keys boasts a multidisciplinary treatment team that is able to provide assessment and treatment of a broad array of addiction and mental and behavioral health problems.
To successfully recover from pseudoephedrine abuse, former addicts and their loved ones need to learn and understand that addiction is a disease of the body, mind and sprit. As is true with any self-improvement initiative, people get out of the process what they’ve put into it.
It can be tough for researchers to quantify the effectiveness of 12 step programs. However, some research has been completed, and it demonstrates the effectiveness of the group model of recovery. These studies have found that:
- Clients with a high level of group support, such as those in 12 step meetings, recovered 83% of the time.
- 33% of 8,000 North American Alcoholics Anonymous members surveyed in 2007 remained sober for 10 or more years.
12 Keys has experience handling every type of addiction crisis people can suffer from, and no problem is too great for our staff. Treatment is individualized and thoughtful, and 12 Keys prides itself on providing more one-to-one counseling than many other rehabs. In fact, each counselor has a maximum case load of just four or five clients.
Importantly, the 12 Keys steps are administered in part by former addicts. This allows recovering addicts to communicate their struggle to someone who has lived it before. When you call us, you know you are speaking with someone who cares and understands what you are going through.
Aside from answering all of your questions, other topics we may discuss on the call include:
- You or your loved one’s addiction
- Recommended treatment options and length of stay
- Our accommodations and amenities
- Our private facility and location
- The recovery process and family involvement
- Insurance coverage and payment options
We take a personal interest in each one of our clients, designing individual treatment plans. This approach works well because everyone is different, and everyone’s addiction is different. Contact 12 Keys Rehab and let us help you get a handle on your situation so we can discuss the next steps in getting your life back on track.