Over-the-counter (OTC) drugs are the medicine sold directly to a consumer without the requirement for a prescription from a healthcare professional. Common OTC medicines available are for headache, common cold, pain & allergies. There is always a risk involved in using these medicines for long-term use. As prolonged use of these medicines does have a side effect. For example, it causes addiction on prolong use, adverse drug reactions, and drug interaction. Patients do not discuss these OTC medications with their physician without knowing the risk associated with them. They are being administered wrongly in the form of incorrect doses and inappropriate use.

OTC medicines that are commonly abused are steroids, antitussives, and expectorants, pseudoephedrine. Cough medicines and pain killers are the most abused medicines. Laxatives are abused for weight loss and antihistamine doses are abused for euphoria. 

Abusing OTC drugs can lead to serious health conditions like kidney failure and heart problems. Common symptoms of OTC drug withdrawal include agitation, anxiety, mood changes, confusion, and much more.

Reasons for abuse

Access to medicine – This is because, for common illnesses, we directly head towards the pharmacy. For example, If the patient is having a fever, he will directly go to the nearest pharmacy and ask for Paracetamol, as it is a well-known name. Unknowingly of the fact that fever can be a symptom of some other problem.

Pharmacist inputs are very much useful 

Many times patients directly seek advice from a pharmacist, thinking that pharmacist will be able to solve their silly issues regarding their illnesses. Thus, pharmacists influence a lot on product selection and OTC medicine purchase.

Marketing strategies like line extension by a drug maker also confuse the patients for selection of OTC product. For example, a common brand say "X" has many line extensions like X-SR, X-TM, X-PM, etc. This creates confusion in the mind of patients. In this type of situation, a patient pharmacist interaction would help the patient in making his decision. 

Advertisement on TV, Newspaper often influence you in selecting OTC product. The advertisement focuses positive effects of the medicines and hardly conveys their contraindication and side effects. This creates misinformation about the product. Here a pharmacist can provide all information about OTC medicine. 

BTC Medications – Third class of drugs

These drugs are available without a prescription but after consultation with a pharmacist. BTC medicines are widely adopted in UK, Ireland, Canada, France, New Zealand, Australia. It was first assessed by Government Accountability Office (GAO) in the US. It came into implementation from the year 2007 by FDA.

The difference between OTC and BTC medication is that the BTC is dispensed only by professional supervision that is a pharmacist. This ensures the safety, appropriateness, effectiveness of dispensed medicine of high clinical risk. This also requires pharmacists to be well trained and qualified for patient counseling. The concept of BTC provides adequate opportunities for pharmacists to reduce OTC medication abuse.

Role of Pharmacist

Pharmacist presence would be essential to purchase a BTC medication. These medicines are provided only upon pharmacist recommendation. OTC medicines that are highly abused can be put under the BTC category. BTC medication acts as a bridge between OTC and prescription medications with efficient knowledge and expertise of a pharmacist accessing the health care.

Pharmacists play an important role in counseling of patients. Good communication between pharmacist and patient will provide help in understanding the issues with OTC medications. Pharmacists need to be well informed of OTC medication abuse. Implementation of BTC would help in improving the patient monitoring for abuse of medicines.