Pseudoephedrine

Pseudoephedrine, Side Effects of Misuse and Abuse, Dangers of Overdose, Treatment

What is Pseudoephedrine?

Pseudoephedrine relieves nasal congestion caused by allergies, colds, and hay fever. It is also used to relieve sinus congestion and pressure temporarily. Pseudoephedrine will relieve symptoms but will not treat the cause of the symptoms or speed recovery [1]. It is in a class of medications called nasal decongestants. Thus, it works by causing narrowing of the blood vessels in the nasal passages. It is found in many over-the-counter medications, such as Sudafed, Allegra-D, Sinutab, and Claritin-D. Pseudoephedrine is a substance that naturally found in the plant Ephedra sinica. The substance is chemically related to amphetamine and often used in the illicit production of the central nervous system stimulant methamphetamine (crystal meth).

According to the US Drug Enforcement Agency (DEA) [2], Pseudoephedrine products that are solid-dosed and starched-based tablets are Schedule V, if they can also be purchased over the counter (OTC) by a customer without a prescription. If no prescription is required and a customer can buy it and sign the log for it, it is Schedule 5. These products cannot be prescribed without a BNDD (Bureau of Narcotics and Dangerous Drugs) number and DEA number.

Pseudoephedrine has also been used to enhance athletic performance and may be banned by many professional athletic associations. In addition, because it has been recognized as an ingredient used in the illegal production of methcathinone (a chemical often used in the production of bath salts) and methamphetamine, this drug is subject to monitoring by the United States Drug Enforcement Administration (DEA). Despite this, it is not listed as a controlled substance.

Pseudoephedrine
Pseudoephedrine, a nasal decongestant found in many OTC cold medicines, can be used to make methamphetamine. For this reason, products containing pseudoephedrine are sold “behind the counter” nationwide.

One of the significant concerns regarding the abuse of pseudoephedrine is the ease of manufacturing into more powerful stimulants such as methamphetamine. In addition, federal law limits the amount of pseudoephedrine any person can buy at one time. It also requires that purchasers produce a photo ID and that retailers keep records of sales of this drug for a minimum of two years. Regardless, individuals who previously abused this drug may be more likely to experiment with other drugs to find a similar high instead of giving up the substance abuse altogether.

How much pseudoephedrine to make meth?

Methamphetamine or crystal meth is a glass-like substance that is smoked but may also be injected or snorted. It is a stimulant drug that increases energy, lifts mood, and makes users feel more alert. It is highly addictive and can lead to withdrawal symptoms such as cravings, depression, and nervousness.

For those curious about how meth is made, it’s important to remember that this process is illegal and is usually performed within criminal organizations. The distribution of methamphetamine is also illegal. Meth is an extremely addictive and harmful drug.

According to the National Institute on Drug Abuse (NIDA) [3]. Meth can be easily made in small clandestine laboratories, with relatively inexpensive over-the-counter (OTC) ingredients such as pseudoephedrine, a common ingredient in cold medications. There are few unique ingredients required and few technical skills needed. Once the manufacturing process is complete, people have a cheap and powerful drug. However, the chemicals used for meth production are dangerous and toxic and can harm individuals near the production area and the environment.

Illegally produced meth is typically made by mixing ephedrine or pseudoephedrine with other chemicals that are usually poisonous or highly flammable. The mixture is then combined with a gasoline solvent and heated to crystallize. Because illegal crystal meth production is not supervised or regulated, and there is no quality control process, any number of cutting agents could conceivably be added to the process to dilute the drug.

It has become much more difficult to buy enough pseudoephedrine to make meth. The Combat Methamphetamine Epidemic Act of 2005 banned over-the-counter (OTC) sales of medicines that contain ephedrine or pseudoephedrine and limited sales to behind-the-counter. In addition, it limited the amount of pseudoephedrine that a person could purchase each month, and retailers like drug stores have to check buyers’ identification and keep personal information about them for two years.

How Is Pseudoephedrine Used?

When this drug is used as intended, Pseudoephedrine is considered safe and effective for battling nasal congestion, and it can reduce symptoms associated with mucus buildup and swollen nasal passages, such as difficulty breathing and pain. The medication works by shrinking the swollen tissue of the nasal passageway and allowing mucus buildup to drain out.

Pseudoephedrine comes as a regular tablet, a 12-hour extended-release (long-acting) tablet, a 24-hour extended-release tablet, and a solution (liquid) to be taken by mouth. The regular tablets and liquid are usually taken every 4 to 6 hours. The 12-hour extended-release tablets usually are taken every 12 hours, and you should not take more than two doses in a 24-hour period. The 24-hour extended-release tablets usually are taken once a day, and you should not take more than one dose in a 24-hour period.

How Is Pseudoephedrine Misused and Abused?

Pseudoephedrine can be misused as an ingredient for the illicit manufacture of methamphetamines. However, it does carry some risks of abuse on its own. Although a lot of people only use it for medicinal purposes, some have found themselves misusing and abusing Pseudoephedrine. Many individuals intentionally take an excessive amount of these drugs to achieve a high similar to other stimulants like meth or cocaine.

In large doses, it will cause a sudden rush of energy, excitability, and hyperactivity. On the downside, taking these drugs in excess can cause a fast heartbeat and high blood pressure, which can lead to cardiovascular issues. The effects of pseudoephedrine abuse can be very harsh, so it’s necessary for individuals to go through a prescription drug rehab program to get medical assistance during withdrawal.

Pseudoephedrine is not a very addictive substance, however, when the medication is used improperly, addiction becomes a concern. Those who use this medication only for its intended indication at the labeled dosage should not worry about developing an addiction. As is true with most other addictive substances, though, pseudoephedrine targets the brain’s reward system by overloading it with dopamine.

The overstimulation of this system, which rewards our natural behaviors, produces the euphoric effects people desire and encourages them to repeat the behavior. When people can get their hands on a sufficient amount of the drug, they can use it to experience its stimulant-like effects.

Abusers of pseudoephedrine report that they experience:

  • Increased feelings of energy and alertness
  • Extreme euphoria and wellbeing
  • A pleasant tingling sensation over their bodies

These effects do not happen at the recommended medicinal levels of the drug but can only happen when someone uses significant amounts of the drug and snort it or even combine it in liquid and inject it. 

pseudoephedrine
Pseudoephedrine itself is not a highly addictive substance – it is when the drug is used improperly that addiction becomes a concern

Pseudoephedrine Misuse in Sporting Events

Let’s face it; medicinal products are not always used as intended. Pseudoephedrine, because of its properties including increased muscle contractility, increased blood flow to skeletal muscles, stimulation of glycogenesis, increased cardiac tropisms, bronchodilatation, activation of the central nervous system, suppression of appetite, is also used as a slimming agent and in sport, as an ergogenic agent: improving efficiency, allowing for faster regeneration and better performance.

The influence of Pseudoephedrine on sporting performance has long been a subject of debate, and observations do not always confirm this effect; however, it is on the list of substances prohibited for use by athletes during competitions. Due to its wide availability, it is considered an anti-doping rule violation when its concentration in urine exceeds 150 μg/mL. This list is a mandatory international standard and is updated annually by the World Anti-Doping Agency (WADA), which is part of the World Anti-Doping Program [4].

Moreover, according to the National Center for Biotechnology Information (NCBI) [5], Pseudoephedrine may also be responsible for a false-positive urine test for amphetamine and methamphetamine. The structural similarity to these drugs means that they may cross-react in a test using the immunological method.

What Are the Side Effects of Pseudoephedrine Abuse?

The combination of pseudoephedrine with other sympathomimetic drugs and monoamine oxidase inhibitors (MAO) should be avoided. MAOIs were the first class of antidepressants to be developed. The combination of MAO inhibitors and this medication can cause an acute hypertensive episode, and bradycardia (slower than normal heart rate). Examples of MAO are Azilect, Eldepryl, and Marplan. Combination with caffeine present in many OTC medications, dietary supplements, and energy drinks may cause hyperglycemia (high blood sugar) and an increase in body temperature.

Side effects from typical pseudoephedrine abuse can include:

  • Urinary retention
  • Insomnia
  • Nervousness or anxiety
  • Dizziness
  • Excitability
  • Irritability
  • Red eyes
  • Dilated pupils
  • Weight loss
  • Problems sleeping
  • Loss of appetite
  • Tolerance
  • Dependence
  • Addiction

Signs of Overdose & Severe Side Effects

Individuals who intentionally consume more than the recommended amount of pseudoephedrine may be at risk for overdose. 

Severe damaging reactions and overdose include:

  • Dilated pupils
  • Hallucinations
  • Hypertension
  • Heart arrhythmias
  • Seizures
  • Skin reactions

Individuals who have cardiovascular disease, diabetes, uncontrolled hypertension, hyperthyroidism, or who are pregnant should not use medications with pseudoephedrine.

Treatment for Addiction

There is no formal withdrawal management protocol linked with recovery from pseudoephedrine abuse. However, physicians could give medications that are specifically designed to treat the symptoms the person is experiencing, such as depression or lethargy.

Medically-assisted detox

A medically-assisted detox program is the first step to a successful recovery for many. There are different stages to detox and the length depends on specific needs. However, the average detox time is about one week. Medical professionals will be by your side throughout your pseudoephedrine abuse withdrawal process to ensure safety and comfort. 

Under no circumstances that drug detox should be attempted at home. Withdrawal symptoms and duration differ from person to person, but they can be uncomfortable and life-threatening. It mostly depends on how large of a dose the user has taken and the length of misuse and abuse.

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 fatigue, nausea, headache, or aches similar to flu symptoms. Medication-assisted treatment (MAT), if necessary, can usually counteract the worst symptoms of acute detox to avoid needless suffering.

Medication-assisted treatment (MAT)

Medication-assisted treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies to provide a “whole-patient” approach to the treatment of substance use disorders. Medications used in MAT are approved by the Food and Drug Administration (FDA), and MAT programs are clinically driven and tailored to meet each client’s needs.

The ultimate goal of MAT is full recovery, including living a self-directed life. This treatment approach has been shown to:

  • Improve client’s survival
  • Increase retention in treatment
  • Decrease illicit opiate use and other criminal activity among people with substance use disorders
  • Increase client’s ability to gain and maintain employment

Psychotherapies

Treatment for pseudoephedrine abuse needs a combination of therapies and services that include treatment for trauma experiences, mental health conditions, particularly depression and anxiety, and physical health.

Effective clinical interventions for people struggling with pseudoephedrine abuse focus on timely access to structured treatment and incentive-based therapies. Proven treatment interventions include:

Motivational Interviewing

  • It is a counseling style that helps individuals overcome feelings of ambivalence and enhances motivation to change substance use behaviors.

Contingency Management

  • This is a type of behavioral therapy that uses positive reinforcements to encourage desired behaviors.

Community Reinforcement Approach

  • This is a treatment approach that identifies behaviors that reinforce stimulant use and makes a substance-free lifestyle more rewarding than one that includes drugs and alcohol.

Cognitive-Behavioral Therapy

  • It is a short-term, goal-oriented psychotherapy treatment that assists individuals in understanding their current problems, challenges, and experiences to change their behaviors and patterns of thinking.

Find the Right Treatment at We Level Up NJ

Pseudoephedrine
The most important thing you can do for your loved ones is to ensure their rehabilitation process is effective and comfortable. 

Someone who has become dependent on or addicted to over-the-counter medicines like Pseudoephedrine should seek professional assistance. During your rehabilitation, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. 

We Level Up NJ provides proper care with round-the-clock medical staff to assist your recovery through our medically-assisted Detox Program. So, reclaim your life, call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

Sources:

[1] NIH – https://medlineplus.gov/druginfo/meds/a682619.html

[2] DEA – https://pr.mo.gov/nursing-advanced-practice-pseudoephedrine.asp

[3] NIDA – https://www.drugabuse.gov/publications/research-reports/methamphetamine/how-methamphetamine-manufactured

[4] [5] NIDA – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152226/

[6] We Level UpHow Long Does Meth Stay In Your System?