Abuse of Dextromethorphan, Naphazoline, and Carbamazepine in Community Pharmacies and Health Centers

Pharmacy Practice

  • Tala I. Qaraqkeh1Department of Pathology Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Jordan.
  • Heba A. Khader2Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan.
  • Ahmad R. Alsayed3Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
  • Luai Z. Hasoun3Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
  • Malek A. Zihlif4Department of Pharmacology, School of Medicine, The University of Jordan, Amman, Jordan.
  • Anas Samara5Department of Software Engineering, Bethlehem University, Bethlehem, Palestine.

Volume 24 Issue 1 Pages 1-13

DOI: 10.18549/PharmPract.2026.1.3412

Abstract

Purpose: This study aims to collect data on the prevalence of abuse of dextromethorphan, naphazoline, and Carbamazepine from pharmacies and comprehensive health centers in Al-Karak, Jordan. Moreover, it seeks to understand the medical staff awareness and knowledge of this issue. Method: This cross-sectional study was conducted between July 2023 and October 2023 and two questionnaire forms were constructed. The first one was handed to pharmacists in twenty community pharmacies in Al-Karak. The second one was distributed to physicians who work in five comprehensive health centers in the same area. Results and conclusion: This study showed that cold and cough medications containing dextromethorphan and ophthalmic solutions containing naphazoline are the most widely abused OTC drugs (55% and 45%, respectively). Most pharmacists (95%) agreed that dextromethorphan can cause euphoria and hallucination at high doses, and 80% recognized that naphazoline can cause similar effects. All physicians (100%) stated that OTC drugs can be abused, and all participants reported that dextromethorphan and naphazoline can cause euphoria and hallucinations if overused. Most participants from both pharmacies and health centers had faced suspected cases of OTC drug abuse. Almost 95% of pharmacists suspected the abuse of dextromethorphan and naphazoline, and 60% noted that suspicious customers were both regular and strangers. Among health center participants, 80% prescribed these drugs daily, while 20% prescribed them 2 to 6 days per week. The main reasons for abuse were identified as these drugs were non-prescribed and easily accessible. Regarding carbamazepine abuse, which is a prescribed drug, 55% of pharmacists stated that carbamazepine has a potential for abuse, and the demand for it had increased recently. Moreover, 65% reported that people often requested multiple packs at once. Among physicians, 80% stated that carbamazepine has a potential for abuse and 40% observed that specific individuals requested carbamazepine more frequently than others did and displayed signs and symptoms of carbamazepine abuse.

Keywords

  • Dextromethorphan
  • naphazoline
  • carbamazepine
  • abuse
  • OTC drugs
  • pharmacists and physicians
Pharmacy Practice

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