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Clinical Characteristics of Over-The-Counter Drug Misusers in Psychiatric Practice in Japan: Comparison Between
Yuko Tanibuchi1,2, Soichiro Omiya2,3, Takashi Usami2,4
1Chiba Hospital, Funabashi, Chiba, Japan.
Neuropsychopharmacology Reports
|February 18, 2026
Summary
Misuse of dextromethorphan (DXM) in Japan is linked to younger individuals, females, and those with a history of self-harm. Acute intoxication and mood disorders are significant factors associated with DXM misuse, necessitating targeted support and prevention.
Area of Science:
- Psychiatry
- Clinical Psychology
- Pharmacology
Background:
- Over-the-counter (OTC) medication misuse is a growing concern in Japanese psychiatric settings.
- Codeine (COD) and dextromethorphan (DXM) are commonly misused OTC substances.
- Understanding the distinct characteristics of DXM misuse is crucial for developing effective interventions.
Purpose of the Study:
- To compare clinical characteristics of individuals misusing codeine (COD) versus dextromethorphan (DXM).
- To identify factors associated with dextromethorphan (DXM) misuse.
- To inform the development of targeted support measures for DXM misusers.
Main Methods:
- Utilized data from the 2024 National Survey on Drug-Related Disorders in Psychiatric Inpatient Facilities.
- Extracted and compared demographic, diagnostic (ICD-10), and comorbidity data between COD and DXM misusers.
- Employed Fisher's exact test for group comparisons and multivariable logistic regression for factor analysis.
Main Results:
- The DXM group (n=72) comprised more females and younger individuals than the COD group (n=160).
- DXM misusers exhibited higher rates of recent drug use, self-harm, and suicide attempts.
- Significant associations with DXM misuse included younger age, acute intoxication, and comorbid mood disorders (F3).
Conclusions:
- DXM misuse is associated with specific demographic and clinical profiles, including higher risks of self-harm and suicide.
- Management of DXM misuse requires acute-phase care, comprehensive psychiatric assessment, and suicide risk evaluation.
- Preventive strategies should integrate mental health and suicide prevention education, alongside regulatory measures for OTC sales.
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