Like kids in a candy store

Kyoto, Japan – A non-prescription drug abuse crisis in Japan seems only one overdose away. The demand for a particular anti-cough drug has been rising, along with the social impact of its abuse due to its psychosomatic effects.

The ease of obtaining information online about how to acquire over-the-counter medications or OTCs for achieving overdose, however, does not appear to be the real problem.

Now, a study by a team of researchers at Kyoto University suggests that reliable information about OTC abuse needs to be readily available and effectively disseminated.

"We focused on potential OTC abusers at risk of addiction though they did not show sufficient symptoms to justify or necessitate visits to medical institutions or support facilities," says corresponding author Azusa Kariya of KyotoU's Graduate School of Medicine and School of Public Health.

Users of Japan's largest consumer-generated media -- or CGM -- service, Yahoo! Chiebukuro, post their questions and responses about OTCs primarily to learn more about overdosing, such as access to the drugs, their efficacy and effects, and health risks.

Abuse results from two causes: one is from seeking symptomatic relief from some physical pain and overdosing to the point of addiction. The other occurs when people intentionally overdose to cause either self-harm or psychosomatic changes.

Kariya's team also found that OTC abusers and potential abusers sought advice on quitting their drug addiction on the Yahoo! community website. Most poignantly, the team discovered that OTC overdosers resist consulting others in person, making the CGM a convenient source of anonymously obtained information.

"Our study aims to make sense of our CGM data to identify possible overdosers. We could then be better positioned to cooperate with health professionals and seek support from pharmacies to reduce OTC abuse," adds Kariya.

Kariya's team searched the names of commonly abused OTCs, tracked the keywords overdose and OD, and tallied the number of relevant questions posted on the Yahoo! site.

The number of OD-related queries containing the keyword BRON -- an antitussive and expectorant -- has increased sharply, pointing to the significant impact of community-based websites.

Furthermore, the team extracted 467 items of question data that met the eligibility criteria from 528 items of BRON-tagged text data, generating 26 codes and six categories. Three main themes resulted: expectations for overdose, anxieties about overdose, and troubles in quitting overdose.

"The current crisis that mental health professionals are confronting is just the tip of the iceberg. We must dive below to see the scale of abuse hidden from view," reflects Kariya.