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Pseudoephedrine Addiction: Side Effects, Detox, Withdrawal, and Treatment

pseudoephedrine in cold syrup

What is Pseudoephedrine?

Pseudoephedrine is a decongestant drug that is sold under the brand name Sudafed. It works by shrinking the blood vessels in the nasal passages to clear the nose of congestion.1 It is an active ingredient in many cold medicines and although many of those medicines used to be available over-the-counter, most are now only available for purchase behind the pharmacy counter.

Although consumers can purchase some medications containing pseudoephedrine without a prescription, the FDA has greatly restricted access to the drug by limiting the amount people can buy per month, requiring a photo ID, and making each person sign a log when they purchase it.2 These restrictions are due to the high likelihood of pseudoephedrine being abused.

When used properly, pseudoephedrine is not addictive, but when it is abused, it carries many risks. Pseudoephedrine is most commonly misused by converting it into an ingredient that is used to make methamphetamine or bath salts. Some people may also misuse it as an illegal stimulant to increase alertness or enhance physical performance but it is most dangerous when it is used to make meth.

People who use pseudoephedrine to make meth and get high typically smoke it, snort it, or inject the powder form of meth after dissolving it in water.

Ever since the U.S. government set restrictions on pseudoephedrine in 2005, meth lab incidents around the country have decreased.3 Many drug manufacturers have also changed the ingredients of their products to exclude pseudoephedrine, such as by replacing it with alternatives like phenylephrine in an effort to curb abuse. 

Regardless, people who previously abused pseudoephedrine may be more likely to experiment with other drugs to find a similar high instead of giving up the substance abuse altogether.

Slang for Pseudoephedrine

The following terms are street names or slang for pseudoephedrine:

  • Chalk
  • Crank
  • Meth
  • Speed 

About Pseudoephedrine Abuse and Addiction

Teens may be more likely to abuse pseudoephedrine and a common practice is to combine it with alcohol. This practice is very dangerous and may result in overdose because the stimulating effects of pseudoephedrine can dampen the effects of alcohol, making a person more likely to drink more than they normally would.

The most common form of pseudoephedrine abuse is using it to make methamphetamine. This involves chemically altering the pseudoephedrine into an ingredient that can be used in the meth “cooking” process. While the process of converting pseudoephedrine to make meth is fairly simple, it’s also extremely dangerous and can cause explosions or fires.4 

Misusing pseudoephedrine in this way is extremely addictive and meth can cause serious physical and psychological side effects that can last for weeks, months, years, or even a lifetime.

Although the Combat Methamphetamine Epidemic Act has made pseudoephedrine more difficult to acquire, the abuse of methamphetamine is still rampant in the U.S. and contributes to the number of ER visits, law enforcement resources used, crimes committed, and serious health problems plaguing Americans.

Side Effects of Pseudoephedrine Abuse

Short-term effects of pseudoephedrine abuse may include:

  • Euphoria
  • Increased alertness
  • Increased energy
  • Pleasant tingling sensation
  • Irritability
  • Red eyes
  • Loss of appetite
  • Dilated pupils

Long-term effects of pseudoephedrine abuse may include:

  • Weight loss
  • Problems sleeping
  • Tolerance 
  • Dependence
  • Addiction 
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Signs and Symptoms of Pseudoephedrine Abuse and Addiction

In the past, teens were likely to abuse pseudoephedrine because it was cheap, and available over-the-counter via drugs like Sudafed. However, since access to pseudoephedrine has been restricted, teens are now more likely to turn to other more easily accessible substances they can abuse to get high, such as herbal drugs, over-the-counter drugs like DXM, or prescription drugs they get from friends.

If someone is misusing pseudoephedrine or is addicted to meth that is made using pseudoephedrine, he or she may display some of the following signs:

  • Isolating from family and friends
  • Purchasing large amounts of cold and flu medication containing pseudoephedrine
  • Displaying sudden changes in appearance, hygiene, and/or social circles
  • Losing interest in regular hobbies and activities

Pseudoephedrine Detox and Withdrawal

Although there is no scientific evidence that pseudoephedrine produces withdrawal symptoms, some users may experience withdrawal symptoms that are similar to stimulant withdrawal, such as:

  • Depression
  • Anxiety
  • Irritability
  • Lethargy
  • Extreme sleepiness
  • Increased appetite
  • Vivid nightmares
  • Nasal congestion
  • Drug cravings

Although none of these withdrawal symptoms are life-threatening, stimulant withdrawal can be very uncomfortable and the intense discomfort can make it very difficult to stay sober. 

There is no formal withdrawal management or treatment for the abuse of pseudoephedrine or cold medicines, but a medically-assisted detox program can be extremely helpful because they can provide treatment for individual withdrawal symptoms such as depression. This gives clients the chance to relax and rest while they receive additional clinical support from addiction treatment professionals.

Treatment for Pseudoephedrine Addiction

Although there is no designated treatment process for people who are abusing cold medicines or are addicted to pseudoephedrine, there are several ways addiction treatment can help people who are ready to get sober. According to the National Institute on Drug Abuse (NIDA):

  • Individuals should receive treatment right away
  • Individuals should receive treatment for both mental health issues and the substance use disorder
  • Treatment professionals should use a combination of medication and evidence-based therapy
  • Treatment professionals should encourage family members to be actively involved in the person’s recovery
  • Treatment professionals should seek to ensure that the person remains in treatment for an adequate length of time5

After completing a medical detox program, people who are struggling with pseudoephedrine abuse may greatly benefit from also completing a long-term rehab program that lasts at least 90 days.

During rehab, clients will work closely with addiction treatment professionals and their peers to do the following things: 

Staff help clients achieve these objectives by providing various types of behavioral therapy, individual counseling, group counseling, educational lectures, family therapy, social activities for rehab clients, and more.

Inpatient Drug Rehab vs. Outpatient Drug Rehab for Pseudoephedrine Addiction

If you are considering going to drug rehab for pseudoephedrine addiction, inpatient rehab and outpatient rehab are two common types of treatment. While both are different, each provides quality, comprehensive care. The chart below offers a quick comparison of these two types of rehab.

In residential rehab, clients:

  • Complete rehab while living at the rehab center
  • Adhere to a strict schedule of treatment sessions, social activities, meals, exercise, free time, etc.
  • Attend daily counseling sessions and process groups where various types of therapy may be used
  • Participate in family therapy and/or family workshops
  • Have immediate access to medical and clinical care onsite

In outpatient rehab, clients:

  • Complete rehab while living at home or at a sober living home
  • Attend a set number of outpatient group meetings at a designated facility
  • Complete assignments independently at home
  • Participate in family therapy and/or family workshops
  • Maintain personal obligations while enrolled in rehab (school, work, childcare, etc.)

Your doctor or an addiction treatment professional can help you determine which type of rehab is best for you depending on your needs, life circumstances, and financial ability. Depending on the program, clients usually have several different options to pay for rehab, such as:

Continued Care Options for Pseudoephedrine Addiction Treatment

There are several different types of addiction treatment programs that clients can take advantage of after they complete a rehab program. These additional services are designed to provide well-rounded support to prevent relapse and gradually ease the client back into everyday life and an independent lifestyle in recovery.

Sober Living Programs

Sober living programs are designed to help detox and rehab alumni adjust to a sober life with the continued support of staff and sober peers. Sober living homes come in all shapes and sizes but the primary goal of transitional housing is to act as a bridge between life in rehab and independent sober life.

Sober living programs offer support by providing clients with recovery services such as:

  • Regular drug and alcohol testing
  • Tiered recovery programming
  • Educational planning
  • Employment assistance
  • Volunteer placement services
  • Peer-monitoring programs
  • Family involvement in the sober living program

The cost of a sober living program will vary greatly, depending on the type of program, the location and amenities of the sober living home itself, and the type of recovery support services offered. However, clients often pay one monthly payment like they would for rent.

Aftercare Programs

Aftercare programs for people in recovery offer yet another layer of support and an opportunity to engage in one’s recovery journey. Aftercare programs consist of a series of outpatient group meetings at a designated location. These meetings are intended to be safe, supportive, and welcoming groups where clients can talk freely about their personal struggles in recovery as well as their successes.

Aftercare groups also provide excellent opportunities for clients to offer encouragement and advice to other people in recovery, work to improve their communication skills, and develop strong, healthy relationships that can continue to thrive long after addiction treatment is complete.

Pseudoephedrine abuse and addiction may seem impossible to overcome, but you can get sober and live the life that you want. There is help available when you’re ready and there are many different routes to recovery. Please call (512) 605-2955 to learn more about your treatment options today.



  1. https://www.drugs.com/pseudoephedrine.html
  2. https://www.fda.gov/drugs/information-drug-class/legal-requirements-sale-and-purchase-drug-products-containing-pseudoephedrine-ephedrine-and
  3. http://www.nascsa.org/PDF/psedoephedrineWhitepaper4.18.16.pdf 
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793278/
  5. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment


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