Why It's Time to Move Benzedrex Behind the Counter to Combat Rampant Abuse

Addiction to any drug can have devastating impacts not just on the individual struggling with it, but on those around them as well. Since April of 2021, my brother has been to 9 different rehabs, three different sober houses, and had multiple inpatient stays at various facilities. In total, he’s spent over 1 year, out of the past three, in some form of rehab or mental health facility. One of the rehabs he stayed at was run by an American company in Mexico and locked him and other patients in cages, and forced them to endure numerous abuses. In the times he’s been home, he’s stolen my car twice and my credit card once. He’s stolen my brother's car, my parents' car, crashed his own car, stole money from my parents and brothers, and driven all the way to Arizona, Wyoming, and Nevada while under the influence. He’s tried to apply for multiple credit cards, lasted less than a month at six different jobs, bought a plane ticket to Seattle, had to drop out of three different colleges, and will disappear from home for days at a time, during which he won’t eat or sleep. He was a straight-A student, a talented programmer, and by all measures had everything going for him to lead a successful life. But his addiction derailed that. Once, I spent a whole day with him; we paddleboarded, played video games, and shot hoops. But that night, he snuck into my room, stole my keys, and drove off with my car. That’s what addiction does; it makes you do crazy things you never would in pursuit of getting high again, without any regard for those who care for you. And that just scratches the surface of how destructive my older brother’s addiction has really been.

While the term 'drug addiction' might conjure images of shady alleyway transactions and meth dens, the reality of my brother’s addiction is far more mundane — and alarmingly accessible. So accessible, in fact, he was able to get it doordashed to him at an inpatient facility. If you walk into almost any pharmacy across the United States, you’ll be able to find it sitting on a shelf, for as low as $5, and you can buy it without needing to talk to anyone or provide an ID. Because you don’t need to talk to anyone to get it, it’s also incredibly easy to steal. Anyone, of any age, anywhere in the United States, can get their hands on this destructive of a drug, for free. If you’re trying to clear a stuffy nose, you can see the drug on the shelves among its less dangerous competitors, such as Flonase and Afrin. Benzedrex, advertised as a nasal decongestant, contains the active ingredient Propylhexedrine, a chemical relative of meth. Despite the fact that Propylhexedrine is extremely addictive and easy to abuse (and there are multiple competitors to Benzedrex that don’t have an addictive stimulant as an active ingredient) it’s still sold over-the-counter in thousands of pharmacies across the country, easily obtainable for anyone who struggles with addiction. This needs to change.

Propylhexedrine, developed as a way to replace the dangerous amphetamines that were formerly common in decongestants, shares many qualities with the very drug it was designed to replace. On drug tests, propylhexedrine will even show up as meth, since the two molecules are almost chemically identical.  Not only are they chemically similar, but they also cause a similar high, with one user describing it as “an intermediate between Adderall and methamphetamine”. There’s even an entire subreddit, r/benzedrex, with over 11,000 members dedicated to the recreational use of Propylhexedrine. Despite its intended purpose, a simple Google search is all it takes to show that Benzedrex is known mainly as an easy way to get a “legal high”, with 5 of the top 10 Google results being about the dangers of Benzedrex abuse. The top search result, in fact, is a warning from the FDA about the potential risks of abusing the substance. Despite this, the FDA continues to allow it to be sold over-the-counter, meaning you don’t need a prescription, or even to talk to anyone to buy it. Because of its OTC nature, it’s extremely easy to steal, meaning there’s practically nothing stopping someone from obtaining it; you can get a high comparable to meth simply by walking into a Walmart, Walgreens, or CVS and taking some off the shelf. Propylhexedrine has even been shown to cause more severe end-organ problems than Meth, meaning it's not only extremely easy to access, but it’s also extremely dangerous. While there currently aren’t many studies into Propylhexedrine abuse and addiction, several rehab centers across the country offer programs specifically for the drug, showing that there is a growing epidemic of abuse. Drugs like meth are illegal, drugs like Adderall require a prescription, yet a drug that has similar effects to both can be picked up without ever talking to a dealer, or anyone for that matter.

The dangers of Benzedrex are clear: its status as an over-the-counter medicine means that anyone, no matter age, economic status, or any other factor can easily access an addictive stimulant. However, there are reasonable measures that would mitigate these risks. Ideally, eliminating Propylhexedrine—an unnecessary component—from decongestants would be most effective. A more immediate solution would be to place Benzedrex behind the counter, requiring identification and direct interaction for purchase. Not only would this ensure that only people of age are buying the medicine, but it would also add a steep barrier for many drug addicts to overcome. It would make the drug impossible to steal, and limit the amount that can be bought at once, making it harder to get lots at once to get high. Sudafed, another decongestant, was originally an OTC drug, but was moved behind the counter because it can be used to make meth. If the FDA moved a drug behind the counter because it could be used to make meth, why couldn’t they do the same to a drug that’s nearly chemically identical to meth? Propylhexedrine is on the controlled substance list in several countries around the world, such as Australia and Brazil, and is restricted in several states like Arizona and Georgia. It was even used to be on the controlled substance list in the United States, but was removed in the 90s. My brother normally steals Benzedrex when he uses, so a move as simple as making it available behind the counter would already be extremely beneficial in decreasing his access to the drug, and an added age restriction can make it much harder for high schoolers to get hooked on the substance. While not a cure-all solution, moving Benzedrex behind the counter is an important step in minimizing its risk.

The true danger of Benzedrex lies in its inconspicuous nature—it defies the typical image of life-destroying drugs. Without the need for a dealer, an ID, or even leaving the house, anyone can access what could be termed 'meth lite.' Its alarming availability not only facilitates addiction but also positions it as a potential gateway drug, with reports of abuse in individuals as young as 12 years old. Furthermore, the dangers are underscored by an FDA study in which 60 addicted individuals were examined, resulting in 23 experiencing severe, life-threatening events, and nine fatalities. Despite these findings, the FDA’s response has been minimal—merely advising manufacturers to make the packaging harder to open, a trivial hurdle for an addict. A more substantial measure, such as placing Benzedrex behind the counter, is urgently needed. This action would not only make it more challenging for existing addicts to sustain their dependency but would also create a significant barrier to initial abuse. While this step won't completely resolve the issue, it represents a critical move towards protecting our communities from this hidden yet deadly threat.