Why Trust Recovery Guide Tylenol PM is a drug that can be bought over-the-counter (OTC) and comes in the form of a tablet. Getting Tylenol PM does not require a prescription, making it easily available at most stores. The medication combines acetaminophen for pain and fever relief with diphenhydramine, an antihistamine that causes drowsiness.
This drug is intended to be swallowed by mouth. Taking it in any way other than directed, including snorting it, can have harmful side effects and may be a sign of drug abuse. Snorting Tylenol PM is particularly dangerous because the tablets contain fillers and binders not meant to be inhaled. The large amount of acetaminophen in each tablet can also cause severe nasal damage and dangerous overdose levels when the body’s natural absorption process is bypassed.
Learn more about the dangers and effects of snorting drugs.
What Makes Tylenol PM Different Than Tylenol?
The main difference between regular Tylenol and Tylenol PM is that while regular Tylenol contains only acetaminophen for pain and fever relief, Tylenol PM contains the added ingredient diphenhydramine, an antihistamine that can relieve allergies and cause sleepiness. This addition of diphenhydramine is what gives Tylenol PM its nighttime formula properties, making it effective as both a pain reliever and a sleep aid, but also making it potentially more dangerous when misused since users are consuming two active drugs instead of one.
What Does Snorting Tylenol PM Do?
Snorting drugs, also known as insufflation, is a common sign of drug misuse. While often done to feel the effects of a drug more quickly, this can also lead to potentially serious side effects.
Side effects of snorting Tylenol PM can include:
- irritated or runny nose
- nosebleeds
- intense drowsiness
- dizziness
- upset stomach
- blurred vision
- dry mouth
- dry nose
Snorting a lot of Tylenol PM, or crushing it and mixing it with other drugs, can lead to additional side effects, including changes in mood, behavior, and vital signs.
Why Do People Snort Tylenol PM?
Snorting over-the-counter drugs like Tylenol PM is uncommon. However, sometimes people will snort Tylenol by itself or crush it and mix it with other drugs.
People may snort Tylenol PM to:
- get high
- get rapid pain relief
- fall asleep
- stave off withdrawal symptoms
Tylenol PM is sometimes crushed and mixed with heroin. This has been referred to as “cheese” heroin. It is tannish or brown in color.
Snorting Tylenol PM mixed with heroin can be very dangerous, due to a high risk of drug dependence over time, addiction, and overdose.
Who Is Most At Risk Of Snorting Tylenol PM?
While anyone can misuse over-the-counter medications, certain groups are at higher risk of snorting Tylenol PM. Teenagers and young adults are particularly vulnerable, as OTC drugs are cheap, easy to obtain, and often mistakenly perceived as safer than illicit substances. People already struggling with substance use disorders, especially those addicted to opioids, may turn to Tylenol PM as a cheap alternative or to ease withdrawal symptoms. Individuals with untreated mental health conditions such as anxiety, depression, or insomnia may also misuse Tylenol PM in an attempt to self-medicate.
Because the drug is available at virtually any pharmacy or grocery store without a prescription, it presents a low barrier to misuse that makes it especially accessible to at-risk individuals.
Dangers Of Snorting Tylenol PM
Snorting Tylenol PM can lead to serious effects, in part because this is not how it is supposed to be used. It can also be dangerous depending on the dose taken, and if used with other drugs.
Short and long-term dangers include:
- liver damage
- confusion
- severe skin reactions
- vision problems
- nasal damage
- psychological dependence
- mood swings
- liver damage
- risk of addiction
In September of 2020, the U.S. Food and Drug Administration issued a Drug Safety Communication regarding Benadryl, which contains an ingredient also in Tylenol PM. Within this safety alert, the FDA stated that taking high doses of diphenhydramine, an ingredient in Tylenol PM, may cause heart problems, seizures, coma, and even death.
Overdose After Snorting Tylenol PM
Drug overdose is a potentially life-threatening condition that can occur after taking too much Tylenol PM, or mixing it with other drugs, including alcohol.
Signs of an overdose might include:
- nausea
- vomiting
- stomach pain
- irregular heartbeat
- loss of appetite
- confusion
- seizures
- unconsciousness
If someone is experiencing severe symptoms after snorting Tylenol PM, such as difficulty breathing, stopped breathing, or unconsciousness, seek medical attention right away.
Cheese Heroin Overdose
Cheese heroin refers to Tylenol PM mixed with black tar heroin. Heroin is involved in thousands of drug overdose deaths each year.
Symptoms of a cheese heroin overdose include:
- difficulty breathing
- very slow or stopped breathing
- bluish lips or fingers
- cold, clammy skin
- tiny pupils
- weak pulse
- low blood pressure
- gurgling noises
- unresponsiveness
- unconsciousness
Heroin overdose can be life-threatening. Call 911 right away if someone has stopped breathing, is unresponsive, or has fallen unconscious after snorting heroin and Tylenol PM.
Tylenol PM Abuse And Addiction
National survey data shows that an estimated 3.1 million Americans misuse over-the-counter medications at some point in their lives. Antihistamines and pain-relievers like Tylenol PM are some of the most commonly misused OTC drugs.
Snorting Tylenol PM repeatedly can lead to psychological addiction, physical health problems, and may increase the risk of abusing other drugs, including illicit drugs like heroin.
Treatment For Tylenol PM Abuse
Treatment may include medical detox if the person has developed a physical dependence on the diphenhydramine, as stopping suddenly can cause uncomfortable withdrawal symptoms like anxiety, insomnia, and nausea. Healthcare providers can also check for liver damage from acetaminophen abuse and provide medications to help manage withdrawal symptoms safely.
Professional addiction treatment programs offer the best chance for long-term recovery from Tylenol PM abuse. These programs typically include counseling to address the underlying reasons for drug abuse, behavioral therapy to develop healthy coping skills, and support groups where people can connect with others facing similar challenges. Since Tylenol PM abuse often happens alongside other substance abuse problems, treatment centers can address multiple addictions at once.
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- Dallas Police Department—Cheese Heroin
https://dallaspolice.net/division/narcotics/cheese-heroin - U.S. Food and Drug Administration (FDA)—FDA warns about serious problems with high doses of the allergy medicine diphenhydramine (Benadryl)
https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-problems-high-doses-allergy-medicine-diphenhydramine-benadryl - U.S. National Library of Medicine: DailyMed—TYLENOL PM
https://www.tylenol.com/products/sleep-pain/tylenol-pm-extra-strength-caplet - U.S. National Library of Medicine: MedlinePlus—Heroin overdose
https://medlineplus.gov/ency/article/002861.htm - U.S. National Library of Medicine—Abuse of over-the-counter medicines: a pharmacist’s perspective
https://pmc.ncbi.nlm.nih.gov/articles/PMC5774309/ - U.S. National Library of Medicine—Prescription and over-the-counter drug treatment admissions to the California pubic treatment system
https://pubmed.ncbi.nlm.nih.gov/21193282/