Record Spike in OTC Medication Overdoses: Saving Young Lives from Painkiller and Sleep-Aid Misuse

The government has kept pressing only the accelerator on making medicines easier to buy

Late at night in Shinjuku’s Kabukichō, a teenage girl jumped from a building and lost her life. Just before that, she had taken a large quantity of over-the-counter (OTC) medication.

On social media, the word overdose (OD) is used casually. Easily accessible OTC medicines—painkillers, cold medicine, sleep aids—are being misused by young people as a means of self-harm.

According to the 2025 edition of the Suicide Prevention White Paper, the number of elementary, middle, and high school student suicides last year reached a record high of 529, and a large portion of suicide attempts among young people involve overdosing on OTC drugs.

Why do young people turn to overdosing on OTC medicine? Dr. Toshihiko Matsumoto of the National Center of Neurology and Psychiatry, who has long worked with issues of addiction and self-harm, states firmly:

“Because drugstores have increased, and access to medication has become easier.”

“In 2009, the Registered Salesperson System was introduced, allowing people who are not pharmacists to sell Class 2 and Class 3 OTC drugs. Then, the 2014 revision of the Pharmaceuticals and Medical Devices Act allowed even Class 1 OTC drugs—the highest-risk category requiring mandatory pharmacist explanation—to be sold in drugstores as long as a pharmacist was present.

In 2015, the requirements for becoming a registered salesperson were relaxed so much that neither educational background nor work experience was necessary to take the exam. Drugstores exploded in number nationwide.”

Both sellers and buyers now face lower hurdles.

“In 2017, the Self-Medication Tax Deduction was introduced—basically a policy saying, ‘Don’t go to the hospital; take OTC medicine instead.’ In other words, the government encouraged a society where people freely buy medicine. As a result, misuse among young people increased, yet this year they even decided to allow OTC drugs to be sold in convenience stores.

Do you know the Ministry of Internal Affairs’ Regulatory Reform Promotion Council? It’s a venue where government agencies and business leaders discuss regulatory easing. The problem of OTC medications became a major topic there last year. I was invited as an expert witness.

Even when I presented clear evidence of misuse and death cases, the manufacturer side and business representatives strongly pushed back, saying, ‘That data is biased,’ ‘It’s not sufficient as scientific evidence.’ When strengthening regulations on illegal drugs, they accept weak evidence—but when it comes to limiting the number of OTC drugs sold, suddenly they demand extremely strong evidence.

For example, a certain cough suppressant that became available as a switch-OTC medicine in 2021 already has misuse and death cases, yet there is no restriction on how many units can be purchased. Regulations will finally begin next May but it makes me wonder: Does this country have no intention of stopping children’s suicides?”

Awareness and having a place to belong

As access to medication has become easier, dangerous information about OTC drug combinations and dosages has spread across social media. Posts saying this number of pills will make you sleep or this combo works well circulate widely and are treated like recipes.

Dr. Matsumoto sees overdosing among young people as a cry for help.

“It is often used as a last resort to escape unbearable pain. Many young people who repeatedly overdose suffer from PTSD, trauma flashbacks, severe anxiety, and crushing loneliness. They reach for medication as a way to escape—even temporarily.

In other words, there are kids who are barely staying alive because of overdosing. Simply saying ‘No, absolutely not’ without understanding that background will not stop overdoses.”

The government conducts awareness campaigns on preventing drug misuse, yet emergency transports due to overdoses are skyrocketing, and the number of people with addictions continues to rise.

“In March of this year, the Ministry of Health released a slogan: ‘Do SD (Seek Discussion) instead of OD (Overdose).’ It caused massive backlash and was removed within a week. They hadn’t considered the voices of those affected, who say, ‘I overdose because when I try to talk, I’m just told to stop.’ Unless we address the pain behind the behavior, it’s meaningless.

We need to say, ‘Tell me a bit more about what’s making you feel that way,’ and listen to the problems and suffering behind the suicidal urges. The priority must be to create places where kids who overdose can safely reach out for help.”

Since December 2022, measures such as covering the plaza in “Toe-Yoko” with blue tarps have driven young people away from the area. Yet children who overdose have not disappeared.

“Instead of shutting places down, we should have thought about operating them safely. Every community needs safe spaces for young people. Crackdowns alone never work. Collaboration with NPOs and shelters to build places and connections is key.”

Dr. Matsumoto has treated many young people suffering from overdosing. He says youth suicides are often impulsive—and can be prevented with timely intervention.

“About 70% of young people act within one hour of feeling suicidal. This is in sharp contrast to middle-aged adults, who often think and plan for months or years. Impulsivity is a major feature of youth suicide. If someone speaks to them or acknowledges their feelings in that moment, they often abandon the attempt.”

So if you notice signs that a young person may be suicidal, what should you say or do?

“‘Don’t die,’ ‘If you live, good things will happen,’ ‘What are you talking about?’—these are things you must never say. Avoid lectures and debates. The most important thing is simply to listen.”

Overdosing is an issue society as a whole must confront and address.

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Toshihiko Matsumoto
Director, Department of Drug Dependence Research, National Center of Neurology and Psychiatry / Director, Drug Dependence Clinical Center. Psychiatrist. Works on research and treatment of drug addiction, OTC medicine addiction, overdosing, and self-harm. Author of “I Can’t Stop Hurting Myself” (Kodansha), “Children Who Overdose” (Godo Shuppan), and many others.