ORIGINAL RESEARCH article
Front. Med.
Sec. Regulatory Science
Awareness and Practices of Community Pharmacists Toward Dextromethorphan Misuse in Jeddah, Saudi Arabia: Implications for Regulation and Public Health
Provisionally accepted
Aisha T Alnami1,2Anfal S Aljahdali1,2Haifa M Alqahtani1Maha M Khayat1Amal J Aloshayni1Manal M. Aleesia1
Mohammed M Aldurdunji3*- 1King Abdulaziz University Department of Pharmaceutical Chemistry, Jeddah, Saudi Arabia
- 2King Abdulaziz University King Fahd Medical Research Center, Jeddah, Saudi Arabia
- 3Pharmaceutical Practices Department, Umm Al-Qura University College of Pharmacy, Makkah, Saudi Arabia
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Background: Dextromethorphan (DXM) is an over-the-counter cough suppressant with recognized potential for misuse and abuse when taken at supratherapeutic doses. Community pharmacists are well positioned to identify and prevent such misuse, yet limited data exist from Saudi Arabia regarding their awareness, dispensing practices, and views on regulation. Methods: A cross-sectional survey was conducted among community pharmacists in Jeddah, Saudi Arabia, using a self-administered questionnaire. Descriptive statistics were used to summarize responses, and logistic regression was applied to identify factors associated with perceived increases in DXM sales and the adoption of restriction strategies. Results: A total of 252 pharmacists participated. Most respondents recognized DXM misuse as a local problem (206; 81.8%) and believed sales had increased over the preceding two years (131; 52.0%). Peer influence and social media promotion were identified as common drivers of misuse (206; 81.8%). The majority reported adopting restrictive dispensing practices, including refusal to sell to suspected abusers (178; 70.6%), and expressed strong support for tighter legal controls (230; 91.3%) and public awareness campaigns (198; 78.6%). Logistic regression showed that requests for non-OTC DXM products were associated with perceived increases in sales (OR = 2.13; 95% CI = 1.18–3.85; p = 0.012), while pharmacy location and previous dispensing behaviors predicted restrictive practices (OR = 1.96; 95% CI = 1.08–3.54; p < 0.05). Conclusion: Community pharmacists in Jeddah demonstrated awareness of DXM misuse and recognized the role of social and digital influences in promoting it. Their broad support for regulatory restrictions and preventive campaigns indicates readiness to contribute to public health strategies. Nonetheless, limited confidence in managing suspected cases highlights the need for targeted training and continued research across multiple regions to inform effective regulatory and educational responses.
Keywords: Dextromethorphan, Over-the-counter medicines, Community pharmacists, substance misuse, Saudi Arabia, Public Health
Received: 26 Aug 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Alnami, Aljahdali, Alqahtani, Khayat, Aloshayni, Aleesia and Aldurdunji. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mohammed M Aldurdunji, mmdurdunji@uqu.edu.sa
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