Anti-Diarrhea Medication Abuse Increases

Anti-diarrhea drugs whose key ingredient is loperamide are being abused for treatment of opioid addiction.

A recent study finds that over-the-counter anti-diarrhea medications with the key ingredient loperamide, such as Imodium, are largely being abused by people attempting to treat their opioid addiction, sometimes leading to death.

The study, published in Annals of Emergency, used 2 case studies to outline this occurrence.

"Loperamide's accessibility, low cost, over-the-counter legal status and lack of social stigma all contribute to its potential for abuse," said lead study author William Eggleston, PharmD. "People looking for either self-treatment of withdrawal symptoms or euphoria are overdosing on loperamide with sometimes deadly consequences. Loperamide is safe in therapeutic doses but extremely dangerous in high doses."

The analysis outlines 2 studies in which patients with histories of substance abuse attempted to self-treat opioid addictions with high doses of loperamide. According to the study, both patients overdosed and required cardiopulmonary resuscitation, naloxone, and standard Advanced Cardiac Life Support. Both incidences resulted in death.

Postings to web-based forums about oral loperamide abuse increased 10-fold between 2010 and 2011, while 70% of the user-generated content discussed using the drug to treat opioid withdrawal.

Some users posted about abusing the medication for its euphoric properties.

According to the study, the Upstate New York Poison Center had a 7-fold increase in calls about loperamide abuse from 2011 to 2015. National poison data reported a 71% increase in calls related to this issue from 2011 to 2014.

"Our nation's growing population of opioid-addicted patients is seeking alternative drug sources with prescription opioid medication abuse being limited by new legislation and regulations," Dr. Eggleston concluded. "Health care providers must be aware of increasing loperamide abuse and its under recognized cardiac toxicity. This is another reminder that all drugs, including those sold without a prescription, can be dangerous when not used as directed."