Loperamide Abuse | Effects, Risks, & Signs Of Addiction
- What Is Loperamide?
- Loperamide Abuse
- Loperamide & The Opioid Epidemic
- Side Effects Of Loperamide
- Can You Overdose On Loperamide?
- Risks Of Loperamide Abuse
- Signs Of Loperamide Addiction
- Addiction Treatment
According to information from the National Poison Data System, health care providers, pharmacists, and poison control centers have encountered increasing cases of loperamide drug abuse and overdose since 2010, with tragic results.
What Is Loperamide?
Loperamide, or brand name Imodium, is commonly used in over-the-counter antidiarrheal medications. It works by slowing the flow of fluids and electrolytes to the bowel, thereby slowing intestinal and bowel activity along with the frequency of bowel movements and diarrhea.
The medication, available in both OTC and prescription forms, is produced in tablets, capsules, or liquid solutions.
Although the drug interacts with certain opioid receptors, like opiate/opioid drugs, loperamide is considered to have a very low abuse potential and does not generate physical dependence at recommended doses.
Loperamide Abuse
Loperamide has no euphoric properties at therapeutic doses and cannot cross the blood-brain barrier to any significant degree.
However, at excessively high doses this can change, and the drug will instead act as a more potent opioid agonist, binding to and activating opioid receptors throughout the central nervous system with pleasurable effects.
Loperamide & The Opioid Epidemic
A recent surge in loperamide abuse has been directly linked to the ongoing American opioid epidemic.
Because loperamide is cheap and uncontrolled, some have begun using it when other opioids are inaccessible, often sharing their experiences on online forums.
These individuals may take anywhere from 50 to 400 pills in a day, more than 100x the recommended daily dosage, to generate strong narcotic effects.
Others have taken to using loperamide to self-treat opioid use disorder, rapidly taking dozens of pills of the ‘‘poor man’s methadone” with the goal of tempering uncomfortable opioid withdrawal symptoms and cravings.
Side Effects Of Loperamide Use & Abuse
While generally safe when used as directed, loperamide is associated with certain potential side effects, including:
- abdominal cramping
- colic
- constipation
- difficulty urinating
- dizziness
- drowsiness
- dry mouth
- headache
- nausea and vomiting
These side effects may occur more often and severely when the drug is abused, either when it is taken in high doses or mixed with other substances of abuse.
Can You Overdose On Loperamide?
Use of loperamide in excessively large or reckless doses may cause severe or even life-threatening loperamide overdose symptoms. Using the drug for an extended period of time, or in combination with substances that interact with loperamide, can also increase the risk.
Signs and symptoms of loperamide toxicity can include:
- cardiac arrhythmias (irregular heart rhythm)
- tachycardia (elevated heart rate)
- cardiac arrest (interrupted heartbeats)
- respiratory depression (slow, stopped, or difficult breathing)
- kidney injury or failure
- difficulty urinating
- stomach pain
- dilated pupils
- drowsiness
- dizziness
- fainting
- loss of consciousness
Unfortunately, while ingestion of high doses of loperamide is potentially harmful, the concentration of the drug that will generate cardiotoxicity or other overdose symptoms can vary dramatically from individual to individual.
And while the opioid overdose naloxone can help reverse the effects of a loperamide overdose, other forms of emergency care may also be urgently needed to stabilize a person’s heart activity and other vital functions.
Risks Of Loperamide Abuse
Prolonged, high dose abuse of loperamide has been associated with a wide range of negative health effects, even without a specific overdose event.
Potential health consequences noted in case reports and studies include:
- CNS depression, including respiratory depression
- serious heart problems including syncope, life-threatening QTc and QRS prolongation, torsades de pointes, ventricular arrhythmias, other dysrhythmias, and cardiac arrest
- gastrointestinal dysfunction and constipation
- kidney problems or kidney failure
- addiction and physiological dependence
Signs Of Loperamide Addiction
If a person abuses loperamide, they will likely exhibit the same telltale signs and symptoms as opiate/opioid abuse and other forms of substance use disorder.
Signs of loperamide addiction can include:
- continuing to use the medication after prescribed treatment
- needing to take higher doses over time due to tolerance
- taking excessively large doses or taking the drug with other substances, including alcohol, to increase its effects
- spending excessive amounts of time or money on loperamide abuse
- being unable to stop taking loperamide even if one would like to
- unstable mood and behavioral changes
- withdrawing from friends, family, responsibilities, and former passions
- declining personal self-care and outward appearance
Loperamide Addiction Treatment
Even though it is an over-the-counter drug, loperamide misuse and addiction should be taken very seriously. Personalized, professional addiction treatment and recovery programs can help those who struggle with loperamide misuse, or who are improperly self-treating with the drug.
Common evidence-based treatment options that may be recommended include:
- medical detoxification and treatment for withdrawal symptoms
- inpatient or outpatient rehab
- medication-assisted treatment using methadone, buprenorphine, or naltrexone
- dual diagnosis treatment for contributing mental health disorders
- behavioral therapy
- peer support groups
- aftercare and case management
For information on our inpatient and outpatient substance abuse treatment programs, please contact Ark Behavioral Health today.
Written by Ark Behavioral Health Editorial Team
©2024 Ark National Holdings, LLC. | All Rights Reserved.
This page does not provide medical advice.
Practical Pain Management - What are the dangers of loperamide abuse?
U.S. Food and Drug Administration (FDA) - IMODIUM Capsules Rx
U.S. Food and Drug Administration (FDA) - FDA Drug Safety Communication: FDA warns about serious heart problems with high doses of the antidiarrheal medicine loperamide (Imodium), including from abuse and misuse
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