‪‪Antidiarrhoeal‬, ‪Loperamide‬, ‪Food and Drug Administration
Channel: Tey Yomiko
Date: 2018-02-03

Some People Are Using Diarrhea Meds To Get High, And The FDA Is Concerned

The U.S. Food and Drug Administration is concerned over a number of people turning to anti-diarrhea medication to get high, using significant amounts of Imodium A-D to satisfy their opioid addiction.

It's not surprising at all, though. For starters, the said medicine can be acquired over the counter and is inexpensive. It is also readily available and completely legal.

On Jan. 30, the FDA requested manufacturers to produce packages with low quantities of the drug for short-term use in an attempt to curb the problem.

Loperamide

Loperamide, the generic name of the medicine, is considered safe at 8 milligrams a day, or four tablets. There's a 16-milligram cap for prescription strength doses, too, but these are generally low levels and can't enter the blood or brain. Some individuals, however, are consuming between 50 to 400 pills each day to feel high, said William Eggleston, pharmacist and clinical assistant professor at Binghamton University. He's also Upstate New York Poison Center's clinical toxicologist.

Ingesting that many pills each day is practically impossible, but people have been creative. Eggleston explained that, for example, one patient crushed hundreds of anti-diarrhea pills and mixed them in with this smoothie.

But why? Well, Eggleston said loperamide can act as an opioid, but when taken in low levels, it does not incur the same effects anywhere, except in the intestinal region of the body. When someone takes somewhere up to 50 pills a day and above, they'll feel akin to having injected heroin or even morphine.

"You can get that same high sensation, that euphoria," said Eggleston. The sensation of being high, however, isn't as potent as one would encounter by injecting more severe drugs. It doesn't provide the same level of "head rush" that heroin does, he said.
Abusing Loperamide To Avoid Withdrawal

Some abusers are taking significant amounts of loperamide not to satisfy their addiction, but to actually prevent it. Some patients abuse the drug to function without the use of morphine, fentanyl, or heroin. But given a high enough dosage, some patients report feeling an opiate-like experience.

"The issue of opioid misuse and abuse remains one of my highest priorities and we believe it's going to take carefully developed, sustained, and coordinated action by everyone involved to reduce the tide of opioid addiction and death afflicting our communities; while maintaining appropriate prescribing for patients in medical need," said FDA commissioner Scott Gottlieb.

As a preliminary preventive measure, the FDA is changing how loperamide is packaged. As mentioned, it's asked manufacturers to limit the amount of loperamide in retail packaging. For example, a blister packaging that contains eight 2-milligram capsules. It also plans to reach out to online distributors and ask them voluntary steps to mitigate the issue. It wants to eventually stop bulk sales of the medicine, which is one of the ways that could lead to individuals abusing it.

Currently, loperamide can be purchased on Amazon for $10.99, which contains 400 pills. The FDA's solution can't persist in the long term, according to Eggleston. Making loperamide a behind-the-counter drug might work, but that's a huge step to take, and will likely only happen when the abuse grows more abysmal.



People using Imodium AD diarrhea drug to get high

GREEN BAY, Wis. (WBAY) This story is one we can hardly even believe is happening, but doctors and even the FDA are issuing warnings in the last week, urging people not to try getting high by taking too much loperamide, known as Imodium AD.

Yes, we're talking about the anti-diarrheal medication.

A study published in the Annals of Emergency Medicine warns people taking incredibly high doses of the medication that it has lethal consequences.

Like many of us, BayCare Clinic emergency medicine physician Dan Gale is a bit dumbfounded over the latest attempts to get a high.

"There's no smart drug to abuse as a kid. This one's a really stupid one," says Dr. Gale.

The study reports two people died overdosing on loperamide.

Dr. Gale says most people abusing it are addicts, using it to treat severe withdrawal symptoms.

But the issue is the amount they're taking -- up to 200 times the recommended dose.

In small amounts, like the recommended dose, Dr. Gale says the body doesn't really absorb the drug. But in large amounts, he says the body will absorb it and that affects other organs.

"The biggest safety issue is what happens to the heart. It disrupts our electrical pathways in our heart. When it happens, it's like flipping a switch. It's not like you feel a little bit worse and a little bit worse and then you die. You just collapse," he explains.

While people may be buying large amounts of Imodium online, Tuesday, the FDA announced it is "working with manufacturers... to limit the number of doses in a package."