Annals of Emergency Medicine recently published a report online describing two deaths in New York after loperamide abuse. Imodium, the popular anti-diarrhea medication with the active ingredient loperamide offers a cheap high if its consumed in large amounts. Addicts who cannot get their hands on opioid painkillers are turning to the over the counter drug. In the past 18 months a hand full of overdoses can be linked to Imodium, causing the users to have life-threatening irregular heartbeats and even death. This came as a shock to most physicians who just recently realized that the uncomfortably constipating drug could be abused by addicts. As the CDC rolled out its new Opioid painkiller prescribing guidelines, the Imodium overdoses have skyrocketed seven fold. This epidemic is like those who turn to mouthwash when their alcohol runs out, the toxic over the counter medications currently has little national data on the problem but emergency departments and toxicologists believe the problem is growing.

Many addiction specialists believe addicts are taking the drug to ease the pain of opioid withdrawal. When someone who is addicted to heroin or opioids cannot obtain the drug of choice, the user can experience painful withdrawal symptoms like muscle pain, vomiting, diarrhea, and nausea. The anti-diarrhea medication is cheap and can be purchased over the counter without a prescription. Tracking the loperamide abuse can be difficult, super stores like Costco are known to sell 400 pills for just under $8.00. In the article published by Annals of Emergency Medicine, the paper outlines two case studies of patients with histories of substance abuse who attempted to self-medicate their opioid addiction with large doses of loperamide. Both patients overdosed and died after emergency medical services were called. Dr. Eggleston said “Our nation’s growing population of opioid addiction patients are seeking alternative drug sources with prescription opioid medication abuse being limited by new legislation and regulations,” He also mentioned “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.”

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