Imodium: Risk of Abuse

 

The abuse of Imodium may come as a shock. In the public mind, Imodium is a benign over-the-counter drug, one that a person may hope not to need but can safely resort to as necessary. However, at high doses, Imodium has psychoactive effects and can be abuse-forming. There is no clear rule for what a high dose of Imodium is, but it helps to know the recommended dose versus the doses people who abuse this drug may take.

According to a New York Times article on this topic, there have been reports of people taking 100 2 mg Imodium pills every day (and some abused this drug for months). There are other reports that in order to get high on Imodium, a person (depending on physiological factors, such as sex, height, and weight) would need to take 30-300 pills in a day. According to the makers of Imodium (Johnson & Johnson pharmaceuticals), the recommended dose is no more than 8 mg in a 24-hour period if self-managing the use, or a maximum of 16 mg in 24 hours if under a physician’s care.

As the public largely knows by now, the US is experiencing a prescription opioid and heroin abuse epidemic. The pharmaceutical industry and the government have made efforts to stem the epidemic. For instance, the branded opioid pill OxyContin has been reformulated to make it harder to crush and inject. The government has called for states to implement a prescription drug monitoring system to cut down on the possibility of people “doctor shopping” for prescription opioids. While these controls are necessary in view of the epidemic, they carry unexpected consequences. One such consequence is Imodium abuse.

Presently, it is not known if Imodium abuse will spread, but there does appear to be a trend in this direction based on the statistics provided above. The public should not be surprised that individuals who are addicted to opioids have searched for, and found, a low-cost, accessible alternative.

In view of the rising levels of Imodium abuse, the Food and Drug Administration may in the near future limit the number of Imodium pills an individual can buy at any one pharmacy. This approach is akin to how the government has limited the number of certain cold medications a consumer can buy because these drugs have been used to make crystal meth. The pharmaceutical industry and the government have worked on the supply side of the prescription opioid pill epidemic, not the demand. One way to lower the demand side, and keep individuals from seeking alternatives to opioid pain pills, is to get people who need help into treatment.

 

Knowing the signs of Imodium abuse is an important early step in recognizing the need for treatment. These signs can be physical, psychological, and behavioral. The following are some of the milder, more common physical side effects associated with Imodium use:

Currently, there appears to be little research-based information about additional physical or psychological signs related to taking Imodium in high doses.  However, anecdotal evidence is available from online forums in which people discuss their experience of abusing loperamide/Imodium. Some personal accounts provide the following insights on loperamide/Imodium abuse:

• A street nickname for loperamide is lobe.  A concerned person may hear a loved one using the term lobe,which can be a tipoff that abuse is occurring. A person who buys Imodium for occasional diarrhea would not likely use this street term.
• Loperamide abuse can confer a warm sense of euphoria.
• Some individuals report feeling psychologically addicted to loperamide. There are numerous signs associated with a psychological addiction to Imodium, including stockpiling the drug. Another sign is that a person may spend an inordinate amount of time buying, using, or recovering from Imodium abuse.
• One person who had been taking approximately 42 (2 mg) doses of loperamide each day for over a month reported experiencing withdrawal after she stopped using the drug. Withdrawal symptoms included a panic attack, cravings for loperamide, body tremors, chattering teeth, sweating, and anxiety. She initiated a tapering process to avoid withdrawal symptoms in an attempt to stop the abuse. The taper appeared to be helping.

The behavioral signs of addiction are expansive, yet they all have one thing in common: They demonstrate a noticeable change in the affected person. Though humans are not always consistent, they do tend to have a core personality and way of doing things, but drug abuse can radically alter every facet of a person’s existence. For this reason, a radical shift in character is itself an overarching sign that drug abuse may be occurring. The following are some additional behavioral signs of substance abuse:

• Sudden or progressive decrease in school or work performance
• Having financial problems, which may provoke a person to borrow money and not pay it back, steal, lie, or cheat
• Becoming secretive about how one spends time or money, or whom one is hanging out with away from home
• Having new friends, spending time in new areas, and/or using drug lingo
• Uncharacteristically getting into fights, engaging in illegal activities, or experiencing more accidents than ever before

One of the challenges prescription and over-the-counter drugs pose to the public is their benign appearance. On the one hand, these drugs are safe; on the other hand, if abused, they are exceptionally dangerous. The type of public drug education needed today cannot be the same as in earlier times. The dual nature of prescription and over-the-counter drugs – that they can help but also harm – is a main point that needs to be made clear to the public.

 

As the foregoing discussion notes, abuse of loperamide is relatively new compared to other drugs of abuse. From a recovery standpoint, however, loperamide abuse is 100 percent treatable. As the National Institute on Drug Abuse explains, there are two main components of drug recovery treatment: medications and therapy. Regarding medications, only a few drugs of abuse are treated with medications (during the detox and/or primary care phase). While loperamide acts on opioid receptors in the gut, treatment for abuse of this drug may not align with treatment for opioid abuse. A treating physician at the rehab center will explain to incoming clients whether any medications can be safely used during the detoxification process or if a tapering process is recommended.

While the use of targeted medications is limited to specific drugs of abuse, therapy is used to treat the abuse of any drug. The goal of therapy is to address the emotions and thoughts that underlie the drug abuse. For this reason, therapy does not revolve around the type of drug abused but rather the abuse itself. There are numerous research-based therapy approaches being used in rehab centers across America, including but not limited to Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Motivational Interviewing, and 12-Step facilitation therapy. Individuals in treatment generally receive both individual and group therapy to address and heal the drug abuse. These therapies, in addition to others (depending on the rehab program), can be used to help a person recover from loperamide abuse.

While medications and therapy make up the core of rehab services, there are several additional forms of treatment that a rehab program may provide. The following is a partial list of supplemental and supportive forms of drug recovery treatment:

Whether a person is abusing loperamide to stave off opioid withdrawal symptoms or to experience a high, rehab services can help. Presently, entering a rehab program is the most universally recommended way to treat addiction. In addition to addressing the addiction head on, a person can learn skills and develop tools to create a blueprint for a drug-free life. Though a person’s life may go down the path of addiction, there is always an exit. For many, rehab provides that exit.