The FDA has recommended that loperamide (brand name: Imodium) be sold in limited quantity and in blister packs in the hope that such a move will stifle the growing problem of addicts abusing the drug.
If the manufacturers agree, it’s a terrific first step in preventing deaths from loperamide abuse.
My longtime readers know that I, myself, was addicted to loperamide for a couple of years. I was also the Index Case in this loperamide abuse crisis — having gone into cardiac arrest and almost dying in February 2012 from an overdose of the drug. Lots of research has gone on since then. (Please feel free to peruse my site for more information on this).
I became convinced that I could help prevent people from dying as I did. So, for a few years now, I have worked with the toxicologists at the Upstate Poison Control Center in Syracuse NY to battle this ongoing problem that has become part and parcel to the nation’s Opioid Epidemic. The doctors at Upstate have seen countless patients presenting in their emergency rooms, some of whom have sadly died as a result of abusing loperamide.
I’d like to think that my efforts, in some small part, have contributed to the research in this field and in changing attitudes of healthcare workers and the general public toward those with addiction issues. I hope that, perhaps this recommendation — requesting that the manufacturers and sellers of Loperamide voluntarily comply with the new FDA recommendations of limits on the packaging — will save some lives.
In a nutshell (TL;DR) the recommendation is that loperamide be sold in smaller quantities — instead of selling bottles of 200 — and that they are blister-packed instead of sold loosely in a bottle. This allows the general public to still have access to necessary medication but limits the addict’s ability to get into trouble.
For those who are already addicted, now is your wakeup call. You may, like me, have been waiting for the “right time” to get off the drug. Now is that time. Get yourself into a treatment program where you can get the help that you will need! Outpatient may be all you need — you may not need residential treatment. Treatment for loperamide addiction follows much the same course as a traditional opiate with certain exceptions due to the nature of the drug. Talk to a treatment counselor. Ask lots of questions. Let them work with you to form a TEAM to fight the addiction. You CAN do this — I know because I did (and I’m the hardest-headed person I know!).
Don’t wait or it’ll be too late.
And to those on Amazon (and other sites) who sell Loperamide in ridiculously high quantities (like, 2400 tablets at a time) knowing that addicts are your number one customer: YOU ARE ON NOTICE. Enjoy your sales now because it will end soon. I have a particular set of skills. Skills acquired over a very long career. Skills that make me a nightmare for people like you. I will look for you, I will find you, and I will make you stop selling drugs to people and killing them. You will be held accountable.
Push your shit somewhere else. I’m shutting you down.
From the FDA News Release:
Today, toward these goals, we have taken a new action related to how one opioid product is packaged as a way to help address a growing problem of abuse and misuse of this product. The FDA is requesting that sponsors of OTC loperamide ‒ an FDA-approved product to help control short-term symptoms of diarrhea, including Travelers’ Diarrhea – change the way they label and package these drugs to stem abuse and misuse that leaves us deeply concerned.
Abuse of loperamide has been increasing in the United States. When used at extremely high and dangerous doses, it’s seen by those suffering from opioid addiction as a potential alternative to manage opioid withdrawal symptoms or to achieve euphoric effects of opioid use. The maximum approved daily dose for adults is 8 milligrams per day for OTC use and 16 milligrams per day for prescription use. It’s sold under the OTC brand name Imodium A-D, as store brands, and as generics.
Loperamide is safe at these approved doses. But when higher than recommended doses are taken we’ve received reports of serious heart problems and deaths with loperamide, particularly among people who are intentionally misusing or abusing high doses. The majority of reported serious heart problems occurred in individuals who were intentionally misusing and abusing high doses of loperamide.
The FDA added a warning to the product label in the spring of 2017 to warn of ingesting high doses of loperamide, including from abuse and misuse. Evidence suggests that package limitations and use of unit-dose packaging may reduce medication overdose and death.
Today we sent letters to the OTC manufacturers requesting that they implement changes consisting of packaging limitations and unit-of-dose packaging. We’re requesting that packages contain a limited amount of loperamide appropriate for use for short-term diarrhea according to the product label. One example is a single retail package containing eight 2-milligram capsules in blister packaging. We asked the manufacturers to take the necessary steps to implement these changes in a timely fashion to address these public health concerns.
I also plan to reach out to those who distribute loperamide online, through retail web sites, to ask them to take voluntary steps to help us address this abuse issue. The new packaging should help make limits on sales more easily achieved. The abuse of loperamide requires the purchase of extremely large quantities. Often this is done through the purchase of large bottles of loperamide, which is a common configuration in which the pill form of the medication is currently packaged. Today’s action is intended to change how the product is packaged, to eliminate these large volume containers. We know that many of the bulk purchases of these large volumes are being made online through major online web retailers.
I believe anyone who is distributing health care products has an obligation to be a partner in helping address the most pressing public health challenges like opioid abuse. If you’re selling a drug with the potential for abuse and misuse through an online website, you’re no longer in the business of selling widgets, or books. You have a social contract to take voluntary steps to help address public health challenges.