Since the news story about Loperamide Abuse broke last week, based on a study published in the Annals of Emergency Medicine, I’ve seen a bit of disinformation spreading around. Lots of misinformed comments on the news articles. There are many pieces written on Sobrietyland (like this, and this) dealing with the facts about Loperamide, its history, what it does in overdose situations, and offering my own experience, strength, and hope regarding loperamide addiction.
That said, let me clear a few things up for those commenters out there:
Some Random Factoids/Answers:
1. Yes. Imodium and Loperamide are essentially the same thing.
Imodium is simply a brand name for the drug Loperamide (just like Tylenol is a brand of the drug Acetaminophen).
Loperamide (pronounced low-PARE-a-mide) tablets have Loperamide HCl as their main ingredient. Inactive ingredients in the pills are generally fillers and binders. This is not true of liquid or combination formulations. Addicts generally use pill form loperamide. Generally speaking, users commonly call the drug Lope or Loperamide. Most consume it in pill form.
2. There are two types of Lope abuse going on.
- Some people use the drug recreationally as a means of getting high or as a mildly euphoric substitute for their opiate drug of choice. They’re usually disappointed as loperamide does not make a person high like a traditional opiate.
- The majority of users are opiate addicts trying to find a way to take away the withdrawal symptoms from their drug of choice (heroin, oxycontin, vicodin, etc.).
- Some stop using loperamide after a week or so, being on it just long enough to through the initial withdrawal sickness.
- A large proportion of people, however, do not stop and, over time, end up just as addicted to the loperamide as they would be to a more stereotypical opiate.
3. Addicts don’t buy brand name.
At least the ones I know don’t. So don’t bother pointing your finger at Johnson & Johnson, the makers of Imodium Brand loperamide. It simply isn’t all that popular in abuse situations. Generic loperamide is significantly cheaper and can be purchased in bulk from everyday pharmacies as well as Walmart (Equate) and Amazon (Kirkland). That, in and of itself, is a problem.
4. Selling Loperamide in bulk is an unnecessary and dangerous practice.
If you need loperamide for the occasional case of diarrhea, you should be able to purchase it. But do you really need 2800 tablets of it?
What do addicts buy? Big bottles. Selling 200+ pills at a time only serves to encourage the addicts to use more and exploits the abuse situation. And if you think 200 pills at a time is a lot, you can buy 2800 on Amazon for $50. A healthy person using Imodium as directed, would never need that much; anyone with IBS or another intestinal disorder should only use larger quantities under the direction of their physician. Reviews on Amazon like what is shown below are on most of these bulk Loperamide items. This seller definitely knows his buyers are abusing the Loperamide they purchase from him. That’s why this dude sells so many in bulk.
By [REDACTED] on September 20, 2015
Verified PurchaseMassive amounts of “lope” . Great with an antacid like tagamet beforehand and washed down with white grapefruit juice. Works wonders. YES it does cross the bbb, or accumulates or overpowers the PGP inhibitors or whatever it works
5. Poop jokes aside, this is serious.
Yeah. Okay. Funny. We get it. Make all the poop jokes you want. We all know it’s coming. “No shit!” is the most common one. Get it all out of your system.
Then, respect the science. Loperamide is an opiate just like any other (though it was previously believed to be abuse-resistant, it’s not abuse-free). It is an opiate first, and an anti-diarrheal second.
Want to know if these Lope abusers ever poop? Yes they do. Lope is no more constipating than any other “traditional” opioid like Vicodin or Oxycontin (even in high quantities). Speaking for myself, I ate a lot of fiber and never had much of an issue with constipation.
Remember too as you’re laughing about this, the reason this has become such a problem is SECRECY — embarrassing those who have a serious problem only discourages them from ever coming forward and asking for help. That’s how so many people are getting sick and dying. Your son or daughter could be doing this. If they wound up dead, how many people would you want snickering at their funeral? Just sayin’.
6. The news reporting Imodium abuse isn’t the same as giving permission.
Many people seem to think that by reporting loperamide abuse in the media that we are encouraging more people to try it. On the contrary: we want people to stop. Anyone with an internet connection can find out about using loperamide in mega-doses. That’s not hard at all. Anyone trying to detox off their favorite opiate has probably run across this “home remedy” in more than one internet search. And there are SO MANY sites and videos that tell people it’s perfectly safe and okay to take a hundred or so caplets of Imodium which is patently untrue. We are reporting that it will kill you. Addictions thrive in secrecy — bringing it into the open means that important conversations can start happening and fewer people wind up dead. And now that this story is hitting Big Media, more doctors and ER physicians will be made aware — they’ll better know what they’re dealing with and can save more lives. Addicts will know that Lope is not a safe substitute. It’s win-win for everyone.
7. Why is this making news when this has only happened to a couple of people?
It hasn’t only happened to a couple of people. The literature from the last couple of years reports numerous cases of this. On this site, I link to at least two dozen articles. And those are just the people who are in the case studies. Many more are not. And while Eggleston’s paper follows only two cases of people who died, many more deaths have been attributed to loperamide and anecdotally reported to me — and countless others hospitalized, many likely died because of the ignorance of the medical community and the patient’s fear of revealing their secret habit.
8. Some kind of regulation is in order.
Enough people have died or been hospitalized that this has been called “a growing public health danger,” so something needs to be done. Eggleston, et al, suggest that loperamide should become a restricted, over-the-counter medication (like Sudafed) that you have to request from your pharmacist. Loperamide started off life as a controlled substance, by prescription only. This would not re-schedule the medication, but make it so you would request a pack of Imodium from your pharmacist for occasional diarrhea instead of buying it off the shelf. It can also serve to restrict sales of high-quantity bulk packs. Perhaps those who require long-term use to control IBS can get a waiver. I’ll leave that up to the powers that be. If such a minor inconvenience could serve to save the life of you or someone you know, is that really so bad?
9. Just let ’em all die is not an option.
Come on folks, seriously? The number of letters I receive from parents, siblings, brothers, sisters, friends, spouses, and the addicts themselves speaks to the desperation and heartbreak that addiction causes. Calling for the death of all addicts is just insane. The next addict you see could be someone you love — they may be there already, but they’re afraid to tell you because they know you will treat them with contempt instead of kindness. Nice job.
10. Who am I and what do I have to do with any of this?
I’m the index case. Patient zero. The canary in the coal mine. The warning shot. The first reported case since one overdose received a paragraph at a medical conference way back in 1994 (if you dig deep enough, you might find that one). I’ve been here long enough to know the history of this thing. The researchers from Upstate Poison Control who wrote the most recent paper, “Loperamide Abuse Associated With Cardiac Dysrhythmia and Death” are the same ones who treated me back in 2012, and published my case later that same year. I thank them for my life every day and have been willing to set aside my own dignity to try to save the lives of other addicts following the same tragic path. I’ve made it my mission to gather data about loperamide abuse and help disseminate it to the general public, fellow addicts, and any medical personnel willing to listen.
Make my life matter: learn from me.
I can be reached via email at firstname.lastname@example.org.
“If you can quit for a day, you can quit for a lifetime.” – Benjamin Alire Sáenz