Imodium (Loperamide) abuse has emerged as a significant problem among people attempting to undergo withdrawal from opiates. In the United States, an estimated 2.1 million people are addicted to prescription painkillers, with another 467,000 addicted to heroin, reports the National Institute on Drug Abuse. One of the biggest barriers to overcoming addiction is making it through the tough withdrawal process.
Withdrawal from opiates is associated with diarrhea, nausea, aching muscles, runny nose, chills, sweats, and powerful cravings. Taking Imodium (or loperamide), an over-the-counter drug, can ease these symptoms. Unfortunately, people trying to go through opiate withdrawal soon find themselves dependent on Imodium / Loperamide, taking 100 pills or more each day.
Imodium / Loperamide Uses and Facts
Imodium / Loperamide is an opioid receptor agonist, meaning that it binds to and stimulates opioid receptors. The drug primarily works on receptors in the gastrointestinal system, where it decreases activity of the smooth muscle of the intestine. This allows more water to be drawn out of the contents of the intestine, making Imodium an effective anti-diarrheal medication.
When taken as recommended, Imodium / Loperamide primarily affects the intestines and is not habit forming. However, small amounts of the active ingredients do have the ability to cross the blood-brain barrier and enter the brain. Once there, it can act on opioid receptors in the brain, similar to (but less potent than) the ways in which prescription painkillers or heroin act.
Opiate Withdrawal and Imodium / Loperamide Addiction
When you first began taking opiates, your body started changing to accommodate the drug use. This includes making more opioid receptors and altering the sensitivity of existing receptors. The withdrawal symptoms triggered when you stop using opiates are the opposite of the drug’s typical side effects. This includes diarrhea, anxiety, sweating, and dilated pupils.
As soon as your body enters the withdrawal stage, you may notice a difference in your gastrointestinal activity. Opiate withdrawal often involves severe cramping and diarrhea. This is why many people turn to Imodium to treat diarrhea and related symptoms. Although the recommended dose of Imodium is no more than 16 mg (two 2 mg pills, up to eight times per day), many people take 60 mg or more when they are going through the withdrawal process. These large doses can cause Imodium to be habit forming.
America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. National Institute on Drug Abuse. Retrieved on August 24, 2015.