Loperamide abuse may not be a term that you’ve heard of, but the FDA believes that it is a danger to public health in the midst of an opioid epidemic. Loperamide, also known by the brand name Imodium-AD, is an over-the-counter anti-diarrhea drug. Although the problem is not widespread, apparently people with opioid use disorders have turned to the drug when desperate for some relief or to get a slight “high.”

Loperamide is a common drug used to battle flu, irritable bowel, food poisoning and other stomach cramps and diarrhea from unknown causes. You can buy it anywhere, and it’s entirely safe when taken as prescribed. The maximum approved daily dose for adults is 8 mg per day.

According to Wikipedia, loperamide is a drug that has been around since 1976. It has a good reputation and is on the World Health Organization’s List of Essential Medicines. The drug is considered safe, efficient, and essential in the treatment of disease.

The safety of this drug is now in jeopardy, however, as more people have begun to abuse it. In recent years, with the opioid epidemic raging, drug users have become aware that loperamide is opioid receptor agonist. Hospitals are seeing increased cases of people taking vast amounts of the drug to get high or ease withdrawal symptoms.

Loperamide Overdoses Increasingly Common

In 2016, the FDA directed companies to change product labels to warn consumers against ingesting high doses.

One reason for loperamide overdoses is people who believe that large amounts of the drug can ease withdrawal symptoms. They are desperate to get relief as they detox alone from heroin or other opioids. Because of this, people who are

Unfortunately, when people turn to this drug and take it in large quantities, they can cause heart problems for themselves. Some people have died when they ingest too much, but it’s unclear whether their deaths were from a heart problem or seizures.

When taken at high doses, drug interactions with commonly used medicines also increase the risk of serious cardiac adverse events. The FDA recommends that doctors refer patients with opioid use disorders for treatment if they are using the drug for relief or it’s suspected they want to use it to get high.

FDA Actions to Prevent Loperamide Overdoses

In 2016, the FDA asked manufacturers to put warnings about loperamide abuse on the boxes of the drug.

Now, the FDA is asking manufacturers to go a step further, and only sell small quantities of loperamide. Currently, people can buy the drug in bulk online and in discount stores, making it easy for a person to purchase hundreds of the pills for less than $20. Doctors sometimes recommend loperamide to treat “traveler’s diarrhea.”

The FDA worries that people who buy loperamide in bulk may be planning to use it as “poor man’s methadone.”