There’s a growing problem in the opioid fight: diarrhea medication

Read the original article source of this excerpt.

USA Today on 1/19/2020 by Jon Webb

(Opinion)

In September, the FDA stepped in to limit abuse of Imodium and other anti-diarrhea drugs. Apparently it’s a growing problem.

This lends itself to way more questions than answers, a friend of mine wrote on Facebook the other day above a weird photo.

It showed three boxes of Imodium A-D — that trusted anti-diarrhea medication — lying crumpled in a parking lot. What nightmarish emergency, he wondered, could have possibly led to this?

Turns out, it was nightmarish. Just not in the way most of us would think.

A few commenters on the post explained what was probably going on: People battling opioid withdrawal sometimes gobble Imodium by the fistful.

Imodium is the brand-name of loperamide: a drug that, if taken in gigantic quantities, can produce an opioid-like high — and present serious dangers to a person’s health.

I had no idea this was a problem. But apparently it’s nothing new.

According to U.S. News & World Report, the U.S. National Poison Data System reported a 90 percent spike in loperamide overdoses between 2010 and 2016.

Abusing the drug can, naturally, lead to horrific constipation. But it can also wreak havoc on your heart – usually through irregular heartbeats, the New York Times reported in 2016. Back then, overdose deaths had reportedly occurred in at least five states.

“Most physicians just recently realized loperamide could be abused, and few look for it,” the story read. “There is little if any national data on the problem, but many toxicologists and emergency department doctors suspect that it is more widespread than scattered reports suggest.”

A 2019 paper out of Rutgers University confirmed that. It said loperamide fatalities have spiked over the last few years.

All that has finally caused the FDA to step in.

In September, the agency announced it would limit Imodium A-D, Imodium Multi-Symptom Relief and Be Health Loperamide HCI capsules — as well as their generic offshoots — to 48 milligrams per package, or about 24 capsules per box. The maximum daily dosage is eight milligrams.

“Abuse of loperamide continues in the United States and taking higher than recommended doses can cause serious heart problems that can lead to death,” acting FDA Commissioner Ned Sharpless said in the release.

But the FDA isn’t going to come crashing through pharmacy windows if stores don’t follow those guidelines. The new rules are nothing more than voluntary.

That becomes pretty clear if you take a stroll through a local pharmacy.

Battling dirty looks from pharmacy workers and customers alike, I scoped out several stores around Evansville this week and found a variety of anti-diarrhea displays.

Some kept Imodium locked in clear plastic cases. Others sported cage-free boxes that held as much as 96 milligrams per package.

I suppose you could rant about how all this is a sign of a deteriorating culture. I can’t even buy diarrhea medication anymore without feeling like a drug addict!

The saddest part for me, though, is that people feel they have to resort to this. I hope whoever left those crumpled boxes behind can find the help they need to kick their addiction.