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Imodium Addiction: Why Are Some People Hooked on the Anti-Diarrheal Medication?

By Lan Pham, Jacqueline Hensler
Medically Reviewed by Yilang Tang, MD, PhD on July 26, 2021
For individuals dependent on opioids and experiencing withdrawal symptoms, it may be enticing to self-treat with the medication Imodium. In high doses, Imodium can have undesirable side effects.

Sometimes, a person experiencing an opioid addiction may want to maintain a high or self-treat withdrawal symptoms. In order to attempt this, they may turn to the over-the-counter diarrhea medication Imodium. Read on for more information about the connection between Imodium and opioids.  

What Is Imodium? 

The key ingredient in Imodium is loperamide, an antidiarrheal drug taken to ease symptoms of diarrhea. Imodium slows down intestinal movement while reducing bowel movements. It also helps to reduce loss of fluid that occurs with frequent diarrhea. 

You can purchase Imodium over-the-counter and take it in capsule, tablet, or liquid form. The medication is safe to take if you follow its recommended dosing information.

Imodium Misuse

According to a 2019 article published the Journal of Addiction Medicine, high concentrations of loperamide can create opioid agonism in the central nervous system. This means that an excessive amount of the drug can effect your brain in the same way that opioids do.

A person experiencing opioid addiction may therefore turn to Imodium if their drug of choice becomes unavailable to them, or if they want to ease the symptoms of withdrawal. The recommended initial dose of Imodium is 4mg (two capsules) followed by 2 mg (one capsule) after each unformed stool. Daily dose should not exceed 16mg (eight capsules) for adults. An abuser of loperamide “may take around 30-100 times the normal dosage,” Michael Damioli, LCSW, CSAT, an addiction specialist, tells WebMD Connect to Care.  

“[Loperamide] is technically a substance that acts similarly to an opioid medication, but it doesn’t penetrate your brain unless in very high concentration,” Damioli says. “There are anecdotal reports of Imodium creating euphoria and intoxication in high enough doses, but no report has shown it to have pain-relieving effects,” Damioli adds.      

The number of people addicted to loperamide is relatively low. Imodium addiction is so unique that it’s generally only seen in individuals who are already addicted to other opioids, such as heroin or oxycodone. “I see Imodium abuse in one to five percent of opioid users and it is always in addition to other opioids being abused as a self-treatment for opioid withdrawal,” Damioli says. 

Side Effects of Imodium Misuse

Abuse of Imodium can produce unpleasant side effects which may include: 

  • Cramping 
  • Constipation 
  • Vomiting 
  • Headache 
  • Nausea 

Sustained, heavy use of the medication may lead to multiple health problems. “A risk of overuse of loperamide is possible long-term damage to the gastrointestinal and cardiac systems,” Damioli says.

Misusing Imodium is not a healthy option for leaving an opioid addiction behind. There are steps you can take to prevent an addiction to medications. Additionally, outpatient or inpatient treatment can be a great help in the recovery process. 

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