As an anti-diarrhea agent, loperamide works primarily on opioid receptors in your gut to slow down the movement of your intestines. That's why one of the side effects of loperamide and other opioids is constipation. The U.S. Food and Drug Administration (FDA) has deemed loperamide safe when used at approved doses, which for adults is a single 4 mg initial dose followed by 2 mg after each loose stool. As the FDA stated, each day the dose should not exceed 8 mg per day for over-the-counter use and 16 mg for prescription use.
However, putting hundreds of tablets in a blender and creating a constipation smoothie to drink is another story.
In one of the stranger consequences to come out of the opioid crisis, the Food and Drug Administration said it’s working with manufacturers to limit the number of anti-diarrhea pills in a box, hoping to discourage misuse and abuse by people taking large amounts to get a cheap, opioid-like high or to relieve symptoms of opioid withdrawal.
"We are starting to see more and more people coming to hospital or just dying suddenly at home courtesy of this drug that most of us perceive as pretty innocuous."
They call it the poor man’s methadone.
The epidemic of opioid addiction sweeping the country has led to another form of drug abuse that few experts saw coming: Addicts who cannot lay hands on painkillers are instead turning to Imodium and other anti-diarrhea medications.
Some people are taking extremely large doses of the anti-diarrhea medication Imodium in an attempt to get high, or to self-treat an addiction to painkillers, in what experts call a dangerous but growing trend.
What's that you say? You don't recall any buzz the last time you had the runs and resorted to a dose of Imodium? That's because the opioid effect kicks in only at very high doses, at least 10 times the recommended amount. Like other opioids, Imodium slows the system down, but in the case of Imodium's intended use, it works specifically on intestinal movement so that bowel movements slow down.
There has now been A LOT said about the Imodium/Loperamide crisis. And the media is getting a few things wrong in the translation. Let me clarify one particular thing that’s really been bothering me. They said that Imodium gets you as high as heroin or oxycodone if you take it in a large enough dosage. Not really.
“We’ve had patients tell us they take 400 to 500 tablets day … They put it in a blender and make a smoothie and drink it over one or two hours.”
Why suffer when you can treat diarrhea and get on with your day? IMODIUM® products contain an active ingredient called Loperamide, which works to help restore your body’s natural rhythm so you can start to feel like yourself again.