FDA presses for Loperamide restrictions

[sk8phaze (OP)]

https://www.washingtonpost.com/news/morning-mix/wp/2016/05/04/physicians-alarmed-by-abuse-of-over-the-counter-diarrhea-medicine-you-know-well/


Abuse of diarrhea medicine you know well is alarming physicians
By Ben Guarino Morning MixMay 4
 
(iStock)
When the emergency team arrived, it was already too late. The 24-year-old man, who had a history of opioid addiction, was not breathing and lacked a pulse. His case report, recently published in the Annals of Emergency Medicine, includes an unusual detail along with this all-too-typical tragedy: The responders found a half-dozen boxes of loperamide — a popular anti-diarrhea medication, sold over the counter as Johnson & Johnson’s Imodium or Medique’s Diamode — all completely empty.

Long considered an innocuous drug — the Centers for Disease Control recommends it for travelers who find themselves abroad with the runs — loperamide has been swept up in America’s ongoing opioid epidemic. Four in 10 Americans say they know someone addicted to opioid painkillers such as hydrocodone and oxycodone, not to mention those who are addicted to illegal opioids such as heroin. In a 2014 Senate testimony, the director of the National Institute on Drug Abuse, Nora D. Volkow, said that 2.1 million people in the United States were abusing or addicted to pain relievers.

Some of these people, pharmacists fear, are now turning to loperamide to reduce their symptoms. Or to achieve euphoria.

“Loperamide’s accessibility, low cost, over-the-counter legal status and lack of social stigma all contribute to its potential for abuse,” William Eggleston, an author of the case study and a pharmacist at Upstate New York Poison Center, said in a news release. Timed with their report, Eggleston and his colleagues released a searing statement against loperamide abuse on Tuesday, calling it “dumb and dangerous.”

The active ingredient in loperamide is an opioid, as is the active ingredient in Vicodin, Oxycontin and Percocet. But unlike the latter trio of drugs, loperamide is not used as a painkiller. Humans have opioid receptors in our guts and in our brains. Typical opioids can access both types of receptors. In fact, because painkillers can induce constipation when they interact with the intestine — and because so many Americans now take opioids — an ad for opioid relief made it to the commercials during the Super Bowl.

AstraZeneca: 'Envy'  Play Video1:03
 
But loperamide seemed to be different: all gut, no brain. A membrane called the blood-brain barrier, the popular thinking went, prevented the drug from stimulating the receptors in our heads.

The Food and Drug Administration approved loperamide in the 1970s, and early pharmacological trials left experts feeling confident the likelihood of addiction was low. “Loperamide poses little threat of potential abuse,” concluded one 1980 study in the journal Clinical Pharmacology and Therapeutics; the researchers reported that men randomly given codeine, a placebo or loperamide rarely reported loperamide as “dope” and “‘liked’ little or not at all.”

A few decades later, as the number of Americans addicted to opioids rises, loperamide’s fate changed. By 2013, reports of loperamide being used recreationally had circled the Web long enough for loperamide to pick up a nickname: “poor man’s methadone.”

[Officials reportedly probe possible Prince overdose involving painkiller Percocet]

A 2012 study of nearly 1,300 posts on online drug forums determined that people were dosing themselves with 70 to 100 milligrams of loperamide. The maximum recommended dose for diarrhea relief is 16 milligrams a day. As Eggleston put it: “People looking for either self-treatment of withdrawal symptoms or euphoria are overdosing on loperamide with sometimes deadly consequences.”

Just how significant a problem loperamide poses is uncertain. Eggleston and his colleagues believe that the Web-forum data, coupled with an influx of calls to poison-control centers, indicate loperamide abuse is on the rise. Between 2011 and 2014, according to their statement, U.S. poison-control calls reflected a 71 percent increase in people dosing themselves with high amounts of loperamide.

That doesn’t mean everyone should abstain from taking anti-diarrhea medication. In the recommended doses, the pharmacists note, loperamide is safe.

But it does indicate that the potential for abuse is real. Eggleston and his co-authors conclude their paper by urging the FDA to limit the sales of loperamide, in the same way that Sudafed and other over-the-counter cold medicines containing pseudoephedrine are sold only in small batches. “This is another reminder that all drugs, including those sold without a prescription,” he said, “can be dangerous when not used as directed.”

[sk8phaze (OP)]

1st kratom,  now loperamide? All these restrictions are only gonna make the situation worse IMO.

[Thoms]

Yep, we all knew the big three weren't going to last forever. The only thing we are missing is an article on seed abuse. I'm sure if I wanted to look I coulld pull one up pretty quick.  The nbottom line is that anything that is helpful for a junky is not okay with the normies. The junkys must be stopped at any cost!! Think of the children!!

[Chip]

This should not be happening. Yes, seeds next then tighter restrictions on Codeine, perhaps ... they are forcing everyone back to the street or into often unwanted Treatment.

Welcome to how it is in Oz ... this is why Methadone, Bupe or the 'street' are the ONLY 3 viable options. It sucks. I always thought that the USA was going to keep these "soft landing" products in the mainstream but apparently not. *shakes head*. a retrograde move.

We need to help each other even more now that all the backups are being pulled down.

[Oxyphile]

Wow, loperamide? Really? This is fucking ridiculous...god damn junkies overdosing on lope for euphoria! Personally I've never had much use for lope, but I know a lot of people swear by it. Sad to see another viable option being scrutinized and criticized in this manner. Stock up if you use it, I wouldn't be surprised to see crackdowns coming...

[Chip]

Will this not lead to a black market of lope ?

[Tainted]

Will this not lead to a black market of lope ?

if it stays legal/OTC/cheap in other countries, i don't see ANY possibility that this ends lope. all it takes is a couple of people in countries that havent restricted it starting a site on the darkweb or even a regular website that makes an effort to stay lowkey.

honestly, when i was younger, i disagreed with a lot of things that happen in america as they have a real impact globally, but the way things have been going the last 15 years, im starting to lose faith that this country can be fixed/saved in every regard (not trying to start a conversation on politics beyond harm reduction as this isnt the right place for it, but my point is meant to cover harm reduction as well as everything else). it's like anytime we have progress with anything the immediate knee-jerk reaction from 1/3-1/2 americans is 'we dont want that progress, we are going to jump 5 steps back then shoot ourselves in both feet'

[Tainted]

I really don't understand the logic here. People are taking it in doses larger than recommended. They liken it to pseudoephedrine because of that. Lope has killed less people annually then tylenol, people aren't getting high from it or catching a buzz, they are using it to treat medical symptoms. I get, but don't agree with, why medical marijuana is against the law (you can get high from it, but law needs to change) but that isn't the case here. So what the fuck? The next time someone dies from an overdose of ANY off-label use of medication, are we going to outlaw it?

[thetalkingasshole]

For some context
Loperamide was Schedule 5 until the early 90s I believe

[Fluffhead]

I'm gonna start looking hard for lope & stock up as much as I can afford. I've been talking to a couple members trying to learn as much as I can about it.  I'm probably gonna have to buy it off the Internet. Haven't seen it cheap in any stores around here. I'm supposed to be kicking now but I keep putting it off.  But anyday now,  I'm gonna have no choice but start  regardless of my comfort meds. I  have 5 weeks til I go back to work & I wanna be off the shit & partly recovered. Which means, I gotta get cracking asap!

I missed the kratom boat. I waited too long to contact mu & then a lot of other vendors looked sketchy. The only place in my town they sell it charges like .60 cents a gram. And this was run of the mill headshop quality. Finally a friend on FB shared their source with me but did so too late & it was a little weird.

The dude didn't have a page on his site to put in cc info. It said contact him directly. Maybe it's just me but it weirded me out a little. When i asked how to pay we linked up on FB and he sent me a pay through FB thing...I didn't even know you could do that. So I stared at the screen for like an hour contemplating and I asked him when he could get it to me by. He said no guarantee on the date but he uses usps.

From what I could tell on the shipping,  it would be in transit as the calender struck the 30th. Probably get here tue or wed of next week. I finally said fuck it & skipped it. I would be too sketcked out with this dudes laid back approach. Waiting on a bulk order through the mailman. I figured either way, I would feel like I made the wrong decision but at least I didn't waste the money and wig out between now and whenever a mailman knocked on the door.

Anyway, sorry for the kratom tangent but the point is I started thinking that even if I got it here before the 30th. I'd still be a little nervous ordering a bunch after the ban announcement. I would have preferred to have the kratom but I've kicked without it & I will do it again.

So, I've  never used lope either. But for many different reasons I'm gonna start stocking up now. I don't want to be in the same situation as the kratom doing a last minute scramble/panic. This aides won't make me or break me but I would like the option, not have someone else decide for me. We can see the writing on the wall. They want everyone going through sub/done or jails. The powers that be, insist on being included or its not allowed. Stock up soon my friends.

[dizzle]

Jesus christ, I just don't understand why they keep mentioning "they're using it to relieve withdrawl symptoms, and in some cases to achienve some euphoria", SO FUCKING WHAT? WHO CARES? they talk about it like it's a bad thing, it just doesn't make sense to me.

[Opi-ette]

No kidding! "They" need to be reminded that using lope to remedy the chronic diarrhea that comes with withdrawal, is technically not off label use
in that case. After all, it is an anti diarrheal medication, is it not?
This really chaps my hide. Thinking of all the suffering that restricting access to
lope will cause is just infuriating.

[Mr.pooper]

"Four in 10 Americans know someone addicted to opiates" should be simplified to 2 out of 5 Americans.

[QuittingTomorrow]

Yes, 1 out of 2 1/2 Americans know someone on opiates.

9 out of ten Americans know this country is too fucked to save.

Five out of ten Americans can't find Britain on a map.

Five out of ten Americans think Trump can fix things.

A few Americans know just how sad all this really is.

[Snoop]

You know,  despite myself.... I'm loped out today.

It's become a real "go to" when I get cute with my takehomes.

I didn't put much stock in it, til I tried it. It's not like 'holyfuckingshit WDs SMASHED!'

But it does afford me the ability to keep plodding along forward.

God for-fuckin-bid.

Should it be banned for working wonders on bubble guts too?

I mean.... Can't be relieving symptoms, no fucking way.