An opioid epidemic is ravaging many cities in the United States, with many addicts graduating from pain pills to heroin. The federal government has been taking steps to try and cut down on the number of opioid overdoses – the CDC released new guidelines for physicians who prescribe the potent painkillers, and drug-makers have been churning out new versions of the medications that are difficult to crush, dissolve, and abuse.
But people in the grip of drug addiction will go to any length to get their fix, and researchers say the newest weapon in their arsenal is available at any grocery store or pharmacy, and costs just a few bucks. Opioid drug addicts are now turning to anti-diarrheal medicines to help them achieve euphoria, to help them handle withdrawal symptoms, such as Imodium A-D.
Drug addicts seek Imodium and other over-the-counter gastrointestinal medications because of their main ingredient, loperamide. The drug causes the intestines to work more slowly, which helps stop diarrhea. Loperamide is an opioid agent, however, and it helps bind receptors in the brain, resulting in a high similar to the kind you would get from prescription painkillers like OxyContin and Vicodin.
But unlike these prescription drugs, loperamide targets opioid receptors in the gut, not the brain. That’s because loperamide has difficulty breaching the blood-brain barrier.
Loperamide was approved by the FDA in the 1970s. Early pharmacological trials found that the drug posed “little threat of potential abuse.” 
But that was years before OxyContin reached the market. Experts say the drug changed everything.
Study author William Eggleston told the Chicago Tribune:
“People looking for either self-treatment of (opioid) withdrawal symptoms or euphoria are overdosing on loperamide with sometimes deadly consequences.
In a press release from the Annals of Emergency Medicine, Eggleston explained that anti-diarrheal medicines are safe in regular doses, but in order to get high, opioid addicts have to take huge doses, which is “extremely dangerous.”
In the journal, Eggleston and his team document case reports involving 2 patients who each took massive doses of loperamide. Both overdosed, and despite receiving emergency treatment, both died.
It’s all part of a disturbing trend.
The researchers report that between 2010 and 2011, there was a 10-fold increase in Web forum postings about oral loperamide use. About 70% of the postings discussed using the drug to self-treat painful opioid withdrawal, while the other 25% discussed using loperamide to get high.
The team also discovered a 71% spike in loperamide abuse/misuse calls to poison control centers across the U.S. between 2011 and 2014.
Eggleston, who works with the Upstate New York Poison Center in Syracuse, explained that loperamide is easy to and cheap to buy, and you’re not going to be labeled a drug addict for simply purchasing a bottle of anti-diarrheal medication:
“Loperamide’s accessibility, low cost, over-the-counter legal status and lack of social stigma all contribute to its potential for abuse.”
He added that the federal government’s crackdown on prescription painkillers has addicts “seeking alternative drug sources.”
A box of 400 Imodium tablets costs just $10 at virtually any big box store, and the pills work in the body in the same way as heroin, morphine, and oxycodone.
Dr. Jeffrey Reynolds, of the Family and Children’s Association, said:
“Folks that are desperately addicted, folks that are looking to stave off withdrawal symptoms will do whatever it takes sometimes, really extreme things. So in the scheme of things, taking 300 pills is not unheard of.” 
“Our nation’s growing population of opioid-addicted patients is seeking alternative drug sources with prescription opioid medication abuse being limited by new legislation and regulations. Health care providers must be aware of increasing loperamide abuse and its under recognized cardiac toxicity. This is another reminder that all drugs, including those sold without a prescription, can be dangerous when not used as directed.”
Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.