When compared to morphine, loperamide has been shown to be 40-50 times more potent in producing antidiarrheal and central nervous system (CNS) depressive effects. After subsequent studies, in 1988 it was approved for over-the-counter (OTC) use for diarrhea as well.

Loperamide made its debut on the market in 1976, after being approved for the prescription use of chronic and acute diarrhea. 3 Other medications being abused are loperamide (Imodium) and diphenoxylate + atropine (Lomotil) 2 drugs holding labeled indications for the treatment of diarrhea. A drug commonly prescribed for the off-label management of diabetic neuropathy, but holds label and off-label indications for a variety of other diseases too, such as partial onset seizures, post-herpetic neuralgia, social anxiety disorder, alcohol withdrawal, and even hiccups. In recent years, a few unlikely drugs have surfaced, and are now being labeled, as part of the opioid crisis. 1 Unfortunately, the stricter the regulations on prescription opioids become, the more clever individuals with substance use disorder seem to become as well. 2 Today, both federal and state governments are taking extreme measures to try and reduce the number of people being prescribed, and subsequently overdosing on prescription opioids. 1 The start of this opioid crisis can be traced back to the late 1990’s, and there has been an increasing trend in overdoses as the crisis had taken flight. The number of people chronically abusing and/or falling victim to fatal overdose due to excessive ingestion of opioids has skyrocketed in the past 15 years.

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