Epidemiologic Trends in Loperamide Abuse and Misuse

Area of Science:

• Toxicology
• Public Health
• Pharmacology

Background:

• Loperamide abuse is increasing in the US.
• It is used to manage opioid withdrawal or for euphoric effects.
• The FDA warned of serious adverse events, including cardiac dysrhythmias and death.

Purpose of the Study:

• To determine trends in intentional loperamide abuse and misuse.
• To report clinical effects and management of loperamide exposures.
• To analyze medical outcomes reported to poison centers.

Main Methods:

• Assessed loperamide exposures reported to the National Poison Data System (2010-2015).
• Analyzed demographic and temporal trends.
• Examined reported clinical effects, medical management, and health outcomes.

Main Results:

• Reported exposures increased by 91% from 2010 to 2015.
• Exposures rose by approximately 38 cases per year.
• Fifteen deaths were reported, 8 involving single-agent loperamide abuse.

Conclusions:

• Loperamide abuse and misuse are projected to increase without intervention.
• Healthcare providers should consider loperamide toxicity in patients with opioidlike toxicity.