title: Loperamide misuse and abuse.
abstract: OBJECTIVE
  The epidemic of opioid prescription deaths in recent years resulted in the recent rescheduling of hydrocodone-containing products to restrict access to them. Opioid users have recognized that loperamide can ameliorate withdrawal symptoms and also produce euphoria in very high doses. This article discusses the potential for loperamide misuse and abuse and examines trends in the increasing number of published cases of loperamide toxicity.
  
  
  METHODS
  PubMed was used to search MEDLINE for case reports of loperamide abuse.
  
  
  METHODS
  United States.
  
  
  METHODS
  Numbers of cases of loperamide misuse, characteristics of patients, reported toxicities.
  
  
  RESULTS
  From 1985 to 2016, 54 case reports of loperamide toxicity were published, with 21 cases between 1985 and 2013 and 33 cases between 2014 and 2016. In addition, 179 cases of intentional loperamide misuse were reported to the National Poison Database System between 2008 and 2016, with more than half reported after January 1, 2014.
  
  
  CONCLUSIONS
  Loperamide misuse and abuse is increasing in the United States, and pharmacists are encouraged to monitor and restrict their sales.
authors.forename: Heather
authors.initials: H
authors.lastname: Miller
authors.forename: Ladan
authors.initials: L
authors.lastname: Panahi
authors.forename: Daniel
authors.initials: D
authors.lastname: Tapia
authors.forename: Andrew
authors.initials: A
authors.lastname: Tran
authors.forename: John D
authors.initials: JD
authors.lastname: Bowman
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008139:Loperamide / Q000008:administration & dosage / Q000009:adverse effects* / Q000506:poisoning; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D000701:Analgesics, Opioid; D008139:Loperamide