Loperamide is a medication that is used to treat diarrhea or loose stools. It is often used in people that have an ileostomy (an opening in the abdomen for waste to leave through) to reduce the amount of stool they produce. It is also used to treat people with inflammatory bowel disease. Loperamide works by slowing down the movement of the gut which decreases the number of bowel movements and makes the stool less watery. Loperamide does not treat the cause of loose stool or diarrhea, it only treats the symptom. Loperamide is available as a prescription and also as an over-the-counter medication. 
Is Loperamide an Actual Opiate?
Loperamide is classified as an anti-diarrheal medication, however, it acts peripherally as a synthetic opiate or mu-opioid agonist and blocks opioid receptors in your gastrointestinal tract. When taken in large doses, this medication can cross the blood-brain barrier and cause some opioid-related effects. Believe it or not, loperamide is often abused.
Can Loperamide Actually be Abused?
With the current opioid epidemic, abuse of loperamide has risen quite extensively. Since loperamide acts as an opiate, people that are experiencing withdrawal from opioids will often take the medication in large quantities to manage withdrawal symptoms. Individuals have even used the medication to try to get high or experience euphoria. Loperamide is designed to not produce any psychoactive effects, but at extremely high doses, it can cause some heroin-like effects. Those that abuse the medication will usually take 10 or more of the recommended dose to offset withdrawal symptoms or try to experience euphoria.
Loperamide is Recognized as a Mild Opioid Receptor Agonist
The National Institute of Health talks about loperamide abuse because it has been a growing problem in recent years:
At therapeutic doses (16 mg or less per day), loperamide is an opioid with psychoactive effects that are limited by poor absorption when taken orally and active efflux from the central nervous system by the membrane transporter P-glycoprotein. Recreational use of loperamide for its euphoric properties or to lessen symptoms of opioid withdrawal involves large oral dosages (more than 70 mg per day) with or without intentional ingestion of P-glycoprotein inhibitors such as quinine. Because of its opioid effects, nonprescription status, and low cost, loperamide is sometimes referred to as “poor man’s methadone.” Of 179 cases of loperamide abuse reported to the United States National Poison Data System between 2008 and 2016, about half were reported after 2014; 137 (77%) involved men and the median age was 26 years. (NIH)
Taking large doses of loperamide is extremely dangerous. It can cause cardiac arrhythmia and/or respiratory depression which can lead to death.
Can Loperamide Cause a Positive Test for Opiates on a Drug Test?
Loperamide does not show up as opiates on a drug test. It is not an opiate medication, it is an anti-diarrheal. For loperamide to show up on a drug screen period, it would have to be specifically tested for. Even when loperamide is taken in high doses, it would not cause a false positive reading for opiates on a drug test.
Treatment for Opioid Use Disorder
If you or someone you love is abusing loperamide and you are concerned, help is available. If you or someone you love is struggling with any type of addiction, our addiction specialists are available around the clock to assist you. Evoke Wellness at Miramar offers cutting-edge opioid addiction treatment that includes medical detox, a residential level of care, and outpatient programming. We offer a safe environment and treat our clients with respect. We specialize in making sure our patients have the most comfortable detox process possible. You no longer have to continue to suffer out of fear. Give us a call today for more information on how to permanently overcome your or a loved one’s addiction to opiates.
