Costco is now limiting loperamide purchase to one box.

Loperamide may end up behind the pharmacy counter in the near future because opiate junkies are getting high by using up to 100 pills at a time. 

Frankly, that scares me because I rely on their low-cost loperamide. Prohibition sucks. I found out when I went to Costco yesterday and they blocked me from buying 3 boxes. I'm not sure it has spread nation-wide yet. 

Anyone else see this? 

Original Post

Hey CTB, I think real deal addicts know how to work around those issues with stool softeners, etc.. It's an Art form to these folks. I believe street drugs like Heroin block you up really bad. It just sounds like the DEA is overreaching like they usually do. Let's stop one guy from ODing at the cost of screwing over millions of Americans. I was reading last year about junkies figuring out how to cook and inject the anti-depression drug Wellbutran. You can't stop junkies. I'd just rather see that policing money go into treatment instead of punishment methods like limiting immodium to the public. Who knows where it will go...

Actually Lomotil is diphenoxylate (plus a bit of atropine to discourage overuse), not loperamide. As folks upthread are saying, loperamide is Imodium. If loperamide purchases are being broadly curtailed, that will be a nuisance for many of us. I don't think it will prevent folks from getting what they need, but it might prevent stocking up, and add some extra trips to the pharmacy. I don't think there's much reason for panic buying or excessive stockpiling, since there's no reason to expect true shortages.

In the big scheme of things it just creates another annoying life inconvenience. I'll be able to get immodium prescriptions worst-case unless I end up without health insurance. If the DEA has moved on it with Costco there will be more to come in the future. 

Janpiep, it turns out if you blend 100, 2mg immodium pills in a milk shake you can get high similar to a methadone high (drug used to kick heroin). Currently the underground scientific community is working on street drugs that will bypass the gut mechanisms so smaller doses of immodium can get you very high. That's the future. 

Well, maybe it will go the other way, Marie. It's kind of got me between tears and rage. There are millions of people who rely on Costco for immodium with different bowel conditions. 

I also take opiates to manage chronic pain so it just feels like the system is closing ranks on me. This somewhat fabricated patient opioid epidemic comes above and before patient drug care and access needs. It's really sad. The FDA and DEA are beholden to no one and impose their rules on us with no voter representation.

Seriously, how many people are out there ODing on immodium? Ridiculous. 

Imodium and Lomotil are totally different classes of drugs never mind prescription or over the counter. Imodium is a pure anti-diarrheal. Lomotil has both anti-spasmodic and anti-diarrheal properties. There should be no confusion about this and everyone should understand what these drugs do when you put them in your body. I was given Lomotil due to a very spasmodic Pouch after takedown which is not the same thing as a runny pouch. A spasmodic Pouch is one that causes bursts of bowel movements right after meals, due to excessive peristalsis. If you throw Imodium at that issue it will not go away and will get worse.

Slouchy, you are probably right that sophisticated and veteran narcotic users know how to counteract Imodium with high powered laxatives. I had a client who had triple cervical fusion surgery and told him to take it easy with the pain meds they gave him and he stated to me he could not get constipated because he has ulcerative colitis. Well he ended up having to have an emergency fecal disimpaction. I will spare you all the details of that procedure but my client likened it to a horrible medieval torture. He is now very afraid to take any pain meds.

I don't know what Costco charges for it, but as an alternative, you can still easily get however much Kirkland brand "loperamide" you want on-line via Amazon or ebay - decent prices, often-times free shipping.   How long this will be available, who knows.

n/a, the sellers on ebay/Amazon buy in massive bulk from Costco and earn pennies on each sale. That's the reseller business model in a nutshell. The prices almost doubled overnight on Amazon and Ebay because they now have to deal with the same restrictions. That's where I usually go as online wasn't much more than in store. I saw the sky high prices and figured I'd stock up at Costco. Then at Costco I experienced the limit - which made sense and correlated with the increased online pricing. 

I haven't been able to find anyone that comes close to Costco's price per pill. They are the gorilla of the immodium sellers. 

I'd love to send a complaint to Costco but I doubt anyone who mattered would see it. It's unfortunate. 

Slouchy,

Even if someone at Costco who "mattered" saw your complaint, how would they know you aren't a desperate, narcotic seeking junkie determined to bypass their rules?  The answer is, they wouldn't.  So I doubt it would get anywhere.  It's an unfortunate fact that all of us need medications that cost a lot, or too much. 

This discussion reminds me of a high school classmate of mine who, as a medical doctor specializing in internal medicine, ended up being investigated by the DEA for overprescribing narcotic meds to his patients.  This investigation came after he prescribed narcotic painkillers to a patient of his who notably lived 180 miles away from his office and later died of an overdose of meds he had prescribed.  Apparently word was out on the street about this guy, for the patient who OD'd to know where to go.  The DEA actually accessed some database that showed he had prescribed the 7th highest amount of pain meds in my State during a specified period of time, so he had been on their "watch list" of doctors who were giving out the narcotic meds like candy.  When the investigation revealed he had prescribed meds and billed treatments to Medicare for patients who died or did not exist, it was basically over.  He pled out to all charges and is now serving time in federal prison.  The moral of the story is this drug epidemic is a HUGE problem, and because it's being coupled with Medicare fraud it is on the radar of both DEA and the FBI.  I also have a high school classmate who works for the FBI in the Medicare fraud unit, so I hear a lot about the general concerns of law enforcement in this field.

It's sad that it effects all of us in this way, but this narcotic drug epidemic is a huge problem that we have to do a better job with as a country and a society.

I don't have a solution, and the impact on access to medication upsets me, but the epidemic isn't the least bit fabricated, Slouchy. Here's some information from The New Yorker today:

"Opioids now kill more than 50,000 Americans a year, 10,000 more than AIDS did at the peak of that epidemic - more, too, than gun homicides and motor-vehicle accidents. Opioid overdose is now the leading cause of death for Americans under the age of 50."

I feel bad for those people... really I do but we NEED our meds just to exist and try to live a half decent Life... I am living with Metastatic Colon Cancer and I just started Keytruda on October 9Th and let me tell you the frequency is twice as much as I went before and I’ve always had high frequency! I take both Lomotil and Imodium together and thy helps but I may now have to add another something to this (what I think is a boring cocktail)! 

Dont know what all the hype is about I’ve NEVER come close to getting high from either drug!!!

Yea, fabricated was the wrong word. It's definitely misconstrued to make it seem like people are dying because of prescription drug overdoses alone. The statistics are fudged and the prohibition crowd cherry picks. Most people who OD have a mix in their system, primarily street drugs on top of prescription opiates. You can verify all of this by looking at legitimate DEA/FBI statistics. Canada and the UK don't have problems to this level because they have social medical systems so addicts can get methadone instead of needing to glug down an immodium milk shake. 

Prohibition just doesn't work no matter how you skin that cat. In WA state, plenty of the OD deaths over the years were due to the state skimping on opiate costs. Our medical board wanted to patients to use less costly drugs like methadone for pain (Oxy was more expensive) causing elderly people to stop breathing.

The issue is complex but punishing the majority because of a minority is not the answer. It certainly doesn't pass my ethics radar.

In Alaska, our homeless Indian population drinks mouth wash (like Scope) for the Alcohol content. Does that mean we need to restrict the sale of Scope? Nope, it's absurd when you think about it from that perspective. Are the millions of legitimate Scope users more important than a a few abusers who die of alcohol poisoning from drinking 10 bottles of Scope? I think so.


Slouchy,  

You use the word "prohibition" and are assuming that part of this "prohibition" is to appease the DEA (which is probably true), but another part of it is to protect Costco from litigation for the wrongful death of someone who ODs ingesting both imodium and narcotic drugs, or other detrimental health impacts from the overuse of this product (including fecal disimpactions on those not savvy enough to use stool softeners).  We don't know that such litigation has not already happened. Whatever the federal regulation is, is what it is, and Costco must by law abide with it, but if industry standards are changing and overdose patterns are being connected to the Imodium product, both the manufacturer and the retailer have to take steps to prevent themselves from litigation if they are putting a potentially defective product on the market.  Imodium taken in normal quantities is probably not a defective product, but for purposes of statutes and regulations, if sold in a sufficient quantity to enable the causation of overdose in combination with other drugs, it may be deemed a defective product in the market place.  The resulting lawsuits would burden Costco, if they did not protect themselves on this one.  One thing the public does not understand is that regardless of merits, lawsuits have to be defended and they cost money to defend.  I am an insurance defense attorney, have defended many frivolous lawsuits in my day and I got paid by the hour on every one of them from start to finish.  You do not wave a magic wand and make a frivolous lawsuit go away.  But even if it has some slight merit to it, it will need to be defended in court and at great cost.  Multiple that by 10 or 100 or 1000 and it gets worse.  Stores like Costco are huge targets for lawsuits.  I know because I have defended restaurants and large corporate retailers, and with large corporate retailers and wholesalers, they are huge targets.  In my experience the only less likeable defendants in front of a Connecticut jury are tractor trailer drivers, due to the nature of our highway system and I-95 being a corridor through which there is a very heavy tractor trailer traffic and many serious car accidents caused by this traffic.  Juries do not like some of the large corporate retailers operating physical stores where people slip and fall and have accidents, and they like them even less in this age of e-commerce and Amazon.

I am also questioning your use of the term "majority" and "minority".  Is the number of potentially affected narcotics addicts a "minority" in comparison to the people who need to buy more than one bottle of imodium in a year or two? I think not.  Certainly not from the DEA's, or any governmental regulatory agency standpoint.  I use Imodium as well, although for some reason I do not need very much. My body reacts very sensitively to it, meaning 2 pills will REALLY thicken me up and sometimes I will only need one in a day.  I seem to be lucky on that count.

CT, I see your points. I lean libertarian when it comes to  medicine access/availability. I'd like Costco to address it publicly but they just kind of snuck in the change in the last month or two. A sign next to the loperamide stand with a clear explanation might be useful instead of snatching the extra boxes at the register. It's poorly implemented. I bet it is DEA appeasement related given the sweeping changes throughout the USA after the CDC guidelines were released.  The creep never ends. That and the employees are saying it is DEA related but the lawsuit angle makes sense. 

Mostly, this issue and the general opiate changes just bum me out and make it more difficult to get the medicine I need. IMO, the country needs a patient advocacy lobby to ensure changes are fair, useful, and don't impede pain treatment.

I've been taking 16mg daily for best results. I wish I didn't need any.

Slouchy, I did a bit of research and found this.  It seems like the FDA may also be involved in the regulatory part of it, whereas DEA is more the illegal drug enforcement side of it:

https://www.fda.gov/Drugs/DrugSafety/ucm504617.htm

From that it sounds like narcotics users are taking imodium to self treat withdrawal symptoms and are ending up with serious heart problems.  How many imodiums one must consume to get "high" is an interesting question, but I suspect many would be needed to do that trick, if in fact it can even be done.

I buy four bottles at a time, Kirkland, Amazon, just got some last week.  I take on average 3 a day, so this will last me a while.  It sounds like I'll need to pay a bit more, and 1 at a time. I'm good.  I can imagine the clerk who would see me buying four at a time of ADs!

 

@CALIFORNICATION

We are talking about the OTC stuff sold on Costco's warehouse floor. Kirkland brand Imodium. Non-prescription. I was freaking out because I don't want to see it go away or see its availability change. I've had some years in my life without health insurance and was able to survive by buying cheap Costco Imodium.

The opioid crisis is causing a lot of knee-jerk regulation that might affect the OTC availability of Imodium. That's my thought on it, anyway.

@Jan, I'm going to price out pharmacy loperamide with Costco. I buy a few medications and ask them not to bill insurance purposely because paying cash for a 12 month supply can be cheaper than using insurance/copays over months. It might be relatively cheap.

@CTB, yea you can buy more on separate visits. The limit seems to be based on the transaction so more transactions (more shopping days) shouldn't be a problem. My wife has been picking me up a box 1x per week at Costco so I can stock back up.

I recently went to Costco and found out they no longer produce the bottles of 200 caplets. I didn't know whether to laugh or blow a gasket when the guy tried to sell me a package of 36. I take six caplets a day.

I found some on Ebay for a somewhat reasonable price,  but now the price seems to have doubled.

Has anyone found a resource for reasonably priced imodium in larger quantities for us jpouchers?

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