Epidemiologic Trends in Loperamide Abuse and Misuse - 19/04/17
Abstract |
Study objective |
Loperamide abuse has been increasing in the United States as a potential alternative to manage opioid withdrawal symptoms or to achieve euphoric effects of opioid use. In June 2016, the Food and Drug Administration warned health care providers and the general public about potential serious adverse outcomes, including cardiac dysrhythmias and death. The purpose of this study is to determine recent trends in intentional loperamide abuse and misuse, reported clinical effects and management, and medical outcomes as reported to poison centers across the United States.
Methods |
Loperamide exposures reported to the National Poison Data System indicating intentional misuse, abuse, and suspected suicide between January 1, 2010, and December 31, 2015, were assessed. Demographic and temporal trends, as well as reported clinical effects, medical management, and health outcomes, were analyzed.
Results |
There was a 91% increase in reported exposures from 2010 to 2015, of which half were single-agent loperamide use only. Loperamide exposures reported to the National Poison Data System increased at approximately 38 cases per year (95% confidence interval [CI] 32.5 to 42.9; P<0.0001). Fifteen deaths were reported during this time frame, of which 8 involved single-agent loperamide abuse.
Conclusion |
Loperamide abuse and misuse are projected to increase in the absence of any methods to reduce exposure or curb abuse. Health care providers should consider the potential for loperamide toxicity when managing patients with opioidlike toxicity.
Le texte complet de cet article est disponible en PDF.Plan
| Please see page 74 for the Editor’s Capsule Summary of this article. |
|
| Supervising editor: Richard C. Dart, MD, PhD |
|
| Author contributions: All authors were responsible for design and conduct of the study and preparation, review, and approval of the article. JPV was responsible for collection, management, analysis, and interpretation of the data. JPV takes responsibility for the paper as a whole. |
|
| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. |
|
| The American Association of Poison Control Centers (AAPCC) maintains the national database of information logged by the country's poison control centers. Case records in this database are from self-reported calls; they reflect only information provided when the public or health care professionals report an actual or potential exposure to a substance (eg, an ingestion, an inhalation, a topical exposure), or request information or educational materials. Exposures do not necessarily represent a poisoning or overdose. The AAPCC is not able to completely verify the accuracy of every report made to member centers. Additional exposures may go unreported to PCCs, and data referenced from the AAPCC should not be construed to represent the complete incidence of national exposures to any substance(s). All data produced from the AAPCC databases during the year in which the exposures occur is considered preliminary. Changes occur in only a small number of cases each year because it is possible that a poison center may update a case anytime during that year if new data are obtained. In the fall of each year, the data for the previous year are locked and no changes are permitted, at which time the data for a year are considered closed. |
|
| A podcast for this article is available at www.annemergmed.com. |
Vol 69 - N° 1
P. 73-78 - janvier 2017 Retour au numéro
Article précédent
- The Effect of Combined Out-of-Hospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury
- Daniel W. Spaite, Chengcheng Hu, Bentley J. Bobrow, Vatsal Chikani, Bruce Barnhart, Joshua B. Gaither, Kurt R. Denninghoff, P. David Adelson, Samuel M. Keim, Chad Viscusi, Terry Mullins, Duane Sherrill
- Acute Toxicity Associated With the Recreational Use of the Novel Psychoactive Benzofuran N-methyl-5-(2 aminopropyl)benzofuran
- Katharina E. Hofer, Katrin Faber, Daniel M. Müller, Till Hauffe, Urs Wenger, Hugo Kupferschmidt, Christine Rauber-Lüthy
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?