People abuse #Imodium as an opiate substitute. It is dangerous and potentially deadly. Annals of Emergency Medicine. WASHINGTON --T he over-the-counter anti-diarrhea medication Imodium®, or its key ingredient loperamide, is increasingly being abused by people attempting to self-treat their opioid addiction, with sometime fatal results. Two case studies outlining the phenomenon were published online Friday in Annals of Emergency Medicine ("Loperamide Abuse Associated with Cardiac Dysrhythmia and Death").