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Over-the-Counter Drug Addiction Treatment in Los Angeles

VF
Reviewed by Vinsent Franke, MBA, AMFT, CADC-II, RA, Founder of iRely Recovery. Updated September 2026.
Intro

Over-the-counter (OTC) medications seem harmless. They’re available without a prescription, marketed as safe, and easily accessible at any pharmacy. And advertised ad nauseam. But many people struggling with OTC drug dependence don’t realize they need help until the consequences to their health and habits become severe.

OTC drug abuse should be taken seriously and requires professional intervention. Located between Hollywood and Malibu, iRely Recovery provides comprehensive treatment for adults ready to confront their dependence on substances like cough medicines, sleep aids, and pain relievers.

Recovery from drug abuse starts with recognizing the problem, and we’re here to guide you through every step toward lasting change.

Key Points
  • 3.1 million Americans misuse OTC drugs annuallyOTC drug misuse affects an estimated 3.1 million Americans annually, according to SAMHSA’s National Survey on Drug Use and Health.[5]
  • DXM carries high abuse potentialDextromethorphan (DXM) is found in 120+ over-the-counter cough and cold products and carries high abuse potential.
  • Loperamide misuse carries cardiac riskLoperamide (Imodium) misuse at high doses has prompted FDA black-box warnings for serious cardiac arrhythmias.[6]
  • Specialized OTC treatment is availableiRely Recovery offers specialized OTC detox and residential treatment in Los Angeles.

In Short

OTC drug addiction is real and treatable. iRely Recovery provides medically supervised detox for DXM, diphenhydramine, loperamide, and pseudoephedrine misuse, combined with evidence-based therapy such as CBT and DBT, across our ASAM Level 3.5 residential campuses in Sherwood Forest, Los Angeles. Most major California insurance plans are accepted. Call (818) 262-3537 or (818) 698-2961.

What Is Over-the-Counter Drug Abuse?

Over-the-counter drug abuse describes a pattern of using non-prescription medications in ways other than intended, such as taking higher doses, using them more frequently, or combining them with other substances to achieve euphoric effects.[1]

Common OTC medications that people abuse include cough suppressants containing dextromethorphan (DXM), antihistamines like diphenhydramine, and pain relievers such as acetaminophen or ibuprofen.[2] These substances are readily available at pharmacies, grocery stores, and online, making them appealing to those seeking an accessible high. The widespread availability and legal status of these medications create a false sense of security, leading many to believe they’re harmless even when misused.

Someone might start by taking an extra dose of sleep medication to cope with stress, then increase the frequency and amount over time. Others intentionally seek out the psychoactive effects, particularly teenagers and young adults who view OTC drugs as a safe way to experiment. OTC drug abuse carries serious health risks, including liver damage, cardiovascular problems, respiratory depression, and psychological dependence.

OTC Addiction and Abuse

OTC meds, though easy to access, can come with serious consequences — for example, pseudoephedrine, commonly found in decongestants and cold medications, can produce stimulant-like effects.[3] Large doses of these OTC medicines overwhelm the body’s natural processes, leading to serious health problems, including elevated blood pressure, irregular heart rate, and potential brain damage.

Recognizing OTC addiction requires understanding that withdrawal symptoms are real and can be severe. People dependent on antihistamines may experience rebound insomnia and anxiety, while those abusing cough medicines face psychological dependence on the dissociative effects of DXM. Over-the-counter drugs don’t carry the same social stigma, making it easier for loved ones to dismiss the severity of the problem.

The Four Categories of OTC Misuse

The most commonly misused OTC drugs fall into four categories: cough and cold medications containing dextromethorphan (DXM), antihistamines such as diphenhydramine, decongestants like pseudoephedrine, and anti-diarrheal drugs containing loperamide. Each carries a distinct mechanism of misuse, a unique withdrawal profile, and requires targeted medical intervention.

Why OTC Drug Addiction Is Underdiagnosed: Because these substances are legal and inexpensive, many people do not recognize their use as addiction. Family members may dismiss the behavior as harmless self-medication, and clinicians sometimes overlook OTC misuse when screening patients. At iRely Recovery, our intake process specifically screens for all OTC drug use to ensure no addiction goes undetected or untreated.

Key Statistics and Facts About OTC Drug Abuse

3.1 Million Americans

misuse OTC drugs annually, according to the SAMHSA National Survey on Drug Use and Health.[5]

120+ OTC Products

sold in the United States contain dextromethorphan (DXM), the ingredient most linked to cough-medicine misuse.

Ages 13–25

represent the age range with the highest prevalence of DXM misuse among teens and young adults.

FDA Black-Box Warnings

were issued in 2016 and 2019 after loperamide misuse caused serious cardiac arrhythmias and deaths.[6]

56,000 ER Visits a Year

in the U.S. result from acetaminophen overdose, the leading cause of acute liver failure nationally.

Social-Media-Driven Trends

have sharply increased diphenhydramine (Benadryl) misuse, including high-dose ingestion challenges.

500+ Recoveries Supported

iRely Recovery has supported over 500 Southern California residents through OTC addiction treatment since opening.

Why Choose iRely Recovery for OTC Drug Treatment in Los Angeles?

iRely Recovery operates two residential facilities in the Sherwood Forest neighborhood of Los Angeles: Greenwood Manor (17524 Napa St, CA 91325) and Willow View (17526 Napa St, CA 91325). Both campuses deliver ASAM Level 3.5 residential care, meaning 24/7 medical supervision, psychiatric support, and structured therapeutic programming.

We specialize in the complex, often co-occurring presentations common in OTC drug addiction, including anxiety, chronic pain, insomnia, and depression that initially drove the misuse.

OTC-Specific Medical Detox

Physicians trained in DXM, diphenhydramine, pseudoephedrine, and loperamide withdrawal manage every detox episode.

Evidence-Based Therapies

CBT, DBT, EMDR, motivational interviewing, and group therapy proven effective in peer-reviewed research.

Individualized Treatment Plans

No two OTC addictions are alike; your plan is tailored to your substance, history, and goals.

Small Census, High-Touch Care

Low patient-to-staff ratios ensure personal attention throughout your stay.

Signs and Symptoms That You Need OTC Drug Rehab

Many people minimize OTC drug misuse because the substances are legal. The following signs indicate that professional treatment is necessary:

  • Escalating doses: Taking OTC medications in doses far exceeding the package label.
  • Withdrawal symptoms: Experiencing nausea, sweating, agitation, or a rapid heartbeat when you try to stop.
  • Rising tolerance: Needing increasing amounts of the same product to achieve the desired effect.
  • Physical decline: Unexplained weight loss, fatigue, or chronic gastrointestinal problems.
  • Cardiac symptoms: Palpitations or an irregular heartbeat, particularly with loperamide or pseudoephedrine misuse.
  • Pharmacy hopping: Visiting multiple pharmacies or stores to avoid purchase-limit flags.
  • Hiding use: Concealing OTC medications or becoming defensive when asked about your use.
  • Time consumed: Spending significant time obtaining, using, or recovering from OTC drug effects.
  • Falling behind: Failing to meet work, school, or family obligations due to substance use.
  • Continued use despite harm: Continuing use despite knowing it causes physical or psychological harm.
  • Self-medicating: Using OTC medications to manage anxiety, depression, or insomnia rather than seeking clinical help.
  • Dissociation or psychosis: Experiencing dissociation, hallucinations, or psychosis with high-dose DXM use.
  • Dependence to relax or sleep: Feeling unable to relax or sleep without the substance.
  • Persistent cravings: Preoccupation with the next dose.

Who We Treat at iRely Recovery

Teenagers and Young Adults

DXM and diphenhydramine misuse is most prevalent in this group, often beginning as experimentation found on social media.

Chronic Pain Patients

Those who escalated from appropriate use of acetaminophen or ibuprofen to dangerous doses.

Working Professionals

OTC drug use is easy to conceal and maintain functional performance in the short term.

Athletes

Pseudoephedrine misuse for performance enhancement and DXM for pain management occur in competitive sports environments.

OTC Drug Detox in Los Angeles at iRely Recovery

Medical detox is the first and most critical phase of OTC addiction treatment. At iRely Recovery, detox is conducted under ASAM Level 3.5 supervision at our Sherwood Forest residential campuses in Los Angeles.

Medical Director Note: OTC withdrawal can be dangerous without supervision. Cardiac complications from loperamide cessation, severe anxiety from diphenhydramine dependence, and DXM psychosis during withdrawal require a clinical environment, not a home detox.

  • DXM Withdrawal: Dextromethorphan withdrawal typically begins 12 to 24 hours after the last dose. Symptoms include restlessness, irritability, insomnia, dysphoria, drug cravings, and in heavy long-term users, cognitive disturbances. Our physicians provide supportive care and may use short-acting benzodiazepines to manage acute agitation safely.
  • Diphenhydramine Withdrawal: Chronic diphenhydramine users develop physical dependence characterized by severe rebound insomnia, anxiety, tremors, and in extreme cases, seizures. Medical monitoring and a tapering protocol are essential to prevent neurological complications during detox.
  • Loperamide Withdrawal: Because loperamide activates opioid receptors in high doses, withdrawal closely resembles opioid withdrawal and may include muscle aches, GI distress, sweating, and restlessness. Our team may use adjunctive medications such as clonidine and comfort-focused interventions. Cardiac rhythm monitoring is performed for patients with a history of high-dose loperamide use.
  • Pseudoephedrine Withdrawal: Stimulant-type withdrawal from pseudoephedrine includes fatigue, depression, hypersomnia, and increased appetite. While rarely life-threatening, symptoms can last one to two weeks and are managed with supportive care and psychiatric support.

Commonly Abused OTC Drugs

While any over-the-counter medication can be misused, certain OTC drugs have higher abuse potential due to their psychoactive effects when taken in large doses:[4]

Dextromethorphan (DXM) – Cough Suppressants

DXM is the active ingredient in over 120 OTC cough and cold products, including Robitussin, NyQuil, and DayQuil. At recommended doses it suppresses cough; at high doses (300 to 1,500 mg) it produces dissociation, hallucinations, and euphoria known as “robotripping.” DXM acts on sigma-1 receptors and inhibits NMDA receptors, giving it a mechanism similar to ketamine. Long-term heavy use causes cognitive impairment and persistent psychosis.

Diphenhydramine – Sleep Aids and Antihistamines

Diphenhydramine (Benadryl, Unisom, ZzzQuil) is a first-generation antihistamine with sedating and anticholinergic effects. Misused in doses exceeding 300 mg, it can cause delirium, hallucinations, and tachycardia. Chronic use leads to tolerance and physical dependence. A 2020 social-media trend (the “Benadryl Challenge”) resulted in multiple hospitalizations and deaths among teenagers.

Pseudoephedrine – Decongestants

Pseudoephedrine (Sudafed) is a sympathomimetic agent used for nasal congestion. Because it can be used to manufacture methamphetamine, federal law limits purchase quantities and requires ID. Misuse as a stimulant produces increased energy, decreased appetite, and elevated heart rate. Long-term misuse causes cardiovascular strain and psychological dependence.

Loperamide – Anti-Diarrheal Agents

Loperamide (Imodium) is an opioid-receptor agonist that normally does not cross the blood-brain barrier at standard doses. At very high doses (typically 50 to 300 mg per day), it penetrates the CNS and produces opioid-like euphoria. The FDA issued black-box warnings in 2016 and 2019 after multiple reports of fatal cardiac arrhythmias, including QT prolongation and ventricular tachycardia, associated with loperamide misuse.[6]

Acetaminophen and NSAIDs – Pain Relievers

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are among the most widely used medications in the world. While not producing euphoria, chronic overuse is common among people with chronic pain, leading to hepatotoxicity (acetaminophen), renal damage, and gastrointestinal bleeding (NSAIDs). Acetaminophen overdose is the leading cause of acute liver failure in the United States.

Dimenhydrinate – Dramamine

Dimenhydrinate (Dramamine) is an antihistamine used for motion sickness. In high doses (700 to 1,000 mg), it produces delirium, hallucinations, and sedation. Misuse is more common among adolescents and carries serious risks including respiratory depression and seizures.

High-Dose Caffeine Products

Caffeine anhydrous powders and concentrated caffeine pills are sold OTC and have caused fatalities when misused. A single teaspoon of pure caffeine powder can contain the equivalent of 28 cups of coffee. Dependence and withdrawal (headache, fatigue, irritability) are well-documented.

OTC Drug Addiction Treatment Programs and Therapies in Los Angeles

iRely Recovery provides a full continuum of evidence-based treatment modalities within our Los Angeles residential program. All therapies are delivered by licensed clinicians and tailored to OTC drug addiction specifically.

Medication-Assisted Treatment (MAT)

Where clinically indicated, FDA-approved medications support withdrawal and cravings management.

Psychoeducation

Understanding the neurobiology of OTC addiction to reduce shame and build insight.

Nutritional Counseling

Restoring nutritional balance disrupted by chronic OTC drug use.

Admissions Process at iRely Recovery

Getting started is simple. Our admissions team is available 24 hours a day, 7 days a week at (818) 262-3537 or (818) 698-2961.

Step 1 – Free Confidential Assessment

A licensed clinician reviews your OTC drug use history, physical health, and mental health needs by phone or in person.

Step 2 – Insurance Verification

Our team verifies your benefits and explains your coverage within hours.

Step 3 – Personalized Treatment Planning

Your clinical team designs an individualized plan covering detox, residential treatment, and aftercare.

Step 4 – Same-Day or Next-Day Admission

For most patients we can arrange admission within 24 hours of initial contact.

Step 5 – Begin Treatment

Arrive at our Sherwood Forest campus for a warm welcome, orientation, and intake assessment.

OTC Drug Withdrawal Timeline

DXM Withdrawal Timeline

PhaseSymptoms
Hours 12–24Restlessness, irritability, insomnia begin
Days 2–3Peak acute symptoms; cravings, dysphoria, cognitive fog
Days 4–7Gradual symptom reduction; mood instability may persist
Weeks 2–4Post-acute symptoms (PAWS): difficulty concentrating, anhedonia

Diphenhydramine Withdrawal Timeline

PhaseSymptoms
Hours 12–24Rebound insomnia, anxiety, restlessness
Days 2–4Peak symptoms; tremors, agitation, possible seizure risk in severe cases
Days 5–10Stabilization with supportive care
Weeks 2–6Residual sleep disruption; treated with sleep hygiene and behavioral interventions

Loperamide Withdrawal Timeline

PhaseSymptoms
Hours 24–48Onset of opioid-like symptoms: muscle aches, GI distress, sweating
Days 3–5Peak withdrawal; cardiac monitoring maintained throughout
Days 6–14Gradual resolution; emotional dysregulation may persist
Weeks 2–4Continued craving management and psychological support

Aftercare and Relapse Prevention in Los Angeles

Recovery from OTC drug addiction does not end at discharge. iRely Recovery builds a comprehensive aftercare plan for every patient before they leave our residential program.

Key Insight: Research consistently shows that patients who engage in structured aftercare have significantly lower relapse rates. We make aftercare connection a priority, not an afterthought.

Aftercare Services We Coordinate

  • Partial Hospitalization Program (PHP): 5 to 6 hours of structured programming per day for patients stepping down from residential care.
  • Intensive Outpatient Program (IOP): 3 hours per day, 3 days per week; allows patients to return to work or school while maintaining structured support.
  • Sober Living Referrals: We partner with vetted sober-living homes throughout the Los Angeles area.
  • 12-Step and SMART Recovery Meetings: We facilitate connection to local Los Angeles meetings tailored to OTC addiction and general recovery.
  • Alumni Program: Monthly alumni events, check-ins, and peer mentorship to sustain community.
  • Continuing Psychiatric Care: Warm handoffs to outpatient psychiatrists for medication management if applicable.

Relapse Prevention Strategies Taught at iRely

  • Identifying personal triggers: Recognizing personal OTC drug triggers such as pain, stress, insomnia, or social cues.
  • HALT check: Hungry, Angry, Lonely, Tired — a quick check-in for early craving recognition.
  • Urge surfing: Mindfulness-based relapse prevention (MBRP) techniques for riding out cravings without acting on them.
  • Building a support network: Developing a personal recovery support network in Los Angeles.
  • Emergency action plan: A concrete plan for high-risk situations before they happen.

Health Risks of Long-Term OTC Drug Misuse

Short-Term Risks

  • Cardiovascular events: Arrhythmias, elevated blood pressure, tachycardia.
  • Acute liver injury: From acetaminophen overdose.
  • Respiratory depression: From high-dose DXM or diphenhydramine.
  • Anticholinergic crisis: Severe delirium and anticholinergic crisis.
  • Seizures: In diphenhydramine dependence.

Long-Term Risks

  • Organ damage: Chronic liver and kidney damage.
  • Cognitive impairment: Persistent cognitive impairment from long-term DXM use.
  • Cardiac damage: Cardiac arrhythmia and structural heart damage from loperamide misuse.
  • Severe depression: Severe depression and anhedonia during extended withdrawal.
  • Progression risk: Increased risk of progression to illicit drug use.

OTC Overdose Risk: OTC drug overdose is a medical emergency. If you suspect someone has overdosed on any OTC medication, call 911 immediately. Loperamide cardiac events may not respond to naloxone. Acetaminophen overdose is a medical emergency requiring prompt N-acetylcysteine administration.

DXM Addiction Treatment in Los Angeles: Robotripping Recovery at iRely

DXM addiction, sometimes called “robotripping” or “skittling,” is a significant public health concern in Los Angeles and nationwide. Teenagers and young adults are the most affected demographic, often misusing readily available cough syrups purchased at any pharmacy.

Clinical Reality: DXM addiction is frequently dismissed because the drug is legal and inexpensive. In our experience, patients struggling with DXM misuse face the same neurological changes, behavioral consequences, and treatment needs as those addicted to Schedule I substances.

At iRely Recovery in Los Angeles, DXM-specific treatment includes:

  • Medical evaluation for DXM-induced dissociative or psychotic symptoms
  • Supervised withdrawal management in our residential facility
  • CBT and DBT to address the anxiety, depression, or peer influences driving use
  • Family therapy, given the prevalence of DXM misuse among minors
  • Connection to Los Angeles teen and young adult recovery communities
  • Relapse prevention focused on pharmacy access barriers and peer trigger management

If you or a family member is struggling with DXM addiction in Los Angeles, call iRely Recovery at (818) 262-3537 for a free confidential assessment today.

Take the First Step Toward Freedom from OTC Drug Addiction

OTC drug addiction is real, treatable, and nothing to be ashamed of. The first step is a single phone call.

Call or Text: (818) 262-3537 | (818) 698-2961

Greenwood Manor: 17524 Napa St, Sherwood Forest, CA 91325
Willow View: 17526 Napa St, Sherwood Forest, CA 91325

Frequently Asked Questions About OTC Drug Rehab

What is OTC drug addiction, and is it a real addiction?

Yes, OTC drug addiction is a recognized medical condition. When OTC medications are used in doses or frequencies exceeding their intended purpose, the brain adapts to the substance, creating physical and psychological dependence. Withdrawal symptoms, compulsive use despite negative consequences, and inability to stop are hallmarks of clinical addiction, regardless of whether the substance requires a prescription.

Which OTC drugs are most commonly abused?

The most commonly misused OTC substances are dextromethorphan (DXM) in cough medications, diphenhydramine in sleep aids and antihistamines, loperamide in anti-diarrheal products, pseudoephedrine in decongestants, and acetaminophen in pain relievers. Each produces distinct effects and carries unique health risks when misused.

What does OTC drug treatment look like at iRely Recovery?

Treatment at iRely Recovery begins with a medically supervised detox in our ASAM Level 3.5 residential program. After detox, patients engage in individual therapy, group therapy, DBT, CBT, EMDR, and holistic programming tailored to their specific OTC addiction. Treatment typically lasts 28 to 90 days depending on clinical need, followed by coordinated aftercare.

What is robotripping, and how is it treated?

Robotripping refers to intentional misuse of dextromethorphan (DXM) in cough syrups to produce dissociative or euphoric effects. Treatment involves medical detox to manage withdrawal, therapy to address the underlying reasons for use, and relapse prevention strategies. iRely Recovery has experience treating DXM addiction in teenagers and young adults in Los Angeles.

Is loperamide (Imodium) addiction dangerous?

Yes. Loperamide misuse at very high doses can cause fatal cardiac arrhythmias including QT prolongation and ventricular tachycardia. The FDA has issued black-box warnings about this risk. Medical supervision during loperamide detox is critical. Do not attempt to stop high-dose loperamide use without medical guidance.

Can teenagers receive OTC addiction treatment at iRely Recovery?

iRely Recovery treats adults 18 and older in our residential program. For teenagers under 18, our admissions team can provide referrals to appropriate adolescent treatment programs in the Los Angeles area. We encourage parents to call us for guidance on navigating options for their minor child.

How long does OTC drug detox take?

Detox duration varies by substance. DXM and diphenhydramine acute withdrawal typically resolves within 5 to 10 days with medical support. Loperamide withdrawal, resembling opioid withdrawal, may take 7 to 14 days. All patients are monitored continuously until they are medically stable and ready to transition into residential programming.

Does insurance cover OTC addiction treatment?

Many major insurance plans cover OTC drug addiction treatment, including Medi-Cal and commercial carriers. iRely Recovery works with most major California insurance providers and can verify your benefits within hours of your initial call. Our admissions team explains all out-of-pocket costs before you commit to treatment.

Can I get OTC drug treatment near me in Los Angeles?

Yes. iRely Recovery operates in the Sherwood Forest neighborhood of Los Angeles. Our residential campuses serve patients from across Los Angeles County, the San Fernando Valley, Ventura County, and broader Southern California. For drug addiction treatment near you, call (818) 262-3537 to speak with our admissions team.

What is the difference between OTC drug treatment and prescription drug rehab?

The core treatment principles, including medically supervised detox, evidence-based therapy, and aftercare planning, are similar. However, OTC drug addiction involves unique substances with distinct pharmacology. For example, loperamide detox requires cardiac monitoring that is not standard in alcohol or benzodiazepine detox. iRely Recovery clinicians are trained specifically in OTC drug presentations.

Is OTC drug addiction treatment the same as a prescription drug rehab near me?

Prescription drug rehab and OTC drug rehab share many elements but differ in the specific detox protocols and therapeutic focus. iRely Recovery treats both OTC and prescription drug addiction and can accommodate patients with complex, multi-substance presentations. Call us to discuss your specific situation.

What are the signs of diphenhydramine addiction?

Signs of diphenhydramine addiction include taking doses far above the recommended amount to fall asleep, experiencing rebound insomnia without it, feeling anxious or shaky when skipping a dose, and purchasing multiple boxes to maintain supply. If sleep has become impossible without diphenhydramine, professional detox and treatment are recommended.

How does iRely Recovery treat dual diagnosis patients?

More than 70% of patients at iRely Recovery have a co-occurring mental health condition such as anxiety, depression, PTSD, or ADHD. Our integrated dual-diagnosis model means that your psychiatrist, therapist, and medical team collaborate on a single unified treatment plan addressing both the addiction and the underlying mental health condition simultaneously.

What should I bring to residential OTC drug treatment?

Bring government-issued photo ID, insurance card, a 2-week supply of any prescribed medications in original labeled bottles, comfortable clothing for daily activities, toiletries (alcohol-free), and any personal comfort items permitted by our facility guidelines. Our admissions team provides a complete packing checklist at the time of admission scheduling.

How do I start OTC drug addiction treatment at iRely Recovery today?

Call or text (818) 262-3537 or (818) 698-2961 at any time. Our admissions coordinators are available 24/7. We will complete a free confidential assessment, verify your insurance, and schedule your admission, often within 24 hours. You do not need a referral from a doctor to contact us.

Sources

[1, 2] National Institute on Drug Abuse. (2017, December 17). Over-the-Counter Medicines DrugFacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/over-counter-medicines on May 28, 2025

[3] Pseudoephedrine: MedlinePlus Drug Information. (2018). Medlineplus.gov. https://medlineplus.gov/druginfo/meds/a682619.html on May 28, 2025

[4] Sansgiry, S., Bhansali, A., Bapat, S., & Xu, Q. (2016). Abuse of over-the-counter medicines: a Pharmacist’s Perspective. Integrated Pharmacy Research and Practice, Volume 6(6), 1–6. https://pmc.ncbi.nlm.nih.gov/articles/PMC5774309/ on May 28, 2025

[5] Substance Abuse and Mental Health Services Administration. (2023). National Survey on Drug Use and Health (NSDUH). SAMHSA, U.S. Department of Health and Human Services.

[6] U.S. Food and Drug Administration. (2016, updated 2019). FDA Drug Safety Communication: FDA limits packaging for anti-diarrhea medicine loperamide (Imodium) to encourage safe use, after reports of serious heart problems with high doses.