Opium

Opium is a narcotic formed from the latex released by lacerating (or "scoring") the immature seed pods of opium poppies (Papaver somniferum). Opium contains up to 12% morphine, an opiate alkaloid, which is most frequently processed chemically to produce heroin for the illegal drug trade. The resin in Opium also includes codeine and non-narcotic alkaloids, such as papaverine, thebaine and noscapine. Meconium historically referred to related, weaker preparations made from other parts of the poppy or different species of poppies. Modern opium production is the culmination of millennia of production, in which the source poppy, methods of extraction and processing, and methods of consumption have become increasingly potent.

In China recreational use of the drug began in the fifteenth century but was limited by its rarity and expense. Opium trade became more regular by the seventeenth century, when it was mixed with tobacco for smoking, and addiction was first recognized.

Recreational or addictive opium use in other nations remained rare into the late nineteenth century, recorded by an ambivalent literature that sometimes praised the drug.

Global regulation of opium began with the stigmatization of Chinese immigrants and opium dens, leading rapidly from town ordinances in the 1870s to the formation of the International Opium Commission in 1909. During this period, the portrayal of opium in literature became squalid and violent, British opium trade was largely supplanted by domestic Chinese production, purified morphine and heroin became widely available for injection, and patent medicines containing opiates reached a peak of popularity.

Reintroduction to Western medicine

Opium became stigmatized in Europe during the Inquisition as a Middle Eastern influence and became a taboo subject in Europe from approximately 1300 to 1500 A.D. Manuscripts of Pseudo-Apuleius's fifth-century work from the tenth and eleventh centuries refer to the use of wild poppy Papaver agreste or Papaver rhoeas (identified as Papaver silvaticum) instead of Papaver somniferum for inducing sleep and relieving pain.

Recreational use

The earliest clear description of the use of opium as a recreational drug came from Xu Boling, who wrote in 1483 that opium was "mainly used to aid masculinity, strengthen sperm and regain vigor," and that it "enhances the art of alchemists, sex and court ladies. Opium smoking began as a privilege of the elite and remained a great luxury into the early nineteenth century, but by 1861, Wang Tao wrote that opium was used even by rich peasants, and even a small village without a rice store would have a shop where opium was sold.

Smoking of opium came on the heels of tobacco smoking and may have been encouraged by a brief ban on the smoking of tobacco by the Ming emperor, ending in 1644 with the Qing dynasty, which had encouraged smokers to mix in increasing amounts of opium.

Cultivation in the UK

In late 2006, the British government permitted the pharmaceutical company Macfarlan Smith (a Johnson Matthey company) to cultivate opium poppies in England for medicinal reasons, after Macfarlan Smith's primary source, India, decided to increase the price of export opium latex. This move is well received by British farmers, with a major opium poppy field based in Didcot, England.

Consumption

In the industrialized world, the USA is the world's biggest consumer of prescription opioids, with Italy one of the lowest. Most opium imported into the United States is broken down into its alkaloid constituents, and whether legal or illegal, most current drug use occurs with processed derivatives such as heroin rather than with pure and untouched opium.

Intravenous injection of opiates is most used: by comparison with injection, "dragon chasing" (heating of heroin with barbital on a piece of foil) and "ack ack" (smoking of cigarettes containing heroin powder) are only 40% and 20% efficient, respectively. One study of British heroin addicts found a 12-fold excess mortality ratio (1.8% of the group dying per year). Most heroin deaths result not from overdose per se, but combination with other depressant drugs such as alcohol or benzodiazepines.

The smoking of opium does not involve the pyrolysis of the material as might be imagined. Rather, the prepared opium is indirectly heated to temperatures at which the active alkaloids, chiefly morphine, are vaporized. In the past, smokers would utilize a specially designed opium pipe which had a removable knob-like pipe-bowl of fired earthenware attached by a metal fitting to a long, cylindrical stem. A small "pill" of opium about the size of a pea would be placed on the pipe-bowl, which was then heated by holding it over an opium lamp, a special oil lamp with a distinct funnel-like chimney to channel heat into a small area. The smoker would lie on his or her side in order to guide the pipe-bowl and the tiny pill of opium over the stream of heat rising from the chimney of the oil lamp and inhale the vaporized opium fumes as needed. Several pills of opium were smoked at a single session depending on the smoker's tolerance to the drug. The effects could last up to twelve hours.

In Eastern culture, opium is more commonly used in the form of paregoric to treat diarrhea. This is a weaker solution than laudanum, an alcoholic tincture which was prevalently used as a pain medication and sleeping aid. Tincture of opium has been prescribed for, among other things, severe diarrhea. Taken thirty minutes prior to meals, it significantly slows intestinal motility, giving the intestines greater time to absorb fluid in the stool.

Chemical and physiological properties

Opium contains two main groups of alkaloids. Phenanthrenes include morphine, codeine, and the baines are the main narcotic constituents. Isoquinolines such as papaverine have no significant central nervous system effects and are not regulated under the Controlled Substances Act. Morphine is by far the most prevalent and important alkaloid in opium, consisting of 10%-16% of the total, and is responsible for most of its harmful effects such as lung edema, respiratory difficulties, coma, or cardiac or respiratory collapse, with a normal lethal dose of 120 to 250 milligrams—the amount found in approximately two grams of opium. Morphine binds to and activates μ-opioids receptors in the brain, spinal cord, stomach and intestine. Regular use leads to physical tolerance and dependence. Chronic opium addicts in 1906 China or modern-day Iran consume an average of eight grams daily.

Both analgesia and drug addiction are functions of the mu opioids receptor, the class of opioids receptor first identified as responsive to morphine. Tolerance is associated with the super activation of the receptor, which may be affected by the degree of endocytosis caused by the opioids administered, and leads to a super activation of cyclic AMP signaling. Long-term use of morphine in palliative care and management of chronic pain can be managed without the development of drug tolerance or physical dependence. Many techniques of drug treatment exist, including pharmacologically based treatments with naltrexone, methadone, or ibogaine.

Help is at hand for Opium users

Teen Challenge’s rehabilitation programmes for opium abuse is open to everyone both men and women who need addiction help. Wilkerson House Center in London is open to men only and Hope House Center in Wales is for women. Both are residential and the programme term is 12 months. The programme is FREE, for more information you will need to complete an online application form. Call us today on 0208 553 3338 if you need to talk to a qualified counselor.

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