Laudanum (Opium Tincture) Poisoning

What is Laudanum (Tincture of Opium)?

Thomas Sydenham first introduced laudanum into medical practice in the 16th century.

During Victorian-era Europe and North America, laudanum was once considered as a cure-all treatment and creative aid. Laudanum is a tincture, and it is also known as a tincture of opium.

Until the early 20th century, drugs like laudanum were sold without a prescription as patent medicines. In time, opiate drugs like laudanum went from common painkillers to blacklisted substances.

Opiates like laudanum act as depressants on the central nervous system. Laudanum is a highly-concentrated liquid solution made up of dissolved drugs and alcohol concoctions. Reddish-brown and bitter, laudanum contains almost all of the opium alkaloids. These drug concoctions include:

• Opium
• Morphine
• Codeine

Opium tinctures like laudanum typically contain 25 percent alcohol on average. However, some variants contain up to 60 to 90 percent alcohol. 

Laudanum is a highly addictive drug. This is because it contains various habit-forming drugs. Historically, laudanum addiction was a common but unrecognized public health illness of the 19th century. Patients used laudanum to help with everything, from headaches to depression to menstrual cramps. However, drug addiction and dependence was not understood during the 19th century. 

As a result, laudanum addiction was often untreated. The drug was responsible for more suicides by overdose than any other substance throughout the 1800s.

Samuel Taylor Coleridge was an English poet, critic, and philosopher. He took opium to address his health issues. His use of opium is extensively documented. His poem, Kubla Khan, was reportedly written under the drug’s influence. Samuel Taylor Coleridge's opium use led to severe consequences. His opium addiction was harmful to his life, and it severely impacted his career.

What Is Laudanum Used For?

Laudanum was typically taken orally, buccally (inserted between the cheek and gum), and sublingually (applied under the tongue.) It was used to soothe physical and mental ailments.

However, laudanum is a form of the highly addictive drug opium. Today it is rarely prescribed by health care professionals. Safer and more sophisticated opiate medicines have mainly replaced it.

Laudanum is still available by prescription in the United States. In the rare circumstances that laudanum is prescribed, the drug can reduce symptoms of:

• Acute or persistent diarrhea — If medications like Imodium are not effective in treating severe diarrhea, some doctors may prescribe laudanum.
• Neonatal abstinence syndrome — the drug may alleviate acute opiate withdrawal symptoms in babies whose mothers were dependent on opioids during pregnancy.
• Moderate to severe pain — laudanum is an opioid used for pain relief. 

Side Effects of Laudanum

Due to its opiate components, laudanum affects the body, similar to how opioids do.

Side effects of laudanum may include:

• Shortness of breath 
• Irregular breathing 
• Dysphoria, or sadness 
• Itchy skin (familiar with morphine) 
• Pinpoint pupils, or miosis

Severe side effects of laudanum may include:

• Euphoria — the drug binds to the brain’s opioid receptors. This releases a rush of dopamine in the brain. 
• Constipation — as laudanum prevents diarrhea, high doses of the drug can lead to constipation.
• Respiratory depression — due to the high percentage of alcohol in laudanum, the drug can lead to respiratory depression.  
• Physical dependence — as laudanum contains various opioids, the drug is highly addictive. Continuous use of laudanum can eventually make someone physically dependent on it. This means they may experience withdrawal symptoms when they are not using it.
• Alcohol use disorder — as laudanum often contains high alcohol levels, patients can develop an alcohol use disorder from the drug.
• Opioid use disorder — consuming laudanum can lead to opiate addiction or an opioid use disorder. Treating a laudanum use disorder may require the user to seek professional help.

What is Laudanum Poisoning (Intoxication)?

As laudanum can be highly addictive and dangerous in substantial doses, health care professionals provide it in minimal quantities. However, when laudanum is used often, a patient requires larger amounts to experience its effects. Consistent laudanum use can lead to laudanum poisoning or overdosing.

What Causes Laudanum Poisoning?

When ingested in significant amounts, laudanum poisoning can occur. This may lead to severe and potentially lethal symptoms.

More deaths by overdose result from prescription medicines like opioids and depressants than street drugs like heroin and cocaine.

Symptoms of Laudanum Poisoning

There are several symptoms of laudanum poisoning:

• Respiratory depression — as laudanum contains high alcohol levels, ingestion of significant quantities of the drug may lead to respiratory distress. Or, it may depress the functions of the respiratory system.
• Constipation — high amounts of laudanum may lead users to suffer from constipation.
• Constriction of the pupils — opiates like laudanum can cause pupillary constriction, otherwise known as miosis. This can occur even in the absence of light. An easy way to evaluate a laudanum overdose is to look at the pupils of the user.
• Euphoria — the main active ingredient of laudanum is morphine. This drug contributes to the enhanced feeling of well-being among users. This is the feeling of joy or invulnerability, which is most often caused by the stimulation of opioid receptors in the brain.
• Dysphoria — while laudanum can make users feel elated, it can also disrupt the brain's chemical balance. Those experiencing a laudanum overdose may feel profound sadness or depression.

Treatment for Laudanum Poisoning & Addiction

There are various treatments for laudanum poisoning and addiction: 

Laudanum Poisoning Treatment

Immediate overdose treatment for laudanum poisoning is crucial. The aim during treatment is to remove the excess amount of the drug in the system.

Health care professionals may implement the following treatments for laudanum overdose:

• Administration of emetics 
• Gastric lavage application 
• Intravenous fluid administration 
• Administration of activated charcoal 
• Intravenous application of flumazenil, a benzodiazepine antidote

In extreme cases, dialysis may be necessary to remove laudanum. Further nursing care, including the close monitoring of vital overdose signs, is typically part of laudanum poisoning treatment.

Laudanum Addiction Treatment

Laudanum addiction treatment is often similar to opioid and alcohol use disorder treatment. It includes medication-assisted treatment (MAT). People experiencing laudanum addiction may attend a detox clinic, outpatient facility, or rehab center to recover from the drug.

For the best results, laudanum users may participate in various care programs, starting with medically assisted detox and finishing with aftercare.

Rehab for laudanum dependency helps users with underlying issues as well as preventing relapse. 

Intensive outpatient treatment may involve the client visiting a rehab center or health department daily or weekly. This type of recovery program includes several hours of treatment per session, which may include group therapy.

Patients may also attend one-on-one meetings with their psychiatrists or counselors when attending recovery programs.

Residential programs are an excellent option for people who prefer intensive recovery treatment outside of a hospital setting. 

Support groups like SMART recovery may also be part of an outpatient treatment program. Generally, a rehab program is designed specifically for each patient and their unique circumstances.