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Updated on November 12, 2021

Laudanum (Opium Tincture) Poisoning

What is Laudanum (Tincture of Opium)?

Laudanum is a tincture of opium. A tincture is a concentrated liquid solution. In the case of laudanum, it's a red-brown solution made up of dissolved opiates and alcohol.

Thomas Sydenham first introduced laudanum into medical practice in the 16th century. In the Victorian era, it was considered a cure-all treatment and creative aid.

Starting in the early 20th century, it went from common painkiller to blacklisted substance.

Opiates found in laudanum include:

  • Opium
  • Morphine
  • Codeine

Laudanum contains 25 percent alcohol on average. For some variants, this may be 60 to 90 percent.

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

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. Coleridge's opium use led to severe consequences for his life and career.

What Is Laudanum Used For?

Laudanum was either inserted between the cheek and gum or applied under the tongue. It was used to soothe physical and mental ailments.

Today, it is rarely prescribed. Safer and more refined opiate medicines have replaced it.

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

  • Acute or persistent diarrhea
  • Moderate to severe pain
  • Neonatal abstinence syndrome (to alleviate acute opiate withdrawal symptoms in babies whose mothers were dependent on opioids during pregnancy)

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Laudanum and Opium

With laudanum tinctures, opium is the primary ingredient. Laudanum is largely an opium extract. Laudanum resembles opium in its raw form when taken from the opium poppy plant.

Is Laudanum Addictive?

Yes, laudanum is highly addictive. This is because it contains several habit-forming drugs, including opium, morphine, codeine, and alcohol.

Historically, laudanum addiction was a common but unknown disease of the nineteenth century. Laudanum was used for everything from soothing headaches to treating depression. Physical dependence was not understood at this time.

Because of this, laudanum addiction went largely untreated. It is believed that laudanum was responsible for many suicides by overdose.

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Side Effects of Laudanum

Laudanum affects the body in a similar manner to opioids.

Side effects of laudanum may include:

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

Severe side effects of laudanum may include:

What is Laudanum Poisoning (Intoxication)?

As laudanum can be highly addictive, health care experts provide it in minimal quantities. However, as tolerance builds, a patient requires larger amounts to experience its effects.

Consistent laudanum use can lead to overdose.

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What Causes Laudanum Poisoning?

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

Symptoms of Laudanum Poisoning

There are several symptoms of laudanum poisoning:

  • Breathing difficulties
  • Constipation
  • Constriction of the pupils
  • Euphoria
  • 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 goal during treatment is to remove excess amounts 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 
  • Use of activated charcoal
  • Intravenous application of flumazenil

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

Treatment Options for Opioid Abuse & Addiction

There are several options for people suffering from opioid addiction. These include:

Medication-Assisted Therapy (MAT)

There are three medications approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. These medications are used only with medical supervision.

Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. Because of this, a person experiences reduced cravings for opioids, thereby restoring balance in the brain circuits.

Naltrexone is less commonly used, but it blocks your opioid receptors, making it impossible to get high. Medication-assisted therapy is most effective when combined with other forms of treatment.

Inpatient Programs

Inpatient programs are the most intensive and effective treatment options for opioid addiction.

These programs guide you through medically supervised detoxification, then behavioral therapy and other services (possibly including MAT), will be added to your treatment.

They typically last 30, 60, or 90 days. However, they may be longer if necessary.

Partial Hospitalization Programs (PHPs)

PHPs are also known as intensive outpatient programs (IOPs). They are the next most intensive type of treatment for opioid addiction.

They provide similar services to inpatient programs such as detoxification, behavioral therapy medical services, and custom treatments such as MAT.

The difference is that in a PHP, the patient returns home to sleep. Some programs will include transportation and meals, but this varies by program.

Partial hospitalization programs are helpful for both new patients and patients who have completed inpatient treatment and still need intensive recovery therapy.

Outpatient Programs

Outpatient programs work best for people who have a high level of motivation to recover. They create treatment programs that work around your schedule.

These programs can either be an effective treatment option for new patients or a part of an aftercare program for people who complete inpatient or partial hospitalization programs.

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Resources

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  1. Comparing Opium Tincture (OT) With Methadone for Medication-assisted Treatment of Opioid Use Disorder (OT-RCT), United States National Library of Medicine, Clinical Trials, July 2019
  2. Somogyi, Andrew A et al, Flexible dosing of tincture of opium in the management of opioid withdrawal: pharmacokinetics and pharmacodynamics., British Journal of clinical pharmacology vol. 66,5
  3. Opium tincture, National Cancer Institute
  4. Thomas Sydenham, Encyclopædia Britannica, January 2020 Van Hout, Marie Claire, and Evelyn Hearne. “"Vintage meds": a netnographic study of user decision-making, home preparation, and consumptive patterns of laudanum.” Substance use & misuse vol. 50,5 : 598-608 “Tincture of Opium and Laudanum.” The Hospital vol. 58,1526 : 493-494.

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