Laudanum (Opium Tincture) Poisoning
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What is Laudanum (Tincture of Opium)?
Laudanum (tincture of opium) is an opium extract. It's a concentrated red-brown solution made up of dissolved opiates and alcohol. The substance resembles opium in its raw form when taken from the opium poppy plant.
Before, the drug was inserted between the cheek and gums. It could also be applied under the tongue.
Laudanum contains 25 percent alcohol on average. For some variants, this may be 60 to 90 percent.8
Today, safer and more refined opiate medicines have replaced it. Laudanum is not typically prescribed in the United States. In the rare case that it is prescribed, the drug can reduce symptoms of:1
- 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)
History of Laudanum
Thomas Sydenham first introduced laudanum into medical practice in the 16th century.4 It was considered a cure-all treatment for numerous issues, including:7
- Menstrual cramps
- Lack of creativity
However, physical dependence and laudanum addiction became common but unrecognized public health concerns in the 19th century.
Laudanum was responsible for more suicides by overdose than any other substance throughout the 1800s. Starting in the early 20th century, it went from a common painkiller to a blacklisted substance.
Side Effects of Laudanum
Laudanum affects the body similarly to opioids. Side effects of laudanum may include:
- Shortness of breath
- Irregular breathing
- Dysphoria, or sadness
- Itchy skin
- Pinpoint pupils
Severe side effects of laudanum may include:
- Breathing difficulties
- Physical dependence
- Alcohol use disorder
- Opioid use disorder
Is Laudanum Addictive?
Yes, laudanum is highly addictive. This is because it contains several habit-forming drugs, including:
Early Signs of Laudanum Addiction
The early signs of laudanum addiction are similar to those of opiate addiction. These early signs include:
- Taking more laudanum to relieve pain
- Taking laudanum to relieve stress
- Feeling sick if you’re not able to take laudanum for a long time
- People around you expressing concern about your laudanum intake
- Poor performance at work
- Unexplained periods of absence
- Isolating oneself from friends or family members
What is Laudanum Poisoning (Intoxication)?
As laudanum can be highly addictive, healthcare experts provide it in minimal quantities. However, as tolerance builds, a person will require larger amounts to experience its effects.
When ingested in significant amounts, laudanum poisoning can occur. This may lead to severe and potentially lethal symptoms. Consistent laudanum use can lead to overdose.
Symptoms of Laudanum Poisoning
There are several symptoms of laudanum poisoning:
- Breathing difficulties
- Constriction of the pupils
- Profound sadness or depression
Treatment for Laudanum Poisoning
Immediate overdose treatment for laudanum poisoning is crucial. The goal during treatment is to remove excess amounts of the drug from the system.
Healthcare professionals may implement the following treatments for laudanum overdose:
- Administration of emetics (medicine that causes vomiting)
- Gastric lavage application
- Intravenous fluid administration
- Use of activated charcoal
- Intravenous application of flumazenil
In extreme cases, dialysis may be necessary to remove laudanum. Nursing care, including closely monitoring vital overdose signs, can be a part of treatment.
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- Nikoo, M., et al. “Comparing Opium Tincture (OT) With Methadone for Medication-assisted Treatment of Opioid Use Disorder (OT-RCT)”, United States National Library of Medicine, Clinical Trials, 2019.
- Somogyi, A., et al, “Flexible dosing of tincture of opium in the management of opioid withdrawal: pharmacokinetics and pharmacodynamics.” British Journal of Clinical Pharmacology, 2008.
- Opium tincture, National Cancer Institute.
- Thomas Sydenham, Encyclopædia Britannica, 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, 2015.
- Rahimi-Movaghar, A., et al. “Pharmacological therapies for management of opium withdrawal.” The Cochrane database of systematic reviews, 2018.
- Crocq, MA. “Historical and cultural aspects of man's relationship with addictive drugs.” Dialogues in clinical neuroscience, 2007.
- Solhi, Hassan et al. “Does ingestion of tincture of opium notably raise blood alcohol concentration?” Addiction & health, 2014.