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Updated on September 27, 2021

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. 

Laudanum and Opium

With laudanum tinctures, opium is the primary ingredient. Laudanum is largely an opium extract. As a reddish-brown and bitter solution, laudanum resembles opium in its raw form when taken from the opium poppy plant.

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Is Laudanum Addictive?

Yes, laudanum is highly addictive. This is because it contains several habit-forming drugs, which are 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. However, physical dependence and addiction were not recognized or understood at this time.

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

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.

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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.

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.

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. Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. 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 program.

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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

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 (2008)

Opium tincture, National Cancer Institute

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 (2015): 598-608 “Tincture of Opium and Laudanum.” The Hospital vol. 58,1526 (1915): 493-494.

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