Opium

From Wikipedia, the free encyclopedia
Jump to: navigation, search
For other uses, see Opium (disambiguation).
Opium
Slaapbol R0017601.JPG
Opium poppy seed pod exuding latex from a cut
Botanical Opium
Source plant(s) Papaver somniferum
Part(s) of plant latex
Geographic origin Uncertain, possibly Southern Europe[1]
Active ingredients Morphine, Codeine
Main producers Afghanistan (primary), Pakistan, Northern India, Thailand, Turkey, Laos, Burma, Mexico, Colombia, Hungary
Main consumers Worldwide (#1: U.S.)[citation needed]
Wholesale price $3,000 per kilogram (as of 2002)[2]
Retail price $16,000 per kilogram (as of 2002)[2]

Opium (poppy tears, lachryma papaveris) is the dried latex obtained from the opium poppy (Papaver somniferum). Opium latex contains approximately 12% of the analgesic alkaloid morphine, which is processed chemically to produce heroin and other synthetic opioids for medicinal use and for the illegal drug trade. The latex also contains the closely related opiates codeine and thebaine and non-analgesic alkaloids such as papaverine and noscapine. The traditional, labor-intensive, method of obtaining the latex is to scratch ("score") the immature seed pods (fruits) by hand; the latex leaks out and dries to a sticky yellowish residue that is later scraped off, and dehydrated. The word "meconium" (derived from the Greek for "opium-like", but now used to refer to infant stools) historically referred to related, weaker preparations made from other parts of the poppy or different species of poppies.[3]

The production of opium itself has not changed since ancient times. Through selective breeding of the Papaver somniferum plant, the content of the phenanthrene alkaloids morphine, codeine, and to a lesser extent thebaine, has been greatly increased. In modern times, much of the thebaine, which often serves as the raw material for the synthesis for hydrocodone, hydromorphone, and other semi-synthetic opiates, originates from extracting Papaver orientale or Papaver bracteatum.

Opium for illegal use is often converted into heroin, which is less bulky,[citation needed] making it easier to smuggle, and which multiplies its potency to approximately twice that of morphine.

History[edit]

Apothecary vessel for storage of opium as a pharmaceutical, Germany, 18th or 19th century

Cultivation of opium poppies for food, anaesthesia, and ritual purposes dates back to at least the Neolithic Age (new stone age). The Sumerian, Assyrian, Egyptian, Indian, Minoan, Greek, Roman, Persian and Arab Empires all made widespread use of opium, which was the most potent form of pain relief then available, allowing ancient surgeons to perform prolonged surgical procedures.[citation needed] Opium is mentioned in the most important medical texts of the ancient world, including the Ebers Papyrus and the writings of Dioscorides, Galen, and Avicenna. Widespread medical use of unprocessed opium continued through the American Civil War before giving way to morphine and its successors, which could be injected at a precisely controlled dosage.

In China, recreational use began in the 15th century,[citation needed] but was limited by its rarity and expense. Opium trade became more regular by the 17th century, when it was mixed with tobacco for smoking, and addiction was first recognized.[citation needed] Opium prohibition in China began in 1729, yet was followed by nearly two centuries of increasing opium use. China had a positive balance sheet in trading with the British, which led to a decrease of the British silver stocks. Therefore, the British tried to encourage Chinese opium use to enhance their balance, and they delivered it from Indian provinces under British control. In India, its cultivation, as well as the manufacture and traffic to China, were subject to the East India Company (EIC), as a strict monopoly of the British government.[4] There was an extensive and complicated system of EIC agencies involved in the supervision and management of opium production and distribution in India. A massive destruction of opium by an emissary of the Chinese Daoguang Emperor in an attempt to stop opium imports, led to the First Opium War (1839–1842), in which Britain defeated China. After 1860, opium use continued to increase with widespread domestic production in China. By 1905, an estimated 25% of the male population were regular consumers of the drug. Recreational use of opium elsewhere in the world remained rare into late in the 19th century, as indicated by ambivalent reports of opium usage.[5]

Global regulation of opium began[citation needed] with the stigmatization of Chinese immigrants and opium dens in San Francisco, California, 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[citation needed], 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. Opium was prohibited in many countries during the early 20th century, leading to the modern pattern of opium production as a precursor for illegal recreational drugs or tightly regulated legal prescription drugs. Illicit opium production, now dominated by Afghanistan, was decimated in 2000, when production was banned by the Taliban, but has increased steadily since the fall of the Taliban in 2001 and over the course of the war in Afghanistan.[6][7] Worldwide production in 2006 was 6610 metric tons[8]—about one-fifth the level of production in 1906.

Ancient use[edit]

Poppy crop from the Malwa India (probably Papaver somniferum var. album[9])

Opium has been actively collected since prehistoric times, and may be the soma plant ubiquitously mentioned in the Rig Veda. Though western scholars typically date the text at 1500 BCE, Indian scholars maintain that the verses and the history contained in them have been orally transmitted thousands of years before. Soma is Vedic Sanskrit for moon, describing both the shape of the bulb and its nocturnal juice emission, which in ancient times would have been visible by moonlight only.[10] A common name for males in Afghanistan is "Redey", which in Pashto means "poppy".[11] This term may be derived from the Sanskrit words rddhi and hrdya, which mean "magical", "a type of medicinal plant", and "heart-pleasing", respectively.[ambiguous] The upper South Asian belt of Afghanistan, Pakistan, northern India, and Burma still account for the world's largest supply of opium.

At least 17 finds of Papaver somniferum from Neolithic settlements have been reported throughout Switzerland, Germany, and Spain, including the placement of large numbers of poppy seed capsules at a burial site (the Cueva de los Murciélagos, or "Bat Cave", in Spain), which have been carbon-14 dated to 4200 BCE.[citation needed] Numerous finds of P. somniferum or P. setigerum from Bronze Age and Iron Age settlements have also been reported.[12] The first known cultivation of opium poppies was in Mesopotamia, approximately 3400 BCE, by Sumerians, who called the plant hul gil, the "joy plant".[13][14] Tablets found at Nippur, a Sumerian spiritual center south of Baghdad, described the collection of poppy juice in the morning and its use in production of opium.[9] Cultivation continued in the Middle East by the Assyrians, who also collected poppy juice in the morning after scoring the pods with an iron scoop; they called the juice aratpa-pal, possibly the root of Papaver. Opium production continued under the Babylonians and Egyptians.

Opium was used with poison hemlock to put people quickly and painlessly to death, but it was also used in medicine. The Ebers Papyrus, circa 1500 BCE, describes a way to "stop a crying child" using grains of the poppy plant strained to a pulp.[clarification needed] Spongia somnifera, sponges soaked in opium, were used during surgery.[13] The Egyptians cultivated opium thebaicum in famous poppy fields around 1300 BCE. Opium was traded from Egypt by the Phoenicians and Minoans to destinations around the Mediterranean Sea, including Greece, Carthage, and Europe. By 1100 BCE, opium was cultivated on Cyprus, where surgical-quality knives were used to score the poppy pods, and opium was cultivated, traded, and smoked.[15] Opium was also mentioned after the Persian conquest of Assyria and Babylonian lands in the 6th century BCE.[9]

From the earliest finds, opium has appeared to have ritual significance, and anthropologists have speculated ancient priests may have used the drug as a proof of healing power.[13] In Egypt, the use of opium was generally restricted to priests, magicians, and warriors, its invention is credited to Thoth, and it was said to have been given by Isis to Ra as treatment for a headache.[9] A figure of the Minoan "goddess of the narcotics", wearing a crown of three opium poppies, circa 1300 BCE, was recovered from the Sanctuary of Gazi, Crete, together with a simple smoking apparatus.[15][16] The Greek gods Hypnos (Sleep), Nyx (Night), and Thanatos (Death) were depicted wreathed in poppies or holding them. Poppies also frequently adorned statues of Apollo, Asklepios, Pluto, Demeter, Aphrodite, Kybele and Isis, symbolizing nocturnal oblivion.[9]

Islamic societies (500–1500 AD)[edit]

Opium users in Java during the Dutch colonial period, circa 1870

As the power of the Roman Empire declined, the lands to the south, and east of the Mediterranean Sea became incorporated into the Islamic Empires. Some Muslims believe hadiths, such as in Sahih Bukhari, prohibits every intoxicating substance, though the use of intoxicants in medicine has been widely permitted by scholars.[17] Dioscorides' five-volume De Materia Medica, the precursor of pharmacopoeias, remained in use (with some improvements in Arabic versions[18]) from the 1st to 16th centuries, and described opium and the wide range of its uses prevalent in the ancient world.[19]

Between 400 and 1200 AD, Arab traders introduced opium to China.[9][14][20] The Persian physician Muhammad ibn Zakariya al-Razi ("Rhazes", 845–930 AD) maintained a laboratory and school in Baghdad, and was a student and critic of Galen; he made use of opium in anesthesia and recommended its use for the treatment of melancholy in Fi ma-la-yahdara al-tabib, "In the Absence of a Physician", a home medical manual directed toward ordinary citizens for self-treatment if a doctor was not available.[21][22]

The renowned Andalusian ophthalmologic surgeon Abu al-Qasim al-Zahrawi ("Abulcasis", 936–1013 AD) relied on opium and mandrake as surgical anaesthetics and wrote a treatise, al-Tasrif, that influenced medical thought well into the 16th century.[23]

The Persian physician Abū ‘Alī al-Husayn ibn Sina ("Avicenna") described opium as the most powerful of the stupefacients, by comparison with mandrake and other highly effective herbs, in The Canon of Medicine. The text mentions the medicinal effects of opium such as analgesic, hypnotic, antitussive, gastrointestinal, cognitive, respiratory depression, neuromuscular disturbance, and sexual dysfunction. It also refers to its potential as a poison. Avicenna describes several methods of delivery and recommendations for doses of the drug in The Canon of Medicine.[24] This classic text was translated into Latin in 1175 and later into many other languages and remained authoritative into the 17th century.[25] Şerafeddin Sabuncuoğlu used opium in the 14th-century Ottoman Empire to treat migraine headaches, sciatica, and other painful ailments.[26]

Reintroduction to Western medicine[edit]

Latin translation of Avicenna's Canon of Medicine, 1483

Manuscripts of Pseudo-Apuleius's 5th-century work from the 10th and 11th centuries refer to the use of wild poppy Papaver agreste or Papaver rhoeas (identified as P. silvaticum) instead of P. somniferum for inducing sleep and relieving pain.[27]

The use of Paracelsus' laudanum was introduced to Western medicine in 1527, when Philippus Aureolus Theophrastus Bombastus von Hohenheim, better known by the name Paracelsus, returned from his wanderings in Arabia with a famous sword, within the pommel of which he kept "Stones of Immortality" compounded from opium thebaicum, citrus juice, and "quintessence of gold."[14][28][29] The name "Paracelsus" was a pseudonym signifying him the equal or better of Aulus Cornelius Celsus, whose text, which described the use of opium or a similar preparation, had recently been translated and reintroduced to medieval Europe.[30] The Canon of Medicine, the standard medical textbook Paracelsus burned in a public bonfire three weeks after being appointed professor at the University of Basel, also described the use of opium, though many Latin translations were of poor quality.[28] Laudanum was originally the 16th-century term for a medicine associated with a particular physician that was widely well-regarded, but became standardized as "tincture of opium", a solution of opium in ethanol, which Paracelsus has been credited with developing. During his lifetime, Paracelsus was viewed as an adventurer who challenged the theories and mercenary motives of contemporary medicine with dangerous chemical therapies, but his therapies marked a turning point in Western medicine. In the 17th century, laudanum was recommended for pain, sleeplessness, and diarrhea by Thomas Sydenham,[31] the renowned "father of English medicine" or "English Hippocrates", to whom is attributed the quote, "Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium."[32] Use of opium as a cure-all was reflected in the formulation of mithridatium described in the 1728 Chambers Cyclopedia, which included true opium in the mixture. Subsequently, laudanum became the basis of many popular patent medicines of the 19th century.

During the 18th century, opium was found to be a good remedy for nervous disorders. Due to its sedative and tranquilizing properties, it was used to quiet the minds of those with psychosis, help with people who were considered insane, and also to help treat patients with insomnia.[33] However, despite its medicinal values in these cases, it was noted that in cases of psychosis, it could cause anger or depression, and due to the drug's euphoric effects, it could cause depressed patients to become more depressed after the effects wore off because they would get used to being high.[33]

The standard medical use of opium persisted well into the 19th century. US president William Henry Harrison was treated with opium in 1841, and in the American Civil War, the Union Army used 2.8 million ounces of opium tincture and powder and about 500,000 opium pills.[9] During this time of popularity, users called opium "God's Own Medicine."[34]

Recreational use in Europe, the Middle East and the US (15th to 19th centuries)[edit]

An artist's view of an Ottoman opium seller

Opium is said to have been used for recreational purposes from the 14th century onwards in Muslim societies. Testimonies of historians, diplomats, religious scholars, intellectuals and travellers, Ottoman and European, confirm, from the 16th to the 19th centuries, Anatolian opium was eaten in Constantinople as much as it was exported to Europe. In 1573, for instance, a Venetian visitor to the Ottoman Empire observed many of the Turkish natives of Constantinople regularly drank a "certain black water made with opium" that makes them feel good, but to which they become so addicted, if they try to go without, they will "quickly die".[35] From eating it, dervishes were said to draw ecstasy, soldiers courage, and others bliss and voluptuousness. Indeed, Turkey supplied the West with opium long before China.[36] In his Confessions of an English Opium-Eater (1821, p. 188), it is Ottoman, not Chinese, addicts about whom Thomas de Quincey writes: "I question whether any Turk, of all that ever entered the paradise of opium-eaters, can have had half the pleasure I had."

Extensive textual and pictorial sources also show that poppy cultivation and opium consumption were widespread in Safavid Iran[37] and Mughal India.[38]

The most important reason for the increase in opiate consumption in the United States during the 19th century was the prescribing and dispensing of legal opiates by physicians and pharmacists to women with "female problems" (mostly to relieve menstrual pain). Between 150,000 and 200,000 opiate addicts lived in the United States in the late 19th century and between two-thirds and three-quarters of these addicts were women.[39]

Recreational use in China[edit]

An opium den in 18th-century China through the eyes of a Western artist

The earliest clear description of the use of opium as a recreational drug in China 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". He also described an expedition sent by the Ming dynasty Chenghua Emperor in 1483 to procure opium for a price "equal to that of gold" in Hainan, Fujian, Zhejiang, Sichuan and Shaanxi, where it is close to the western lands of Xiyu. A century later, Li Shizhen listed standard medical uses of opium in his renowned Compendium of Materia Medica (1578), but also wrote that "lay people use it for the art of sex", in particular the ability to "arrest seminal emission". This association of opium with sex continued in China until the end of the 19th century.

Opium smoking began as a privilege of the elite and remained a great luxury into the early 19th century. However, 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.[40]

A Chinese opium house, photograph 1902

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. The prohibition ended in 1644 with the coming of the Qing dynasty, which encouraged smokers to mix in increasing amounts of opium.[9] In 1705, Wang Shizhen wrote, "nowadays, from nobility and gentlemen down to slaves and women, all are addicted to tobacco." Tobacco in that time was frequently mixed with other herbs (this continues with clove cigarettes to the modern day), and opium was one component in the mixture. Tobacco mixed with opium was called madak (or madat) and became popular throughout China and its seafaring trade partners (such as Taiwan, Java, and the Philippines) in the 17th century.[40] In 1712, Engelbert Kaempfer described addiction to madak: "No commodity throughout the Indies is retailed with greater profit by the Batavians than opium, which [its] users cannot do without, nor can they come by it except it be brought by the ships of the Batavians from Bengal and Coromandel."[20]

Fueled in part by the 1729 ban on madak, which at first effectively exempted pure opium as a potentially medicinal product, the smoking of pure opium became more popular in the 18th century. In 1736, the smoking of pure opium was described by Huang Shujing, involving a pipe made from bamboo rimmed with silver, stuffed with palm slices and hair, fed by a clay bowl in which a globule of molten opium was held over the flame of an oil lamp. This elaborate procedure, requiring the maintenance of pots of opium at just the right temperature for a globule to be scooped up with a needle-like skewer for smoking, formed the basis of a craft of "paste-scooping" by which servant girls could become prostitutes as the opportunity arose.[40]

Chinese diaspora[edit]

Beginning in 19th-century China, famine and political upheaval, as well as rumors of wealth to be had in nearby Southeast Asia, led to the Chinese Diaspora. Chinese emigrants to cities such as San Francisco, London, and New York brought with them the Chinese manner of opium smoking and the social traditions of the opium den.[41][42] The Indian Diaspora distributed opium-eaters in the same way, and both social groups survived as "lascars" (seamen) and "coolies" (manual laborers). French sailors provided another major group of opium smokers, having contracted the habit in French Indochina, where the drug was promoted by the colonial government as a monopoly and source of revenue.[43][44] Among white Europeans, opium was more frequently consumed as laudanum or in patent medicines. Britain's All-India Opium Act of 1878 formalized social distinctions, limiting recreational opium sales to registered Indian opium-eaters and Chinese opium-smokers and prohibiting its sale to workers from Burma.[45] Likewise, American law sought to contain addiction to immigrants by prohibiting Chinese from smoking opium in the presence of a white man.[41]

Because of the low social status of immigrant workers, contemporary writers and media had little trouble portraying opium dens as seats of vice, white slavery, gambling, knife- and revolver-fights, a source for drugs causing deadly overdoses, with the potential to addict and corrupt the white population. By 1919, anti-Chinese riots attacked Limehouse, the Chinatown of London. Chinese men were deported for playing keno and sentenced to hard labor for opium possession. Both the immigrant population and the social use of opium fell into decline.[46][47] Yet despite lurid literary accounts to the contrary, 19th-century London was not a hotbed of opium smoking. The total lack of photographic evidence of opium smoking in Britain, as opposed to the relative abundance of historical photos depicting opium smoking in North America and France, indicates the infamous Limehouse opium-smoking scene was little more than fantasy on the part of British writers of the day, who were intent on scandalizing their readers while drumming up the threat of the "yellow peril".[48][49]

Prohibition and conflict in China[edit]

Destruction of opium in China

Opium prohibition began in 1729, when Emperor Yongzheng of the Qing Dynasty, disturbed by madak smoking at court and carrying out the government's role of upholding Confucian virtue, officially prohibited the sale of opium, except for a small amount for medicinal purposes. The ban punished sellers and opium den keepers, but not users of the drug.[20] Opium was banned completely in 1799, and this prohibition continued until 1860.[50]

British opium ships

Under the Qing Dynasty, China opened itself to foreign trade under the Canton System through the port of Guangzhou (Canton), and traders from the East India Company began visiting the port by the 1690s. Due to the growing British demand for Indian tea and the Chinese Emperor's lack of interest in British commodities other than silver, British traders resorted to trade in opium as a high-value commodity for which China was not self-sufficient. The English traders had been purchasing small amounts of opium from India for trade since Ralph Fitch first visited in the mid-16th century.[20] Trade in opium was standardized, with production of balls of raw opium, 1.1 to 1.6 kilograms, 30% water content, wrapped in poppy leaves and petals, and shipped in chests of 60–65 kilograms (one picul).[20] Chests of opium were sold in auctions in Calcutta with the understanding that the independent purchasers would then smuggle it into China.

After the 1757 Battle of Plassey and 1764 Battle of Buxar, the British East India Company gained the power to act as diwan of Bengal, Bihar, and Odisha (See company rule in India). This allowed the company to exercise a monopoly over opium production and export in India, to encourage ryots to cultivate the cash crops of indigo and opium with cash advances, and to prohibit the "hoarding" of rice. This strategy led to the increase of the land tax to 50% of the value of crops and to the doubling of East India Company profits by 1777. It is also claimed to have contributed to the starvation of 10 million people in the Bengal famine of 1770. Beginning in 1773, the British government began enacting oversight of the company's operations, and in response to the Indian Rebellion of 1857, this policy culminated in the establishment of direct rule over the presidencies and provinces of British India. Bengal opium was highly prized, commanding twice the price of the domestic Chinese product, which was regarded as inferior in quality.[51]

Some competition came from the newly independent United States, which began to compete in Guangzhou, selling Turkish opium in the 1820s. Portuguese traders also brought opium from the independent Malwa states of western India, although by 1820, the British were able to restrict this trade by charging "pass duty" on the opium when it was forced to pass through Bombay to reach an entrepot.[20] Despite drastic penalties and continued prohibition of opium until 1860, opium importation rose steadily from 200 chests per year under Yongzheng to 1,000 under Qianlong, 4,000 under Jiaqing, and 30,000 under Daoguang.[52] The illegal sale of opium became one of the world's most valuable single commodity trades and has been called "the most long continued and systematic international crime of modern times".[53] Opium smuggling provided 15 to 20% of the British Empire's revenue and simultaneously caused scarcity of silver in China.[54]

In response to the ever-growing number of Chinese people becoming addicted to opium, Daoguang of the Qing Dynasty took strong action to halt the import of opium, including the seizure of cargo. In 1838, the Chinese Commissioner Lin Zexu destroyed 20,000 chests of opium in Guangzhou.[20] Given that a chest of opium was worth nearly $1,000 in 1800, this was a substantial economic loss. The British queen Victoria, not willing to replace the cheap opium with costly silver, began the First Opium War in 1840, the British winning Hong Kong and trade concessions in the first of a series of Unequal Treaties.

Map showing the amount of opium produced in China in 1908: The quote "We English, by the policy we have pursued, are morally responsible for every acre of land in China which is withdrawn from the cultivation of grain and devoted to that of the poppy; so that the fact of the growth of the drug in China ought only to increase our sense of responsibility." is by Lord Justice Fry.

Following China's defeat in the Second Opium War in 1858, China was forced to legalize opium and began massive domestic production. Importation of opium peaked in 1879 at 6,700 tons, and by 1906, China was producing 85% of the world's opium, some 35,000 tons, and 27% of its adult male population regularly used opium —13.5 million people consuming 39,000 tons of opium yearly.[51] From 1880 to the beginning of the Communist era, the British attempted to discourage the use of opium in China, but this effectively promoted the use of morphine, heroin, and cocaine, further exacerbating the problem of addiction.[55]

Scientific evidence of the pernicious nature of opium use was largely undocumented in the 1890s, when Protestant missionaries in China decided to strengthen their opposition to the trade by compiling data which would demonstrate the harm the drug did. Faced with the problem that many Chinese associated Christianity with opium, partly due to the arrival of early Protestant missionaries on opium clippers, at the 1890 Shanghai Missionary Conference, they agreed to establish the Permanent Committee for the Promotion of Anti-Opium Societies in an attempt to overcome this problem and to arouse public opinion against the opium trade. The members of the committee were John Glasgow Kerr, MD, American Presbyterian Mission in Canton; B.C. Atterbury, MD, American Presbyterian Mission in Peking; Archdeacon Arthur E. Moule, Church Missionary Society in Shanghai; Henry Whitney, MD, American Board of Commissioners for foreign Missions in Foochow; the Rev. Samuel Clarke, China Inland Mission in Kweiyang; the Rev. Arthur Gostick Shorrock, English Baptist Mission in Taiyuan; and the Rev. Griffith John, London Mission Society in Hankow.[56] These missionaries were generally outraged over the British government's Royal Commission on Opium visiting India but not China. Accordingly, the missionaries first organized the Anti-Opium League in China among their colleagues in every mission station in China. American missionary Hampden Coit DuBose acted as first president. This organization, which had elected national officers and held an annual national meeting, was instrumental in gathering data from every Western-trained medical doctor in China, which was then published as William Hector Park compiled Opinions of Over 100 Physicians on the Use of Opium in China (Shanghai: American Presbyterian Mission Press, 1899). The vast majority of these medical doctors were missionaries; the survey also included doctors who were in private practices, particularly in Shanghai and Hong Kong, as well as Chinese who had been trained in medical schools in Western countries. In England, the home director of the China Inland Mission, Benjamin Broomhall, was an active opponent of the opium trade, writing two books to promote the banning of opium smoking: The Truth about Opium Smoking and The Chinese Opium Smoker. In 1888, Broomhall formed and became secretary of the Christian Union for the Severance of the British Empire with the Opium Traffic and editor of its periodical, National Righteousness. He lobbied the British Parliament to stop the opium trade. He and James Laidlaw Maxwell appealed to the London Missionary Conference of 1888 and the Edinburgh Missionary Conference of 1910 to condemn the continuation of the trade. When Broomhall was dying, his son Marshall read to him from The Times the welcome news that an agreement had been signed ensuring the end of the opium trade within two years.

Official Chinese resistance to opium was renewed on September 20, 1906, with an antiopium initiative intended to eliminate the drug problem within 10 years. The program relied on the turning of public sentiment against opium, with mass meetings at which opium paraphernalia were publicly burned, as well as coercive legal action and the granting of police powers to organizations such as the Fujian Anti-Opium Society. Smokers were required to register for licenses for gradually reducing rations of the drug. Action against opium farmers centred upon a highly repressive incarnation of law enforcement in which rural populations had their property destroyed, their land confiscated and/or were publically tortured, humiliated and executed.[57] Addicts sometimes turned to missionaries for treatment for their addiction, though many associated these foreigners with the drug trade. The program was counted as a substantial success, with a cessation of direct British opium exports to China (but not Hong Kong)[58] and most provinces declared free of opium production. Nonetheless, the success of the program was only temporary, with opium use rapidly increasing during the disorder following the death of Yuan Shikai in 1916.[59] Opium farming also increased after the death of Yuan Shikai, peaking in 1930 when the League of Nations singled China out as the primary source of illicit opium in East and Southeast Asia. Many [60] local powerholders facilitated the trade during this period to finance conflicts over territory and political campaigns. In some areas food crops were eradicated to make way for opium, contributing to famines in Kweichow and Shensi Provinces between 1921 and 1923, and food deficits in other provinces .

Beginning in 1915, Chinese nationalist groups came to describe the period of military losses and Unequal Treaties as the "Century of National Humiliation", later defined to end with the conclusion of the Chinese Civil War in 1949.[61]

In the northern provinces of Ningxia and Suiyuan in China, Chinese Muslim General Ma Fuxiang both prohibited and engaged in the opium trade. It was hoped that Ma Fuxiang would have improved the situation, since Chinese Muslims were well known for opposition to smoking opium.[62] Ma Fuxiang officially prohibited opium and made it illegal in Ningxia, but the Guominjun reversed his policy; by 1933, people from every level of society were abusing the drug, and Ningxia was left in destitution.[63] In 1923, an officer of the Bank of China from Baotou found out that Ma Fuxiang was assisting the drug trade in opium which helped finance his military expenses. He earned $2 million from taxing those sales in 1923. General Ma had been using the bank, a branch of the Government of China's exchequer, to arrange for silver currency to be transported to Baotou to use it to sponsor the trade.[64]

Opium trade under the Chinese Communist Party was important to its finances in the 1940s.[65] Peter Vladimirov's diary provided a first hand account.[66] Chen Yung-Fa provided a detailed historical account of how the opium trade was essential to the economy of Yan'an during this period.[67] Mitsubishi and Mitsui were involved in the opium trade during the Japanese occupation of China.[68]

The Mao Zedong government is generally credited with eradicating both consumption and production of opium during the 1950s using unrestrained repression and social reform[citation needed]. Ten million addicts were forced into compulsory treatment, dealers were executed, and opium-producing regions were planted with new crops. Remaining opium production shifted south of the Chinese border into the Golden Triangle region, at times with the involvement of Western intelligence agencies.[51] The remnant opium trade primarily served Southeast Asia, but spread to American soldiers during the Vietnam War, with 20% of soldiers regarding themselves as addicted during the peak of the epidemic in 1971. In 2003, China was estimated to have four million regular drug users and one million registered drug addicts.[69]

Prohibition outside China[edit]

There were no legal restrictions on the importation or use of opium in the United States until the San Francisco Opium Den Ordinance, which banned dens for public smoking of opium in 1875, a measure fueled by anti-Chinese sentiment and the perception that whites were starting to frequent the dens. This was followed by an 1891 California law requiring that narcotics carry warning labels and that their sales be recorded in a registry; amendments to the California Pharmacy and Poison Act in 1907 made it a crime to sell opiates without a prescription, and bans on possession of opium or opium pipes in 1909 were enacted.[70]

At the US federal level, the legal actions taken reflected constitutional restrictions under the enumerated powers doctrine prior to reinterpretation of the commerce clause, which did not allow the federal government to enact arbitrary prohibitions, but did permit arbitrary taxation.[71] Beginning in 1883, opium importation was taxed at $6 to $300 per pound, until the Opium Exclusion Act of 1909 prohibited the importation of opium altogether. In a similar manner, the Harrison Narcotics Tax Act of 1914, passed in fulfillment of the International Opium Convention of 1912, nominally placed a tax on the distribution of opiates, but served as a de facto prohibition of the drugs. Today, opium is regulated by the Drug Enforcement Administration under the Controlled Substances Act.

Following passage of a Colonial Australian law in 1895, Queensland's Aboriginals Protection and Restriction of the Sale of Opium Act 1897 addressed opium addiction among Aboriginal people, though it soon became a general vehicle for depriving them of basic rights by administrative regulation. By 1905 all Australian states and territories had passed similar laws making prohibitions to Opium sale. Smoking and possession was prohibited in 1908.[72]

Hardening of Canadian attitudes toward Chinese opium users and fear of a spread of the drug into the white population led to the effective criminalization of opium for nonmedical use in Canada between 1908 and the mid-1920s.[73]

In 1909, the International Opium Commission was founded, and by 1914, 34 nations had agreed that the production and importation of opium should be diminished. In 1924, 62 nations participated in a meeting of the Commission. Subsequently, this role passed to the League of Nations, and all signatory nations agreed to prohibit the import, sale, distribution, export, and use of all narcotic drugs, except for medical and scientific purposes. This role was later taken up by the International Narcotics Control Board of the United Nations under Article 23 of the Single Convention on Narcotic Drugs, and subsequently under the Convention on Psychotropic Substances. Opium-producing nations are required to designate a government agency to take physical possession of licit opium crops as soon as possible after harvest and conduct all wholesaling and exporting through that agency.[9]

Regulation in Britain and the United States[edit]

Before the 1920s, regulation in Britain was controlled by the pharmacists. Pharmacists that were found to have prescribed opium for illegitimate causes and anyone found to have sold opium without proper qualifications would be prosecuted.[74] Due to the passing of the Rolleston Act in Britain in 1926, doctors could prescribe opiates such as morphine and heroin on their own accord based on if they felt that their patients needed it. This Act came about due to the fact that Britain didn’t see people’s addiction as an indulgence, but rather as a medical problem that needed weaning off the drug rather than cutting the patient off altogether.[75] The passing of this act put the control of opium use in the hands of medical doctors instead of pharmacists. However, as the 20th century continued, the addiction to opiates, especially heroin in young people, continued to rise and so the sale and prescription of opiates was limited to doctors in treatment centers and if these doctors were found to be prescribing opiates without just cause, then they could lose their license to practice or prescribe drugs.[75] The abuse of opium in the United States began in the late 19th century and was largely stigmatized with Chinese immigrants. During this time the use of opium had little negative connotation and was used freely until 1882 when a law was passed to confine opium smoking to specific dens.[75] Until the full ban on opium based products came into effect just after the turn of the century, physicians in the US considered opium a miracle drug that could help with many ailments. Therefore, the ban on said products was more a result of negative connotations towards its use and distribution by Chinese immigrants who were heavily persecuted during this particular period in history.[75] As the 19th century progressed however, there was a doctor by the name of Hamilton Wright that worked to decrease the use of opium in the US by submitting the Harrison Act to congress. This act put taxes and restrictions on the sale and prescription of opium, as well as trying to stigmatize the opium poppy and its derivatives as "demon drugs," to try and scare people away from them.[75] This act and the stigma of a demon drug on opium, led to the criminalization of people that used opium-based products.

20th century historical use[edit]

During the Communist era in Eastern Europe, poppy stalks sold in bundles by farmers were processed by users with household chemicals to make kompot ("Polish heroin"), and poppy seeds were used to produce koknar, an opiate.[76]

Obsolescence[edit]

Bayer heroin bottle

Globally, opium has gradually been superseded by a variety of purified, semi-synthetic, and synthetic opioids with progressively stronger effects, and by other general anesthetics. This process began in 1804, when Friedrich Wilhelm Adam Sertürner first isolated morphine from the opium poppy.[77][78] The process continued until 1817, when Sertürner published the isolation of pure morphine from opium after at least thirteen years of research and a nearly disastrous trial on himself and three boys.[79] The great advantage of purified morphine was that a patient could be treated with a known dose—whereas with raw plant material, as Gabriel Fallopius once lamented, "if soporifics are weak they do not help; if they are strong they are exceedingly dangerous." Morphine was the first pharmaceutical isolated from a natural product, and this success encouraged the isolation of other alkaloids: by 1820, isolations of narcotine, strychnine, veratrine, colchicine, caffeine, and quinine were reported. Morphine sales began in 1827, by Heinrich Emanuel Merck of Darmstadt, and helped him expand his family pharmacy into the Merck KGaA pharmaceutical company.

Codeine was isolated in 1832 by Pierre Jean Robiquet.

The use of diethyl ether and chloroform for general anesthesia began in 1846–1847, and rapidly displaced the use of opiates and tropane alkaloids from Solanaceae due to their relative safety.[80]

Heroin, the first semi-synthetic opiate, was first synthesized in 1874, but was not pursued until its rediscovery in 1897 by Felix Hoffmann at the Bayer pharmaceutical company in Elberfeld, Germany. From 1898 to 1910 heroin was marketed as a non-addictive morphine substitute and cough medicine for children. By 1902, sales made up 5% of the company's profits, and "heroinism" had attracted media attention.[81] Oxycodone, a thebaine derivative similar to codeine, was introduced by Bayer in 1916 and promoted as a less-addictive analgesic. Preparations of the drug such as Percocet and OxyContin remain popular to this day.

A range of synthetic opioids such as methadone (1937), pethidine (1939), fentanyl (late 1950s), and derivatives thereof have been introduced, and each is preferred for certain specialized applications. Nonetheless, morphine remains the drug of choice for American combat medics, who carry packs of syrettes containing 16 milligrams each for use on severely wounded soldiers.[82] No drug has been found that can match the painkilling effect of opioids without also duplicating much of their addictive potential.

Modern production and usage[edit]

Papaver somniferum[edit]

Main article: Opium poppy

Opium poppies (Papaver somniferum) are popular and attractive garden plants, whose flowers vary greatly in color, size and form. A modest amount of domestic cultivation in private gardens is not usually subject to legal controls. In part, this tolerance reflects variation in addictive potency. A cultivar for opium production, Papaver somniferum L. elite, contains 91.2% morphine, codeine, and thebaine in its latex alkaloids, whereas in the latex of the condiment cultivar "Marianne", these three alkaloids total only 14.0 %. The remaining alkaloids in the latter cultivar are primarily narcotoline and noscapine.[83]

Seed capsules can be dried and used for decorations, but they also contain morphine, codeine, and other alkaloids. These pods can be boiled in water to produce a bitter tea that induces a long-lasting intoxication (See Poppy tea). If allowed to mature, poppy pods (poppy straw) can be crushed and used to produce lower quantities of morphinans. In poppies subjected to mutagenesis and selection on a mass scale, researchers have been able to use poppy straw to obtain large quantities of oripavine, a precursor to opioids and antagonists such as naltrexone.[84] Although millennia older, the production of poppy head decoctions can be seen as a quick and dirty variant of the Kábáy poppy straw process, which since its publication in 1930 has become the major method of obtaining licit opium alkaloids worldwide, as discussed under the Wikipedia Morphine article.

Poppy seeds are a common and flavorsome topping for breads and cakes. One gram of poppy seeds contains up to 33 micrograms of morphine and 14 micrograms of codeine, and the Substance Abuse and Mental Health Services Administration in the United States formerly mandated that all drug screening laboratories use a standard cutoff of 300 nanograms per milliliter in urine samples. A single poppy seed roll (0.76 grams of seeds) usually did not produce a positive drug test, but a positive result was observed from eating two rolls. A slice of poppy seed cake containing nearly five grams of seeds per slice produced positive results for 24 hours. Such results are viewed as false positive indications of drug abuse and were the basis of a legal defense.[85][86] On November 30, 1998, the standard cutoff was increased to 2000 nanograms (two micrograms) per milliliter.[87] Confirmation by gas chromatograpy-mass spectrometry will distinguish amongst opium and variants including poppy seeds, heroin, and morphine and codeine pharmaceuticals by measuring the morphine:codeine ratio and looking for the presence of noscapine and acetylcodeine, the latter of which is only found in illicitly produced heroin, and heroin metabolites such as 6-monoacetylmorphine.[88]

Harvesting and processing[edit]

Harvesting opium

When grown for opium production, the skin of the ripening pods of these poppies is scored by a sharp blade at a time carefully chosen so that rain, wind, and dew cannot spoil the exudation of white, milky latex, usually in the afternoon. Incisions are made while the pods are still raw, with no more than a slight yellow tint, and must be shallow to avoid penetrating hollow inner chambers or loculi while cutting into the lactiferous vessels. In Indian Subcontinent, Afghanistan, Central Asia and Iran, the special tool used to make the incisions is called a nushtar or "nishtar" (from Persian, meaning a lancet) and carries three or four blades three millimeters apart, which are scored upward along the pod. Incisions are made three or four times at intervals of two to three days, and each time the "poppy tears," which dry to a sticky brown resin, are collected the following morning. One acre harvested in this way can produce three to five kilograms of raw opium.[89] In the Soviet Union, pods were typically scored horizontally, and opium was collected three times, or else one or two collections were followed by isolation of opiates from the ripe capsules. Oil poppies, an alternative strain of P. somniferum, were also used for production of opiates from their capsules and stems.[90] A traditional Chinese method of harvesting opium latex involved cutting off the heads and piercing them with a coarse needle then collecting the dried opium 24 to 48 hours later.

Raw opium may be sold to a merchant or broker on the black market, but it usually does not travel far from the field before it is refined into morphine base, because pungent, jelly-like raw opium is bulkier and harder to smuggle. Crude laboratories in the field are capable of refining opium into morphine base by a simple acid-base extraction. A sticky, brown paste, morphine base is pressed into bricks and sun-dried, and can either be smoked, prepared into other forms or processed into heroin.[14]

The production of wheat in Deh Dehi has decreased dramatically since farmers had invested in the opium trade. Over some years, the opium trade has become the key economic activity in the village. A farmer reported that he can earn between 1000–2000 lakhs annual profit from poppy cultivation instead of the 20 he would make cultivating wheat. Now, all the irrigated land is given over to the poppy cultivation, and most of the men and women who worked in the livestock trade are either involved in the opium trade or work overseas.[91]

Other methods of preparation (besides smoking), include processing into regular opium tincture (tinctura opii), laudanum, paregoric (tinctura opii camphorata), herbal wine (e.g. vinum opii), opium powder (pulvis opii), opium sirup (sirupus opii) and opium extract (extractum opii).[92] Vinum opii is made by combining sugar, white wine, cinnamon, and cloves. Opium syrup is made by combining 997.5 part sugar syrup with 2.5 parts opium extract. Opium extract (extractum opii) finally can be made by macerating raw opium with water. To make opium extract, 20 parts water are combined with 1 part raw opium which has been boiled for 5 minutes (the latter to ease mixing).[92]

Heroin is widely preferred because of increased potency. One study in postaddicts found heroin to be approximately 2.2 times more potent than morphine by weight with a similar duration; at these relative quantities, they could distinguish the drugs subjectively but had no preference.[93] Heroin was also found to be twice as potent as morphine in surgical anesthesia.[94] Morphine is converted into heroin by a simple chemical reaction with acetic anhydride, followed by a varying degree of purification.[95][96] Especially in Mexican production, opium may be converted directly to "black tar heroin" in a simplified procedure. This form predominates in the U.S. west of the Mississippi. Relative to other preparations of heroin, it has been associated with a dramatically decreased rate of HIV transmission among intravenous drug users (4% in Los Angeles vs. 40% in New York) due to technical requirements of injection, although it is also associated with greater risk of venous sclerosis and necrotizing fasciitis.[97]

Illegal production[edit]

International drug routes
Afghanistan, Helmand province. A Marine greets local children working in the field of opium poppies near the base.

Opium production has fallen greatly since 1906, when 41,000 tons were produced, but because 39,000 tons of that year's opium were consumed in China, overall usage in the rest of the world was much lower.[51] These figures from 1906 have been criticized as overestimates.[98] In 1980, 2,000 tons of opium supplied all legal and illegal uses.[20] Recently, opium production has increased considerably, surpassing 5,000 tons in 2002. The World Health Organization has estimated that current production of opium would need to increase fivefold to account for total global medical need.[98]

In 2002, the price for one kilogram of opium was $300 for the farmer, $800 for purchasers in Afghanistan, and $16,000 on the streets of Europe before conversion into heroin.[2]

Afghanistan is currently the primary producer of the drug. After regularly producing 70% of the world's opium, Afghanistan decreased production to 74 tons per year under a ban by the Taliban in 2000, a move which cut production by 94 percent. A year later, after American and British troops invaded Afghanistan, removed the Taliban and installed the interim government, the land under cultivation leapt back to 285 square miles (740 km2), with Afghanistan supplanting Burma to become the world's largest opium producer once more. Opium production in that country has increased rapidly since, reaching an all-time high in 2006. According to DEA statistics, Afghanistan's production of oven-dried opium increased to 1,278 tons in 2002, more than doubled by 2003, and nearly doubled again during 2004. In late 2004, the U.S. government estimated that 206,000 hectares were under poppy cultivation, 4.5% of the country's total cropland, and produced 4,200 metric tons of opium, 76% of the world's supply, yielding 60% of Afghanistan's gross domestic product.[99] In 2006, the UN Office on Drugs and Crime estimated production to have risen 59% to 407,000 acres (1,650 km2) in cultivation, yielding 6,100 tons of opium, 82% of the world's supply.[100] The value of the resulting heroin was estimated at $3.5 billion, of which Afghan farmers were estimated to have received $700 million in revenue. For farmers, the crop can be up to ten times more profitable than wheat. The price of opium is around $138 per kilo. Opium production has led to rising tensions in Afghan villages. Though direct conflict has yet to occur, the opinions of the new class of young, rich men involved in the opium trade are at odds with those of the traditional village leaders.[91]

An increasingly large fraction of opium is processed into morphine base and heroin in drug labs in Afghanistan. Despite an international set of chemical controls designed to restrict availability of acetic anhydride, it enters the country, perhaps through its Central Asian neighbors which do not participate. A counternarcotics law passed in December 2005 requires Afghanistan to develop registries or regulations for tracking, storing, and owning acetic anhydride.[101]

Besides Afghanistan, smaller quantities of opium are produced in Pakistan, the Golden Triangle region of Southeast Asia (particularly Burma), Colombia, Guatemala, and Mexico.

200 g Spanish opium ball

Chinese production mainly trades with and profits from North America. In 2002, they were seeking to expand through eastern United States. In the post 9/11 era, trading between borders became difficult and because new international laws were set into place, the opium trade became more diffused. Power shifted from remote to high-end smugglers and opium traders. Outsourcing became a huge factor for survival for many smugglers and opium farmers.[102]

In South American countries, opium poppies are technically illegal, but nonetheless appear in some nurseries as ornamentals.[citation needed]

Legal production[edit]

Main article: Opium licensing

Legal opium production is allowed under the United Nations Single Convention on Narcotic Drugs and other international drug treaties, subject to strict supervision by the law enforcement agencies of individual countries. The leading legal production method is the Gregory process, whereby the entire poppy, excluding roots and leaves, is mashed and stewed in dilute acid solutions. The alkaloids are then recovered via acid-base extraction and purified. This process was developed in the UK during World War II, when wartime shortages of many essential drugs encouraged innovation in pharmaceutical processing.[citation needed]

Legal opium production in India is much more traditional. As of 2008, opium was collected by farmers who were licensed to grow 0.1 hectares (0.25 acre) of opium poppies, who to maintain their licenses needed to sell 56 kilograms of unadulterated raw opium paste. The price of opium paste is fixed by the government according to the quality and quantity tendered. The average is around 1500 rupees ($29 US) per kilogram.[103] Some additional money is made by drying the poppy heads and collecting poppy seeds, and a small fraction of opium beyond the quota may be consumed locally or diverted to the black market. The opium paste is dried and processed into government opium and alkaloid factories before it is packed into cases of 60 kilograms for export. Purification of chemical constituents is done in India for domestic production, but typically done abroad by foreign importers.[104]

Legal opium importation from India and Turkey is conducted by Mallinckrodt, Noramco, Abbott Laboratories, Purdue Pharma, and Cody Laboratories Inc. in the United States, and legal opium production is conducted by GlaxoSmithKline, Johnson and Johnson, Johnson Matthey, and Mayne in Tasmania, Australia; Sanofi Aventis in France; Shionogi Pharmaceutical in Japan; and MacFarlan Smith in the United Kingdom.[105] The UN treaty requires that every country submit annual reports to the International Narcotics Control Board, stating that year's actual consumption of many classes of controlled drugs as well as opioids and projecting required quantities for the next year.[citation needed] This is to allow trends in consumption to be monitored and production quotas allotted.[citation needed]

A recent[when?] proposal from the European Senlis Council hopes to solve the problems caused by the large quantity of opium produced illegally in Afghanistan, most of which is converted to heroin and smuggled for sale in Europe and the USA.[citation needed] This proposal is to license Afghan farmers to produce opium for the world pharmaceutical market, and thereby solve another problem, that of chronic underuse of potent analgesics where required within developing nations. Part of the proposal is to overcome the "80–20 rule" that requires the U.S. to purchase 80% of its legal opium from India and Turkey to include Afghanistan, by establishing a second-tier system of supply control that complements the current INCB regulated supply and demand system by providing poppy-based medicines to countries who cannot meet their demand under the current regulations. Senlis arranged a conference in Kabul that brought drug policy experts from around the world to meet with Afghan government officials to discuss internal security, corruption issues, and legal issues within Afghanistan.[106] In June 2007, the Council launched a "Poppy for Medicines" project that provides a technical blueprint for the implementation of an integrated control system within Afghan village-based poppy for medicine projects: the idea promotes the economic diversification by redirecting proceeds from the legal cultivation of poppy and production of poppy-based medicines (See Senlis Council).[107] There has been criticism of the Senlis report findings by Macfarlan Smith, who argue that though they produce morphine in Europe, they were never asked to contribute to the report.[108]

Cultivation in the UK[edit]

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 located in Didcot, England. The British government has contradicted the Home Office's suggestion that opium cultivation can be legalized in Afghanistan for exports to the United Kingdom, helping lower poverty and internal fighting whilst helping the NHS to meet the high demand for morphine and heroin. Opium poppy cultivation in the United Kingdom does not need a license, but a license is required for those wishing to extract opium for medicinal products.[109]

Consumption[edit]

An Akha man smokes a pipe containing opium mixed with tobacco.

In the industrialized world, the United States is the world's biggest consumer of prescription opioids, with Italy one of the lowest because of tighter regulations on prescribing narcotics for pain relief.[110] 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 unrefined 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 madak and "ack ack" (smoking of cigarettes containing tobacco mixed with heroin powder) are only 40% and 20% efficient, respectively.[111] One study of British heroin addicts found a 12-fold excess mortality ratio (1.8% of the group dying per year).[112] Most heroin deaths result not from overdose per se, but combination with other depressant drugs such as alcohol or benzodiazepines.[113]

The smoking of opium does not involve the burning 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 use 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.[114] 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.[115] Taken thirty minutes prior to meals, it significantly slows intestinal motility, giving the intestines greater time to absorb fluid in the stool.

Despite the historically negative view of opium as a cause of addiction, the use of morphine and other derivatives isolated from opium in the treatment of chronic pain has been reestablished. If given in controlled doses, modern opiates can be an effective treatment for neuropathic pain and other forms of chronic pain.[116]

Chemical and physiological properties[edit]

See also: Opioid, Opiate and Morphinan
Morphine is the primary biologically active chemical constituent of opium.
Codeine is another biologically active chemical constituent of opium.

Opium contains two main groups of alkaloids. Phenanthrenes such as morphine, codeine, and thebaine are the main narcotic constituents.[117] Isoquinolines such as papaverine and noscapine have no significant central nervous system effects, and are not regulated under the Controlled Substances Act. Morphine is 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. Morphine binds to and activates mu opioid receptor in the brain, spinal cord, stomach and intestine. Regular use can lead to drug tolerance or physical dependence. Chronic opium addicts in 1906 China[51] or modern-day Iran[118] consume an average of eight grams of opium daily.

Both analgesia and drug addiction are functions of the mu opioid receptor, the class of opioid receptor first identified as responsive to morphine. Tolerance is associated with the superactivation of the receptor, which may be affected by the degree of endocytosis caused by the opioid administered, and leads to a superactivation of cyclic AMP signaling.[119] Long-term use of morphine in palliative care and management of chronic pain cannot be managed without the possible development of drug tolerance or physical dependence. Many techniques of drug treatment exist, including pharmacologically based treatments with naltrexone, methadone, or ibogaine.[120]

Slang terms[edit]

Some slang terms for opium include "O.P.", "hop", "midnight oil", "tar", "dope", and "Big O". ("Tar" and "dope" can also refer to heroin.) The traditional opium pipe is known as a "dream stick".[121]

Literary cultural references[edit]

There is a longstanding literary history by and about opium users. Thomas de Quincey's Confessions of an English Opium-Eater (1822), one of the first and most famous literary accounts of opium addiction written from the point of view of an addict, details the pleasures and dangers of the drug. De Quincey writes about the great English Romantic poet, Samuel Taylor Coleridge (1772–1834), whose "Kubla Khan" is also widely considered to be a poem of the opium experience. Coleridge began using opium in 1791 after developing jaundice and rheumatic fever and became a full addict after a severe attack of the disease in 1801, requiring 80–100 drops of laudanum daily.[122] George Crabbe is another early writer who wrote about opium. "The Lotos-Eaters", an 1832 poem by Alfred Lord Tennyson, reflects the generally favorable British attitude toward the drug. In The Count of Monte Cristo (1844) by Alexandre Dumas, père, the Count is assuaged by an edible form of opium and his experience with it is depicted vividly.

Edgar Allan Poe presents opium in a more disturbing context in his 1838 short story, "Ligeia", in which the narrator, deeply distraught for the loss of his beloved, takes solace in opium until he "had become a bounden slave in the trammels of opium," unable to distinguish fantasy from reality after taking immoderate doses of opium. In music, Hector Berlioz' Symphony Fantastique (1830) tells the tale of an artist who has poisoned himself with opium while in the depths of despair for a hopeless love. Each of the symphony's five movements takes place at a different setting and with increasingly audible effects from the drug. For example, in the fourth movement, "Marche au Supplice", the artist dreams that he is walking to his own execution. In the fifth movement, "Songe d’une Nuit du Sabbat", he dreams that he is at a witch's orgy, where he witnesses his beloved dancing wildly along to the demented Dies Irae.

Towards the end of the 19th century, references to opium and opium addiction, in the contexts of crime and the foreign underclass, abound within English literature, such as in Wilkie Collins' The Moonstone (1868), where it is used to attempt to uncover the jewel thief. Opium features in the opening paragraphs of Charles Dickens's 1870 serial, The Mystery of Edwin Drood, and in Arthur Conan Doyle's 1891 Sherlock Holmes short story, "The Man with the Twisted Lip". Opium is also one of the main subjects in a more recently written Sherlock Holmes novel by Anthony Horowitz. In Jules Verne's novel Around the World in Eighty Days (1873), the character Passepartout is lured into an opium den by the detective Fix, which causes him to become separated from Phileas Fogg, his employer. Opium likewise underwent a transformation in Chinese literature, becoming associated with indolence and vice by the early 20th century.[59] Perhaps the best-known literary reference to opium is Karl Marx's metaphor in his "Contribution to the Critique of Hegel's 'Philosophy of Right'," wherein he refers to religion as "the opium of the people." (This phrase is more commonly quoted as "the opiate of the masses.")

In the 20th century, as the use of opium was eclipsed by morphine and heroin, its role in literature became more limited and often focused on issues related to its prohibition. In The Good Earth by Pearl S. Buck, Wang Lung, the protagonist, gets his troublesome uncle and aunt addicted to opium in order to keep them out of his hair. William S. Burroughs autobiographically describes the use of opium and its derivatives. His associate, Jack Black's, memoir You Can't Win, chronicles one man's experience both as an onlooker in the opium dens of San Francisco, and later as a "hop fiend" himself. The book and subsequent movie, The Wonderful Wizard of Oz, may allude to opium at one point in the story, when Dorothy and her friends are drawn into a field of poppies, in which they fall asleep.[citation needed] Stephen Maturin, the naval physician in the Jack Aubrey series of nautical novels by Patrick O'Brian, is portrayed as being favorably disposed towards laudanum as a panacea. He claimed to be in control of his own usage, principally as a soporific, which reached as high as 1,000 drops. Opium is also repeatedly mentioned in the novel, The House of the Scorpion, by Nancy Farmer. The plot revolves partly around the poppy flower and opium drug. In George R.R. Martin's novel series A Song of Ice and Fire, a drink referred to in the books as "milk of the poppy" is often used to relieve pain. A 1986 autobiography entitled Poppies: Odyssey of an Opium Eater by Eric Detzer was later made into a film called The Opium Eater. The story explores how Detzer would go about acquiring dried opium poppy pods from flower shops and wild gardens in the Pacific Northwest to feed his opium addiction. Frequent use and dealing of opium is also prevalent in Eleanor Catton's novel The Luminaries.

See also[edit]

References[edit]

  1. ^ Professor Arthur C. Gibson. "The Pernicious Opium Poppy". University of California, Los Angeles. Retrieved February 22, 2014. 
  2. ^ a b c Mark Corcoran. "Afghanistan: America's blind eye". Retrieved 2007-05-11. 
  3. ^ Health on the Net Foundation Mother and Child Glossary
  4. ^ "Opium Factories of Bihar - Bihargatha". Bihargatha.in. Retrieved 2011-10-07. 
  5. ^ Opium : Dikotter, Frank, Lars Laamann and Zhou Xun. 2004. Narcotic Culture: A History of Drugs in China. Chicago: University of Chicago Press; Zheng Yangwen. 2005. The Social Life of Opium in China. New York: Cambridge University Press.
  6. ^ Paul Harris in Peshawar (November 25, 2001). "Victorious warlords set to open the opium floodgates". London: Observer.guardian.co.uk. Retrieved 2010-03-21. 
  7. ^ "UN World Drug Report 2007 – Afghanistan" (PDF). Retrieved 2010-03-21. 
  8. ^ "0.0_Front Matters_05-31-07.qxd" (PDF). Retrieved 2010-03-21. 
  9. ^ a b c d e f g h i Paul L. Schiff, Jr. (2002). "Opium and its alkaloids". American Journal of Pharmaceutical Education. Retrieved 2007-05-08. 
  10. ^ Sanskrit Dictionary
  11. ^ Pashto Names for Boys, khyber.org
  12. ^ Suzanne Carr (1995). [dead link] "MS thesis". Retrieved 2007-05-16.  (citing Andrew Sherratt)
  13. ^ a b c M J Brownstein (June 15, 1993). "A brief history of opiates, opioid peptides, and opioid receptors". Proc Natl Acad Sci USA 90 (12): 5391–5393. doi:10.1073/pnas.90.12.5391. PMC 46725. PMID 8390660. 
  14. ^ a b c d PBS Frontline (1997). "The Opium Kings". Retrieved 2007-05-16. 
  15. ^ a b P. G. Kritikos and S. P. Papadaki (January 1, 1967). "The early history of the poppy and opium". Journal of the Archaeological Society of Athens. Retrieved 2007-05-26. 
  16. ^ E. Guerra Doce (January 1, 2006). "Evidencias del consumo de drogas en Europa durante la Prehistoria". Trastornos Adictivos (in Spanish) 8 (1): 53–61. doi:10.1016/S1575-0973(06)75106-6. Retrieved 2007-05-10.  (includes image)
  17. ^ Ibrahim B. Syed. "Alcohol and Islam". Retrieved 2005-07-07. 
  18. ^ "Islamic Medical Manuscripts at the National Library of Medicine: a note on pharmaceutics". Retrieved 2007-06-06. 
  19. ^ Julius Berendes (1902). "De Materia Medica" (in German). Archived from the original on February 8, 2007. Retrieved 2007-05-10. 
  20. ^ a b c d e f g h Carl A. Trocki (2002). "Opium as a commodity and the Chinese drug plague" (PDF). Retrieved September 13, 2009. 
  21. ^ "Answers.com: al-Razi". 
  22. ^ "Abu Bakr Muhammad ibn Zakariya al-Razi (841–926)". Saudi Aramco World. January 2002. Retrieved 2008-01-12. 
  23. ^ "El Zahrawi – Father Of Surgery". Retrieved 2007-05-04. 
  24. ^ "Medicinal aspects of opium as described in Avicenna's Canon of Medicine.". Acta Med Hist Adriat. 2013. PMID 23883087. Retrieved 25 November 2014. 
  25. ^ Smith RD (October 1980). "Avicenna and the Canon of Medicine: a millennial tribute". West. J. Med. 133 (4): 367–70. PMC 1272342. PMID 7051568. 
  26. ^ Ganidagli, Suleyman M.D., Cengiz, Mustafa M.D., Aksoy, Sahin M.D., PhD, Verit, Ayhan M.D. (January 2004). "Approach to Painful Disorders by Serefeddin Sabuncuoglu in the Fifteenth Century Ottoman Period". Anesthesiology 100 (1): 165–169. doi:10.1097/00000542-200401000-00026. PMID 14695738. Retrieved 2007-05-04. 
  27. ^ "Pseudo-Apuleius: Papaver". Retrieved 2007-06-15. 
  28. ^ a b "Paracelsus: the philosopher's stone made flesh". Retrieved 2007-05-04. 
  29. ^ "The devil's doctor". Retrieved 2007-05-04. 
  30. ^ "PARACELSUS, Five Hundred Years: Three American Exhibits". Retrieved 2007-06-06. 
  31. ^ Stephen Harding, Lee Ann Olivier, and Olivera Jokic. "Victorians' Secret: Victorian Substance Abuse". Retrieved 2007-05-02. 
  32. ^ Ole Daniel Enersen. "Thomas Sydenham". Retrieved 2007-05-02. 
  33. ^ a b Kramer, John C. "Opium Rampant: Medical Use, Misuse and Abuse in Britain and the West in the 17th and 18th Centuries." British Journal Of Addiction (To Alcohol & Other Drugs) 74.4 (1979): 377-389. SocINDEX with Full Text. Web. 7 Nov. 2011.
  34. ^ Donna Young (April 15, 2007). "Scientists Examine Pain Relief and Addiction". Retrieved 2007-06-06. 
  35. ^ Garzoni, Costantino. 1840 [1573]. "Relazione dell'impero Ottomano del senatore Costantino Garzoni stato all'ambascieria di Costantinopoli nel 1573." In Le relazioni degli ambasciatori veneti al Senato, serie III, volume I, ed. Eugenio Albèri. Firenze: Clio, p. 398
  36. ^ Michot, Yahya. L’opium et le café. Traduction d’un texte arabe anonyme et exploration de l'opiophagie ottomane (Beirut: Albouraq, 2008) ISBN 978-2-84161-397-7
  37. ^ Matthee, Rudi. The Pursuit of Pleasure: Drugs and Stimulants in Iranian History, 1500–1900 (Washington: Mage Publishers, 2005), pp. 97–116 [ISBN 0-934211-64-7]. Van de Wijngaart, G., "Trading in Dreams," in P. Faber & al. (eds.), Dreaming of Paradise: Islamic Art from the Collection of the Museum of Ethnology, Rotterdam, Rotterdam, Martial & Snoeck, 1993, p. 186-191.
  38. ^ Habighorst, Ludwig V., Reichart, Peter A., Sharma, Vijay, Love for Pleasure: Betel, Tobacco, Wine and Drugs in Indian Miniatures (Koblenz: Ragaputra Edition, 2007)
  39. ^ "Drug Addiction Research and the Health of Women – pg. 33–52" (PDF). Archived from the original on August 22, 2008. Retrieved 2010-03-21. 
  40. ^ a b c Yangwen Zheng (2003). "The Social Life of Opium in China, 1483–1999". Modern Asian Studies 37 (1): 1–39. doi:10.1017/S0026749X0300101X. 
  41. ^ a b Commissioner Jesse B. Cook (June 1931). "San Francisco's Old Chinatown". San Francisco Police and Peace Officers' Journal. Retrieved 2007-09-22. 
  42. ^ H.H. Kane, M.D. (September 24, 1881). "American Opium Smokers". Retrieved 2007-09-22. 
  43. ^ "Opium degrading the French Navy". April 27, 1913. Retrieved 2007-09-22. 
  44. ^ Alfred W. McCoy (1972). "The politics of heroin in Southeast Asia". Retrieved 2007-09-24. 
  45. ^ John Richards (May 23, 2001). "Opium and the British Indian Empire". Retrieved 2007-09-24. 
  46. ^ John Rennie (March 26, 2007). "When a woman ruled Chinatown". Tower Hamlets Newsletter. Archived from the original on September 26, 2007. Retrieved 2007-05-12. 
  47. ^ J.P. Jones (February 1931). "Lascars in the port of London". P.L.A. Monthly. Retrieved 2007-05-12. 
  48. ^ "Opium in the West." Opium Museum. 2007. Retrieved on September 21, 2007.
  49. ^ "Brilliant, Chang! « London Particulars." Retrieved on October 3, 2010.
  50. ^ "Opium timeline". The Golden Triangle. Archived from the original on June 26, 2008. Retrieved September 13, 2009. 
  51. ^ a b c d e Alfred W. McCoy. "Opium History, 1858 to 1940". Retrieved 2007-05-04. [dead link]
  52. ^ Wertz, Richard R. "Qing Era (1644–1912)." iBiblio. 1998. Retrieved on September 21, 2007.
  53. ^ John K. Fairbanks, "The Creation of the Treaty System' in John K. Fairbanks, ed. The Cambridge History of China, vol. 10 Part 1 (Cambridge University Press, 1992) p. 213. cited in John Newsinger (October 1997). "Britain's opium wars – fact and myth about the opium trade in the East". Monthly Review. 
  54. ^ Bradley, James (2009). The Imperial Cruise: a secret history of empire and war. Little, Brown and Company. pp. 274–275. ISBN 978-0-316-00895-2. 
  55. ^ Dikötter, Frank; Lars Laamann; and Zhou Xun Narcotic Culture: A History of Drugs in China. Co-published with C. Hurst & Co. ISBN 978-0-226-14905-9 (ISBN 0-226-14905-6) Spring 2004.[1][2][dead link]
  56. ^ Lodwick, Kathleen L. (1996). Crusaders Against Opium: Protestant Missionaries in China 1874–1917. University Press of Kentucky. ISBN 0-8131-1924-3
  57. ^ Windle, J. (2013). ‘Harms Caused by China's 1906-17 Opium Suppression Intervention’. International Journal of Drug Policy, 24(5): 498-505.
  58. ^ Ellen N. La Motte. "The opium monopoly". Retrieved 2007-09-25. 
  59. ^ a b Joyce A. Madancy (April 2004). "The Troublesome Legacy of Commissioner Lin". Retrieved 2007-09-25. 
  60. ^ Windle, J. (2011). ‘Ominous Parallels and Optimistic Differences: Opium in China and Afghanistan’. Law, Crime and History, Vol. 2(1), pp. 141-164. http://roar.uel.ac.uk/1692/
  61. ^ William A Callahan (May 8, 2004). "Historical Legacies and Non/Traditional Security: Commemorating National Humiliation Day in China" (PDF). Retrieved 2007-07-08. 
  62. ^ Ann Heylen (2004). Chronique du Toumet-Ortos: Looking through the Lens of Joseph Van Oost, Missionary in Inner Mongolia (1915–1921). Leuven, Belgium: Leuven University Press. p. 312. ISBN 90-5867-418-5. Retrieved 2010-06-28. 
  63. ^ Association for Asian Studies. Southeast Conference (1979). Annals, Volumes 1–5. The Conference. p. 51. Retrieved 2011-04-29. 
  64. ^ Edward R. Slack (2001). Opium, State, and Society: China's Narco-Economy and the Guomindang, 1924–1937. Honolulu: University of Hawaii Press. p. 240. ISBN 0-8248-2361-3. Retrieved 2010-06-28. 
  65. ^ Marc Andre Matten, ed. (9 December 2011). Places of Memory in Modern China: History, Politics, and Identity. BRILL. p. 271. ISBN 978-90-04-21901-4. 
  66. ^ Petr Parfenovich Vladimirov (1975). The Vladimirov diaries: Yenan, China, 1942-1945. Doubleday. ISBN 978-0-385-00928-7. 
  67. ^ Chen Yung-Fa (1995). "The Blooming Poppy under the Red Sun: The Yan'an Way and the Opium Trade". In Tony Saich; Hans J. Van de Ven. New Perspectives on the Chinese Communist Revolution. M.E. Sharpe. pp. 263–298. ISBN 978-1-56324-428-5. 
  68. ^ Hastings, Max (2007). Retribution. New York: Vintage. p. 413. ISBN 978-0-307-27536-3. 
  69. ^ Michael Mackey (April 29, 2004). "Banned in China for sex, drugs, disaffection". Retrieved 2007-06-08. 
  70. ^ Dale Gieringer (March 4, 2007). "State's War on Drugs – a 100-Year Bust". 
  71. ^ Peter McWilliams. "Ain't Nobody's Business If You Do". 
  72. ^ Legal Information Access Centre. "Drug laws in Australia". 
  73. ^ Carstairs C. (2006). "Jailed for Possession: Illegal Drug Use, Regulation, and Power in Canada, 1920–61". 
  74. ^ Anderson, Stuart, and Virginia Berridge. "Opium In 20th-Century Britain: Pharmacists, Regulation And The People." Addiction 95.1 (2000): 23-36. SocINDEX with Full Text. Web. 7 Nov. 2011.
  75. ^ a b c d e Brown, Richard Harvey. "The Opium Trade And Opium Policies In India, China, Britain, And The United States: Historical Comparisons And Theoretical Interpretations." Asian Journal Of Social Science 30.3 (2002): 623. SocINDEX with Full Text. Web. 7 Nov. 2011.
  76. ^ Jennifer Hull (June 24, 2001). "Eastern Europe Shooting Up Under A Red Star". Time. Retrieved 2007-05-10. 
  77. ^ Morimoto, Satoshi; Kazunari Suemori, Jun Moriwaki, Futoshi Taura, Hiroyuki Tanaka, Mariko Aso, Masakazu Tanaka, Hiroshi Suemune, Yasuyuki Shimohigashi, and Yukihiro Shoyama et al. (October 12, 2001). "Morphine Metabolism in the Opium Poppy and Its Possible Physiological Function". Journal of Biological Chemistry 276 (41): 38179–38184. doi:10.1074/jbc.M107105200. PMID 11498543. 
  78. ^ "Dem Morphin auf der Spur". Pharmazeutische-zeitung.de. Retrieved 2011-10-07. 
  79. ^ Huxtable Ryan J., Schwartz Stephen K. W. (2001). "The Isolation of Morphine—First Principles in Science and Ethics". Molecular Interventions 1: 189–191. 
  80. ^ Carter AJ (1996). "Narcosis and nightshade". BMJ 313 (7072): 1630–2. doi:10.1136/bmj.313.7072.1630. PMC 2359130. PMID 8991015. 
  81. ^ Richard Askwith, The Sunday Times (September 13, 1998). "How aspirin turned hero". Retrieved 2007-05-02. 
  82. ^ "Operational Medicine 2001 Field Medical Service School Student Handbook: Molle medical bag/surgical instrument set". December 7, 1999. Retrieved 2007-06-27. 
  83. ^ Frick S, Kramell R, Schmidt J, Fist AJ, Kutchan TM (May 2005). "Comparative qualitative and quantitative determination of alkaloids in narcotic and condiment Papaver somniferum cultivars". J Nat Prod 68 (5): 666–73. doi:10.1021/np0496643. PMID 15921406. 
  84. ^ "Production of thebaine and oripavine". April 20, 2004. Retrieved 2007-05-10. 
  85. ^ Meadway C, George S, Braithwaite R. (August 31, 1998). "Opiate concentrations following the ingestion of poppy seed products—evidence for 'the poppy seed defence'". Forensic Sci Int. 96 (1): 29–38. doi:10.1016/S0379-0738(98)00107-8. PMID 9800363. 
  86. ^ Trafkowski, J; Madea, B; Musshoff, F (Aug 2006). "The significance of putative urinary markers of illicit heroin use after consumption of poppy seed products". Ther Drug Monit 28 (4): 552–8. doi:10.1097/00007691-200608000-00011. PMID 16885724. 
  87. ^ Albert D. Fraser and David Worth (October 1999). "Experience with a Urine Opiate Screening and Confirmation Cutoff of 2000 mg/ml". Journal of Analytical Toxicology 23 (6): 549–551. doi:10.1093/jat/23.6.549. PMID 10517566. Retrieved 2010-03-20. 
  88. ^ Gahlinger 2001
  89. ^ Anil Aggrawal (1995). "Narcotic Drugs". 
  90. ^ "Cultivation of opium poppy and the oil poppy in the Soviet Union". 
  91. ^ a b Goodhand, Jonathan (2000). "From holy war to opium war? A case study of the opium economy in North Eastern Afghanistan". Central Asian Survey 19 (2): 265–280. doi:10.1080/02634930050079354. 
  92. ^ a b Belgische Farmacopee, 5de uitgave, 1966; part 3
  93. ^ W. R. Martin and H. F. Fraser (September 1, 1961). "A comparative study of subjective and physiological effects of heroin and morphine administered intravenously in postaddicts". Journal of Pharmacology and Experimental Therapeutics 133 (3): 388–399. PMID 13767429. Retrieved 2007-06-06. 
  94. ^ Robinson SL, Rowbotham DJ, Smith G. (July 1991). "Morphine compared with diamorphine. A comparison of dose requirements and side-effects after hip surgery". Anesthesia 46 (7): 538–40. doi:10.1111/j.1365-2044.1991.tb09650.x. PMID 1862890. 
  95. ^ "Interpol". 
  96. ^ "UNODC World Drug Report 2005" (PDF). Retrieved 2007-05-02. 
  97. ^ Jeff Sheehy and Corinna Kaarlela (January 26, 2004). "Black tar heroin use explains lower HIV levels among intravenous drug users in the Western U.S". Retrieved 2007-05-19. 
  98. ^ a b Rewriting history, A response to the 2008 World Drug Report, Transnational Institute, June 2008
  99. ^ "Rebuilding Afghanistan: Weekly Activity Update". February 24, 2005. Archived from the original on May 9, 2007. Retrieved 2007-05-11. 
  100. ^ BBC News (August 2, 2006). "UN warns of soaring Afghan opium". Retrieved 2007-06-06. 
  101. ^ "International Narcotics Control Strategy Report: Chemical controls". Retrieved 2007-05-11. 
  102. ^ Brzezinski, Matthew. "Re-Engineering the Drug Business." The New York Times Magazine, June 23, 2002
  103. ^ http://www.cbn.nic.in
  104. ^ Pablo Bartholomew (1996). "Opium for the masses: photo essay on cultivation of opium in India". Retrieved 2007-06-15. 
  105. ^ Senlis Council. "Feasibility Study on Opium Licensing in Afghanistan". [dead link]
  106. ^ Senlis Council (September 26, 2005). "The Kabul International Symposium on Drug Policy". Retrieved 2007-05-04. 
  107. ^ "Poppy for Medicine: Licensing poppy for the production of essential medicines: an integrated counter-narcotics, development, and counter-insurgency model for Afghanistan[dead link]." Senlis Council. June 2007. Retrieved on September 21, 2007.
  108. ^ "Letter from Macfarlan Smith". Retrieved 2010-03-21. 
  109. ^ The painkilling fields: England's opium poppies that tackle the NHS morphine crisis, Press release, September 15, 2007.
  110. ^ S. Mercadante. "Oral morphine consumption in Italy and Sicily". Retrieved 2007-05-04. 
  111. ^ Benjamin Pui-Nin Mo and E. Leong Way (October 1, 1966). "An Assessment Of Inhalation As A Mode Of Administration Of Heroin By Addicts". Journal of Pharmacology and Experimental Therapeutics 154 (1): 142–151. PMID 5924312. Retrieved 2007-06-06. 
  112. ^ Karl A. Sporer, M.D. (April 6, 1999). "Acute Heroin Overdose" 130 (7). pp. 584–590. Retrieved 2007-06-11. 
  113. ^ Darke S, Zador D (December 1996). "Fatal heroin 'overdose': a review". Addiction 91 (12): 1765–72. doi:10.1046/j.1360-0443.1996.911217652.x. PMID 8997759. 
  114. ^ "The Opium Museum". 
  115. ^ "Laudanum". Retrieved 2007-05-04. 
  116. ^ Ballantyne, Jane C., and Jianren Mao. "Opioid Therapy For Chronic Pain." New England Journal Of Medicine 349.20 (n.d.): 1943-1953. SocINDEX with Full Text. Web. 3 Nov. 2011.
  117. ^ "Opiates". Homehealth-uk.com. Retrieved 2011-10-07. 
  118. ^ Max Chamka; Translated by Geraldine Ring. "3 grams of opium for 1 dollar". Caucaz europenews. Retrieved 2007-05-06. 
  119. ^ Finn AK, Whistler JL (December 2001). "Endocytosis of the mu opioid receptor reduces tolerance and a cellular hallmark of opiate withdrawal". Neuron 32 (5): 829–39. doi:10.1016/S0896-6273(01)00517-7. PMID 11738029. 
  120. ^ Alper KR, Lotsof HS, Kaplan CD (January 2008). "The ibogaine medical subculture". J Ethnopharmacol 115 (1): 9–24. doi:10.1016/j.jep.2007.08.034. PMID 18029124. 
  121. ^ Opiate Slang Dictionary That's Poppycock
  122. ^ Hubble D (October 1957). "OPIUM ADDICTION AND ENGLISH LITERATURE". Med Hist 1 (4): 323–35. doi:10.1017/s0025727300021505. PMC 1034310. PMID 13476921. 

Further reading[edit]

External links[edit]