OPIUM

OFFICIAL NAMES: Opium, laudanum, paregoric, Dover's powder

STREET NAMES: Big O, black stuff, block, gum, hop/hops, ah-pen-yen, Aunti, Aunti Emma, black, black pill, chandoo/chandu, Chinese molasses, Chinese tobacco, dopium, Dover's deck, dream gun, dream stick, dreams, easing powder, fi-do-nie, gee, God's medicine, gondola, goric, great tobacco, guma, joy plant, midnight oil, O, O.P., ope, pen yan, pin gon, pin yen, pox, skee, toxy, toys, when-shee, ze, zero

DRUG CLASSIFICATIONS: Schedule II, narcotic

OVERVIEW

Opium, the parent of heroin and a myriad of other addictive derivatives, has a long and fascinating history. Opium has been used for medical, religious, and recreational purposes, and has been featured in, and used to inspire, art, literature, and poetry. As an international commodity, it has been the focus of regulation, legislation, even war. Opium's addictive and detrimental effects have caused untold suffering throughout history. Its ability to relieve pain has brought untold relief to the injured, ill, and dying.

Opium is a naturally occurring narcotic derived from the annual plant Papaver somniferum, widely known as the opium poppy. Although readily recognized in many countries and even celebrated at various times and places in history, the opium poppy lives legally in the United States and many other countries today only in memory and myth. For example, these poppies are popularly recognized in the United States for their role in the children's story, The Wizard of Oz, as the flowers the Wicked Witch used to put Dorothy and her companions to sleep as they traveled to the Emerald City in the mythical land of Oz. However, the true history of the drug and the poppy flower tells an intriguing story in itself.

Scholars have suggested several origins for the opium poppy, including southern Europe, Turkey, and northwestern Africa. Exactly when opium came into medicinal and recreational use is also uncertain; however, it is clear that the cultivation of the plant and use of opium are ancient practices, dating to 4000 b.c. or even earlier. Poppy seeds and seed pods have been discovered in the remains of Neolithic lake villages in what is now Switzerland. The Sumerians referred to the opium poppy as Hul Gil, the "joy plant." The Assyrians, Babylonians, and Egyptians cultivated the opium poppy with trade routes extending into Greece and Europe. The opium derivative, thebaine, even takes its name from poppy fields in the ancient Egyptian city of Thebes. Poppies appeared in Homer's Illiad and Odyssey and Virgil's Aeneid. Several Roman gods were regularly depicted with poppies. It has even been suggested that the vinegar and gall offered to Jesus Christ during his crucifixion was an opium mixture.

Arab traders introduced the opium poppy east into China sometime between the fifth and the eighth century. It was later traded to Europe by the Venetians and then by the Portuguese. Well-known explorers Columbus, Magellan, and Vasco de Gama were all instructed to find opium.

Opium became very popular, especially in Southeast Asia. Among its attractions, opium provided medicine, cheap recreation, and an alternative to alcohol. It was also affordable to the poor and enabled them to do with less food.

Opium cultivation and use became especially prevalent in India and later in China where the Chinese smoked an opium-tobacco mixture (madak or madhak). Sometime during the mid-1700s, they began to smoke pure opium—a habit that spread from the wealthy to the common people. British merchants, in particular, capitalized on the Chinese demand for opium. By building on their already thriving colonial Indian tea trade, the merchants readily dominated opium trade with China. Tensions between Britain and China over the opium trade eventually resulted in the Opium Wars, two separate conflicts occurring during 1839–42 and 1856–60. A number of Westerners made great profits in the opium trade, reputedly including John Cushing, John Jacob Astor, and Warren Delano II (grandfather of U.S. President Franklin Delano Roosevelt).

In the 1800s, Chinese immigrants took their opium-smoking habit around the globe. Chinese laborers were kept impoverished by their habit when by their creditors would sell them high-priced opium. However, opium smoking and the medicinal use of opium increasingly gained popularity across all levels of society. A number of famous people used or became addicted to opium, including writers who used opium while seeking to enhance creativity, imagination, and spontaneity. Writers that embraced opium during this general period include Goethe, Samuel Taylor Coleridge, William Wordsworth, John Keats, Sir Walter Scott, Lord Byron, Elizabeth Barrett Browning, and Edgar Allen Poe. Thomas De Quincey even wrote an autobiographical book, Confessions of an English Opium-Eater.

By the late 1800s, an unregulated patent medicine trade was booming across the United States. These medicines were actually unpatented concoctions, many containing opium; patent medicines that followed contained morphine, heroin, or cocaine. Similar to today's over-the-counter medicines, these concoctions were readily available for purchase in pharmacies, grocery stores, bookstores, and even by mail order without a doctor's prescription. They were marketed as treatments for ailments ranging from athlete's foot to cancer and were frequently promoted for their painkilling and "soothing" properties. Dover's Powder (a mixture of ipecac and opium) and Mrs. Winslow's Soothing Syrup (a cough suppressant) were two popular products.

Use of opium-laced medicines was also widespread in Britain. Since there were no laws required labeling the content of these medicines until the Pure Food and Drug Act of 1906, many users were unaware of exactly what was in their medicine bottle.

Not fully understanding the processes or implications of addiction, physicians encouraged the use of these medicines, which resulted in a growing addiction problem in the United States. The development of opium derivatives compounded the problem. For example, the discovery of morphine, a powerful painkiller derived from opium, and the invention of the hypodermic needle combined to create a new and efficient way to administer drugs. For the first time in history, a powerful painkiller could be administered in a measurable dose. The method was readily embraced by the medical community and provided untold relief for those injured or suffering from dysentery during the Civil War. However, so many soldiers became addicted that morphine addiction came to be known as the "soldier's disease." Heroin, another opium derivative, was isolated in the late 1800s. Due to its depressant effects on the respiratory system, heroin was widely touted as a cough and lung medicine, a welcome intervention in an era before tuberculosis could be cured with antibiotics. Ironically, it was even hailed as a cure for opium addiction at one point.

Addiction was widespread by the turn of the twentieth century, especially among the middle and upper classes, and many addicts were young to middle-aged white women who had originally taken addictive substances under the advice of their physicians. Although there are no verifiable statistics from that time, estimates range from 100,000 to more than one million addicts in the United States. Unlike today, opium use was not associated with criminality but with illness.

As a result of various government efforts, many patent medicines were eliminated from the market. Legislative efforts continued throughout the century. The 1970 passage of the Controlled Substances Act (CSA), Title II of the Comprehensive Drug Abuse Prevention and Control Act, established comprehensive federal guidelines for controlling narcotics that consolidated previous laws.

CHEMICAL/ORGANIC COMPOSITION

Opium is classified as a narcotic. By definition, narcotics have analgesic (or painkilling) properties as well as effects beyond lessening pain, such as producing euphoria and addiction. Opium has long been valued for its analgesic effects. However, not all analgesics are narcotics, because they do not produce these side effects; aspirin and Tylenol are examples of non-narcotic analgesics.

Raw opium is harvested from the seed pod of the opium poppy. As many as 50 substances called alkaloids can then be derived from opium, and the opium can be further processed. Alkaloids are naturally occurring plant products that possess some pharmacological activity, and are found in other plants as well as opium poppies. Cocaine and nicotine are examples of alkaloids derived from the coca plant and the tobacco plant, respectively. Because of their chemical composition, alkaloids are often used in producing medicines.

The alkaloids derived from opium are collectively known as opiates. Morphine, codeine, and thebaine are well-known opium derivatives. Paregoric is an opium tincture (opium in an alcohol mixture).

Semisynthetic and synthetic narcotics are also produced that have opiate-like effects; these narcotics are collectively known as opioids. They include methadone and the designer drug fentanyl, and a number of commonly prescribed medicines such as Darvon, Demerol, Dilaudid, Orlaam, OxyContin, Percodan, Talwin, and Vicodin.

Opium production

The poppies that produce opium grow to be 3–5 ft(1.5 m) tall, produce brightly colored flowers ranging from white, to pink, red, or purple, and do well in warm, dry climates. The plant is an annual, meaning it must be re-planted each season, and will flower and produce the seed pod from which opium is derived only once in its 120-day growth cycle. Many popular varieties of poppy produce three to five of these mature pods per plant.

After the poppies bloom, petals drop off and farmers are able to collect the opium from the unripe seed pod in the center of the flower. Illicitly harvesting opium is labor-intensive work that must be done by hand. The pod is slit with specially designed knives. Called taping, scoring, or lancing, the slit is made just deep enough to get the white latex-like sap to ooze onto the outside of the pod where the farmer allows it to dry. After the sap darkens and thickens into a sticky gum, the farmer collects it by scraping it off with another specially designed tool. This sap is raw opium. High-quality opium will be brown and sticky.

The pods can continue to ooze their sap for several days, so the farmer may tap pods to collect the opium several times. Some of the most productive seed pods will also be harvested to provide seeds for the next year's crop. On average, a single pod produces less than 80 mg of raw opium, according to the United States Drug Enforcement Administration (DEA). An area of2.5 acres (1 hectare) may yield roughly 17.6–33 lb (8–15 kg) of raw opium.

After harvesting, the wet resin must be dried for several days. It will then be wrapped and stored. If dried correctly, it can be stored for an indefinite period. The DEA has reports of opium that has been stored for 10 years without deteriorating.

Raw opium may be smoked, but it is usually "cooked" first, a process in which the raw opium is boiled in water. The opium dissolves and impurities such as twigs and dirt are removed by straining. This leaves a clear, brown liquid called "liquid opium," which is then re-heated until the water evaporates and all that remains is a thick paste. The paste is then sun-dried to the proper consistency for smoking or eating.

Both raw and cooked opium contain alkaloids. These alkaloids can be extracted from the opium to produce opium derivatives for legal pharmaceuticals or for illegal consumption, such as morphine and heroin. The morphine alkaloid content, which ranges from 8% to 12%, determines the quality of the opium.

Morphine is extracted first, and the resulting product can then be converted into heroin. Addicts generally do not use morphine base because it is not readily water soluble, thus not easily absorbed by the body. Further purification is required to produce a more pure product, morphine hydrochloride. This more refined morphine is commonly pressed into a 2 x 4 x 5 in (5 x 10 x 2 cm) block (also called a "brick") weighing approximately 3 lb (1.3 kg). It takes approximately 28.7 lb (13 kg) of opium to produce one of these morphine blocks.

Morphine can then be converted into heroin base and, finally, into heroin. Because of the odor of the chemicals used, heroin conversion labs may be located in rural areas. In the first step of this process, morphine is converted into a tan-colored heroin base that is approximately 70% pure heroin. In step two, this base can then be converted into smokable heroin (also known as heroin no. 3) or injectible heroin (also known as heroin no. 4).

INGESTION METHODS

Opium and synthetic narcotics can be processed such that they can be swallowed or eaten, drank in a variety of mixtures, smoked, injected, inhaled, or absorbed. Poppy farmers may even experience some effects of opium by walking through their fields after tapping the seed pods. Traditionally, however, opium is taken orally or smoked. Opium is sometimes flavored with spices to disguise its bitter taste, or mixed with wine, sugar, and/or honey; sugar or tobacco is sometimes mixed with opium for smoking. Opium ingestion is rare in the United States and other developed countries today.

THERAPEUTIC USE

Therapeutic uses of opium have been known for centuries. Ancient Assyrian medical writings mentioned poppy juice. Ancient Greek physicians knew the medicinal effects of poppies as did Hippocrates, the "father of medicine" (460–377 b.c.), and Hua To, Chinese surgeon of the Three Kingdoms (a.d. 220–264). In ancient Rome, opium was used both as a religious drug and as a poison to commit suicides or murders. Hannibal allegedly committed suicide by taking opium and Nero's mother poisoned a stepson with opium to assure Nero's ascendance to power. In more recent times, opium use was widespread in the United States and Britain during the nineteenth century. Opium and its derivatives were used as a treatment for almost every ailment, as well as by addicts, and by artists seeking recreation and enhanced creativity.

Several powerful and important modern medicines are derived from opium or are synthetic or semi-synthetic narcotics with opiate-like effects. Many of these medicines are primarily used to control pain but are also used to control coughs and diarrhea, and as anesthesia.

USAGE TRENDS

Even though the developed world's appetite for smoking or eating opium is not large, it still exists. The DEA estimates that the U.S. market for cooked opium, consumed by opium smokers, is still as much as 2.2 tons (2 metric tons) annually. Much of this market is apparently among Laotian Hmong and Mien refugees who have settled in Northern California, Minnesota, and Wisconsin.

In the United States and other developed countries, illicit opium derivatives such as heroin or licit synthetic opioids such as Vicodin have generally replaced the use of smoked or eaten opium. According to Drug Abuse Warning Network (DAWN) data provided by the Sub-stance Abuse and Mental Health Services Administration (SAMHSA), there were more than 82,000 emergency department admissions for narcotic analgesics/narcotic analgesic combinations in 2000. Only 167 of these visits were for opium and opium combinations.

Prescription opioids are often the drugs of choice for physicians and other health care professionals who become substance abusers. Their jobs often grant them easy access to pharmaceuticals, and these prescription drugs provide standardized doses without the dangers encountered in obtaining street drugs. These users frequently favor Demerol, Dilaudid, methadone, and morphine.

Opium use in developing nations

In some developing countries, particularly around the poppy fields themselves, opium is used for its medicinal and recreational effects. Opium smoking and/or eating is still a problem in rural areas where the poppies are cultivated. By some estimates, perhaps as much as 25% of the opium produced in Southeast Asia is consumed by opium poppy farmers.

Poppy farmers commonly smoke opium to fight hunger, cold, and chronic pain. Opium also retains a variety of other uses in developing countries. For example, Afghan carpet weavers eat opium to ease pain and to work longer hours. Opium is also used in some developing areas as a form of childcare to keep children quiet while parents work or to soothe their fussiness. It also serves as a treatment for diarrhea. Indeed, the widespread practice of using opium to treat diarrhea and malaria has been noted as an important factor in its rapid and early establishment throughout India, western China, and Southeast Asia, where these ailments were common. Additionally, opium has been believed in various places and points in history to have aphrodisiac (sexually enhancing) properties.

Opium also has a history of use with animals. For example, trainers have used opium balls in domesticating and training elephants. Increasing an elephant's opium allowance has also been used to control them during musth when a rutting, testosterone-driven male elephant might otherwise go on a rampage. For centuries, horses have also been given opium to prepare them for long journeys or military patrols.

MENTAL AND PHYSIOLOGICAL EFFECTS

Opium has been used for centuries for its analgesic (pain-relieving) properties. The opium derivative morphine has long been considered the standard narcotic to which all pain-relieving drugs are compared. These narcotics act on the central nervous system, relieving pain by interrupting pain messages in the brain or spinal cord. Opiates bind to special receptor sites in different parts of the brain and body that are active in transmitting pain signals.

Opium derivatives also have antitussive effects, meaning they suppress the cough reflex. Because of this effect, codeine is a frequently used ingredient in cough syrups. Opiates also slow digestion by slowing messages to the smooth muscles and reducing intestinal secretions. This effect makes them useful in treating diarrhea, but may also lead to constipation, a common problem for those who abuse opium. Additionally, users' heart rate, blood pressure, and respiration slow.

Other central nervous effects of opium and its derivatives include drowsiness, sedation, nausea, weakness, faintness, agitation, restlessness, nervousness, and decreased sex drive. Users may become very sleepy. In some rare cases, effects may include delirium and insomnia. Long-term narcotic use can lead to addiction, depression, difficulty sleeping or concentrating, agitation, tremors, seizures, and an increased sensitivity to pain. An extremely dangerous effect of these drugs is their depressive effect on the respiratory system, which may lead to unconsciousness, coma, and sometimes a rapid death. Users may also experience mood changes, euphoria, dysphoria (feeling unwell or unhappy), mental cloudiness, disorientation, or hallucinations.

These potential effects are impacted by such factors as circumstances of use (e.g., medical use supervised by medical professionals versus abuse), dosage, and route of administration. In general, effects increase as drug potency increases. The onset of these effects ranges from an immediate response to the drug to the user experiencing the impact 30–60 minutes later. The duration of their effects lasts from three to seven hours.

All opium derivatives are addictive and have the potential to be abused. For abusers, these substances produce a strong dependence, a complex concept. In simple terms, long-term opiate use changes the workings of nerve cells in the brain. These cells come to need the drug. The body needs the drug or it will experience effects from the drug's withdrawal. However, many myths surround opiate withdrawal. While it has been described as tortuous (a perspective often perpetuated by the media), other reports equate it to a severe case of the flu. Common withdrawal symptoms include cramps, a runny nose, chills, and muscle aches that are generally over in 24–48 hours.

Tolerance also develops with continued use, meaning that larger doses are needed to achieve the same psychoactive effect. Dosage, route of administration, and medical versus nonmedical use also play a role here. For example, abusers develop a psychological dependence on the drug. They develop a craving for the drug once it is removed. However, this craving does not generally develop among patients taking opioids for relief of severe pain. Pain patients do not continue to seek the drug to satisfy the cravings experienced by abusers. However, like abusers, pain patients do build up a tolerance to the drug. Also, like abusers, they may experience symptoms of physical withdrawal when they stop using the drug.

Harmful side effects

When using opium and its derivatives, the most obvious risk is coma or death from respiratory failure.

Medical professionals are well aware of the potential side effects of opiates and administer them according to strict guidelines. However, overdoses and negative side effects also may occur when taking prescribed drugs; prescription drugs may be diverted from medical use to abuse. Strong painkillers such as Vicodin and OxyContin are likely candidates for abuse. However, for users of street drugs, risks may be especially pronounced.

One group at risk for experiencing unwanted side effects from any drug use are pregnant women. Opioids cross the placenta and some are excreted in breast milk. Some types of prescription opioids may be used during pregnancy on a short-term basis under the direction of a medical professional. Ultimately though, pregnant women should always be guided by the advice of their physicians.

Patients who experience severe pain, either chronically from an illness or short-term from an injury or surgery, are another group with a special interest in the side effects of narcotics. One medical controversy revolves around the extent to which physicians should use powerful narcotics to relieve a patient's suffering. The fear that patients would become addicted (opiophobia) led to cases of doctors under-prescribing pain medication. Research has shown, however, that these fears are largely unfounded. Doctors have also been accused of over-prescribing these medications, leading to additional fears among physicians that legal consequences could result if they liberally prescribe opiate derivatives for patients in severe pain. An unfortunate result was that some patients were not prescribed the strong medicines necessary to alleviate their pain. This controversy led to guidelines from the federal Agency for Health Care Policy and Research addressing pain treatments. Additionally, research is underway seeking compounds that will result in effective pain-relief with smaller doses or no euphoric high.

REACTIONS WITH OTHER DRUGS OR SUBSTANCES

Drug mixing, taking two or more drugs in combination, may alleviate or intensify the effects. Opiates' pain-relieving effects may be intensified by the use of other drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Such use should be monitored by medical professionals to guard against stomach bleeding or organ damage.

When opium is abused, it may be combined with other licit or illicit drugs. In these cases, opium may be mixed with tobacco or other vegetable matter for smoking, a mixture called madak (or madhak). An A-bomb is a marijuana cigarette that contains heroin or opium, while Buddha is a strong form of marijuana spiked with opium. Opium may also be mixed with hashish in a concoction called black Russian or black hash.

Flavoring substances can also be added to opium, including spices, sugar, and/or honey to disguise its bitter taste. It is also mixed into opium wine mixtures, some of which are called Yen Shee Suey. Dross, the residue remaining in the pipe after prepared opium has been smoked, may be mixed with raw opium. Re-using this dross is a cost-cutting measure in opium production.

TREATMENT AND REHABILITATION

An assortment of treatments for opiate drug abusers are tailored to the needs of each user, including behavioral interventions such as counseling, psychotherapy, family therapy, and the use of support groups, treatment with medications, or some combination of both of these approaches. Research has even looked at acupuncture as part of treatment programs. Programs vary greatly in length and may include outpatient and/or inpatient treatments.

Medically assisted narcotic treatment programs use medications that suppress withdrawal symptoms and drug cravings while the person undergoes behavioral therapy and/or receives other health-related services.

These maintenance therapies supply regular doses of a drug that keeps the addict from experiencing withdrawal symptoms, drug cravings, or highs. Methadone and LAAM (levo-alpha-acetyl-methadol) are medications often used in these programs.

Heroin abusers comprise the vast majority of those in treatment for opiate abuse. According to the SAMHSA's Treatment Episode Data Set (TEDS), only 1% of admissions for addiction treatment recorded in 1999 were related to opiates other than heroin. However, the number of these admissions that was for opium itself cannot be determined from the available data because opium is categorized with all other drugs with morphine-like effects. Methadone was part of the treatment plan for 22% of those admitted.

Treatment programs are also needed to address the concerns of opiate users in developing countries. For example, some Afghan refugee camps have found a need to treat refugees for opium addiction. These refugees include laborers and those dealing with the pain of war wounds. In such situations, treatment options may include alternative medication and education.

PERSONAL AND SOCIAL CONSEQUENCES

Opium and its derivatives are addictive substances. In the developing countries where poppies are cultivated and opium is produced, peasants make more producing opium than they could make cultivating legitimate crops. The trade-offs they face include the personal consequences of addiction, the ethnic tensions fueled by the drug trade, the empowerment of drug lords, and corrupt politics, among others.

Poppy cultivation and opium processing also have consequences for the environment. Waste from morphine extraction can cause environmental damage when dumped by processors. In addition to water pollution from this chemical dumping, other environmental concerns include the deforestation that may occur when clearing land for poppy cultivation, soil erosion, and dangers to wildlife in the area where these chemicals are dumped.

LEGAL CONSEQUENCES

Opium poppies are grown and opium legally produced on government-regulated farms in a handful of countries including India, Turkey, and Tasmania in Australia. For most legal commercial production, alkaloids are extracted through a process of milling the "poppy straw." Rather than going through the entire opium-producing stage, the dried pods (the "poppy straw") are processed to obtain morphine, codeine, and thebaine and the seeds are sold as well. Unlike traditional illicit opium production, this process may be done with mechanized agricultural equipment.

One major benefit of this extract is for legitimate medicinal use. The DEA estimates that more than 500 tons (455,000 kg) of opium or its equivalent in poppy straw are annually imported into the United States for this purpose. The poppy also has other legitimate uses. For example, mature poppy seeds are used in the food industry such as in cake and bread decorations, and added to some dishes for crunchiness or flavor. (Alkaloids are only found in the ripening pod; mature pods cease to manufacture alkaloids.) Poppy seed can be pressed into cooking oil. Poppy seed oil is also legitimately used in artists' oil paints and in manufacturing perfumes. Throughout history, opium has also sometimes been used in religious rituals.

The possession of opium poppies was outlawed in the United States in 1942 by the Opium Poppy Control Act. Growing opium poppies is illegal in most countries. However, a number of areas around the world are infamous for their poppy cultivation. The countries of Laos, Burma, and Thailand comprise the Southeast Asian poppy growing area known as the Golden Triangle. The DEA estimates that Southeast Asian poppy fields produced nearly 3 million lb (1.4 million kg) of opium during 2000. Opium poppies are also illegally cultivated in Southwest Asia across a swatch known as the Golden Crescent, an area cutting across Pakistan, Iran, and Afghanistan. According to the U.N. Economic and Social Council Commission on Narcotic Drugs, illicit opium production is also reported in varying amounts in Armenia, Belarus, Colombia, Egypt, Guatemala, India, Italy, Japan, Kyrgyzstan, Latvia, Lebanon, Lithuania, Mexico, Peru, Portugal, Spain, Turkey, Uzbekistan, and Venezuela.

The U.N. Office for Drug Control and Crime Prevention (UNODCCP) reports that Afghanistan had emerged as the leading single source of illicit opium worldwide by 2000. In that year, Afghanistan produced as much as eight million lb (3.6 million kg) of opium, accounting for 70% of the world's illicit opium and 80% of the heroin reaching Europe. Afghan's Taliban rulers implemented a ban on opium poppy cultivation in 2001 and indications are that only 165,000 lb (75,000 kg) of opium were produced in Afghanistan that year. However, the UNODCCP reports that cultivation resumed after the fall of the Taliban due both to lawlessness and to farmers seeking to survive an ongoing drought. The main routes for smuggling Afghan opium to Europe and, in some cases, on to the United States are through Tajikistan, central Asia, and Eastern Europe; through Iran and Turkey to the Balkans; and through Pakistan.

In 2000, 430,000 lb (195,000 kg) of illegal opium were seized worldwide. The majority of these seizures (80%) were made by Iran, which seized approximately 364,000 lb (165,000 kg) of opium during that year.

Countries with the largest opium seizures in Southeast Asia tended to be those with the largest production.

Efforts to curb poppy cultivation have involved a variety of strategies including drug enforcement, the implementation of various legal frameworks, promoting alternative crops and sources of income, eradication efforts that use pesticides to kill plants, and economic interventions such as setting up rural credit systems. Some approaches focus on reducing drug demand and establishing rehabilitation, prevention, and/or drug abuse programs. In addition to reducing trafficking in drugs, some efforts focus on reducing the sale or trafficking of the chemicals used in the refinement process.

The U.N. Commission on Narcotic Drugs recommends that drug strategies also address money laundering, advising agencies to develop knowledge in this arena from experts such as the Turkish International Academy against Drugs and Organized Crime (TADOC). Other recommended training involves identifying drug couriers, establishing regional information exchanges on drug traffickers and current methods of operation, and training and equipping investigators to target major crime figures and financiers. Other recommendations emphasize government cooperation in information exchange, law enforcement efforts, and efforts to curb money laundering. Such cooperation would avoid duplication of effort and maximize resources. They also encourage governments to use the media in supporting their initiatives. The commission also encourages forward-looking drug strategies that look toward future trends and seek ways to interrupt smugglers' use of technology, with special attention given to sea routes and cargo containers.

Each of these strategies faces a number of challenges. Basic supply-and-demand economics impact drug prices. Opium prices fluctuate depending on a number of factors, including the production cycle, weather conditions that help or hinder poppy output, the availability of chemicals required to process the opium, the quality of the drug, and the local supply of opium and heroin. Opium prices saw large declines after the September 11, 2001, terrorist attacks but had recovered by March 2002, according to the U.N. Commission on Narcotic Drugs.

Opium traders buy the raw opium from farmers. In Southeast Asia, the price for raw opium in 1999–2000 ranged from $150 to $350 per kilogram. The price is marked up as the opium goes through each stage of processing and refinement. For example, the DEA reports that cooked opium is usually marked up approximately 20%. The price is then marked up again as the opium is refined into morphine base, morphine, heroin base, and heroin.

Opium production requires little infrastructure. Efforts to encourage alternative crops commonly find inadequate market infrastructures and transportation systems for handling legitimate crops. Targeting the chemicals necessary for processing the opium can be problematic in that many of the chemicals also have legitimate uses. The opium trade may be one element in on going ethnic conflicts. Additionally, when opium supplies are interrupted in one country, another source tends to take its place. In the late 1970s, the controversial defoliant Agent Orange was used to eliminate Mexican poppy fields. Golden Crescent opium production rapidly increased in response to the decreased Mexican supply.

The 1961 U.N. Single Convention on Drugs called for the eradication of opium in 25 years. A 1998 U.N. General Assembly Special Session called for eradication in 10 years. Instead of leading to the elimination of opium, some observers have argued that such goals are unattainable and sap ever-increasing amounts of resources. Many of these observers argue that the real keys to drug control lie in solving the economic and social problems that underlie drug production such as poverty, inequality, and political turmoil. Some observers contend that answers lie in decriminalization or legalization and a return to the view that addicts should be treated as if they are ill rather than lawbreakers. Other observers suggest that such stringent goals as those put forth by the U.N. are imperative in effectively waging any war on drugs.

Drug control efforts have often attempted to reduce both supply and demand. Strategies have included combinations of a range of legal and economic penalties, technologies, treatments, and educational and prevention efforts. The idea that currently illegal drugs should be legalized, or decriminalized, is also hotly debated. In brief, advocates of legalization or decriminalization contend that low rates of drug interdiction and high rates of use and drug-related crime mean that drug control efforts are not working. Their arguments include assumptions that drug prices would decrease; drug-related crime and corruption would decline, thereby freeing law enforcement resources for other needs; quality could be controlled; revenue would be produced for the government; and drug use would not increase significantly. Opponents of legalization argue that the behavioral, criminal, social, and public health problems that would arise would be considerable. They also point to high rates of legal alcohol and tobacco use as examples of what would happen to use rates if many currently illegal drugs were made legal. They cite evidence including the low rate of opium use in the United States today compared to the widespread use at the turn of the twentieth century in support of this last point.

Legal history

As medical understanding of addiction grew in the late 1800s, so too did the calls for reform of patent medicines and drug use in the United States. Many commentators have also connected the development of U.S. drug laws with growing racial fears. Concerns were raised that opium smoking was spreading beyond Chinese immigrants to the wider population and that blacks and Mexicans were unable to handle the growing drug use among those populations. News stories alleged the seduction of white women in Chinese opium dens and attributed a range of antisocial behaviors to minority users of illegal drugs. This began the current stigmatization of drug abusers as being outside mainstream society and as criminals rather than ill persons.

In 1909, Congressional legislation stopped the importation of smokable opium or opium derivatives except for medicinal purposes. The Harrison Narcotics Act of 1914 placed further controls on narcotics by addressing drug content, prescriptive, manufacturing, distribution, record-keeping, and taxation requirements. Under this act, only those licensed to do so could possess these drugs and they could only be prescribed for legitimate medical purposes, not for addict maintenance. A 1919 Supreme Court ruling upheld this position, consequently leading to strong narcotics regulations and ultimately to the current war on drugs.

After federal bans on opium, black markets developed to supply the demand. World War II temporarily interrupted opium smuggling routes. After the war, smuggling resumed with the U.S. government becoming involved in struggles in Southeast Asia that are sometimes blamed for fostering opium production and the heroin trade.

The development of synthetic narcotics was also encouraged by war needs. However, drug control efforts were somewhat haphazard. Although as of 1946 the Federal Bureau of Narcotics (FBN) oversaw potentially addictive synthetic narcotics, non-narcotics drugs and drug abuse were not adequately controlled. The Controlled Substances Act (CSA), Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970 attempted to fill this void. It established regulations, including controls on narcotics, which covered a range of drug control activities. The CSA schedule still includes regulations covering opium in the United States.

Federal guidelines, regulations, and penalties

In the United States, the CSA classifies drugs into schedules according to their medical use, potential for abuse, and ability to produce dependence. The CSA places opium derivatives under different schedules. Opium, morphine, and methadone are Schedule II drugs. Schedule II drugs have high abuse potential, some accepted medical use in the United States, and a likelihood of severe psychological or physical dependence if abused. Federal trafficking penalties for a first offense of2.2 lb (1 kg) or more of a Schedule II substance is 10 years to life (20, if a death is involved) and fines of up to four million dollars for individuals and 10 million dollars for organizations. A second offense carries a minimum 20-year sentence and fines not to exceed eight and 20 million dollars.

Codeine is a Schedule III drug. These drugs have less potential for abuse than Schedule I or II drugs, an accepted medical use in the United States, and the likeli-hood of moderate or low physical dependence if abused. Federal trafficking penalties for a first offense of a Schedule III substance is not more than five years and fines of up to $250,000 for individuals and one million dollars for organizations. A second offense carries a maximum of 30 years to life if a death is involved and fines up to two and 10 million dollars.

Talwin, another opium derivative, is a Schedule IV narcotic. Schedule IV drugs have less potential for abuse than Schedule III drugs, an accepted medical use in the United States, and the likelihood of limited physical or psychological dependence if abused. Federal trafficking penalties for a first offense of a Schedule III substance is not more than three years and fines of up to $250,000 for individuals and one million dollars for organizations. A second offense carries a maximum of 30 years to life if a death is involved and fines up to two and 10 million dollars.

Non-prescription cough medicines with codeine are Schedule V drugs, which have a low potential for abuse compared to Schedule IV drugs, an accepted medical use in the United States, and the likelihood of limited physical or psychological dependence if abused. Federal trafficking penalties for a first offense of a Schedule V substance is not more than one year and fines of up to $100,000 for individuals and $250,000 for organizations. A second offense carries a maximum of 30 years to life if a death is involved and fines up to two and 10 million dollars.

See also Codeine; Heroin; Morphine; Oxycodone

RESOURCES

Books

Berlin, Laini, ed. Physician's Drug Handbook. 8th ed. Spring-house, PA: Springhouse Corp., 1999.

Booth, Martin. Opium: A History. New York: St. Martin's Press,1998.

Courtwright, David T. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press,2001.

Courtwright, David T. Forces of Habit. Cambridge, MA: Harvard University Press, 2001.

Inciardi, James A. The War on Drugs III: The Continuing Saga of the Mysteries and Miseries of Intoxication, Addiction, Crime, and Public Policy. Boston: Allyn and Bacon, 2001.

Musto, David F. The American Disease: Origins of Narcotic Control. New York: Oxford University Press, 1999.

Periodicals

Baldauf, Scott. "Afghan Weavers Unravel a Trade Tradition: Opium Use." Christian Science Monitor Electronic Edition (March 28, 2001). <http://www.csmonitor.com/durable/2001/03/28/fp7s2-csm.shtml>.

Food and Drug Administration. "The Story of the Laws Behind the Labels: Part I. The 1906 Food and Drugs Act." FDA Consumer(June 1981). <http://www.cfsan.fda.gov/~lrd/history1.html>.

Other

"Beyond the ABCs: Opioids and Pregnancy." Alberta Alcohol and Drug Abuse Commission. 2002 (July 8, 2002). <http://corp.aadac.com/drugs/beyond/opioidspreg.asp>.

Emergency Department Trends from the Drug Abuse Warning Network, Preliminary Estimates January-June 2001, with Revised Estimates 1994-2000. DAWN Series D-20, DHHS Publication No. (SMA) 02-3634. Rockville, MD: Substance Abuse and Mental Health Services Administration (SAMHSA),2002. <http://www.samhsa.gov/oas/dawn/TrndED/2001/Text/TrndEDtxt.PDF>.

Illicit Drug Traffic and Supply: World Situation with Regard to Illicit Drug Trafficking and Action Taken by Subsidiary Bodies of the Commission on Narcotic Drugs United Nations Economic and Social Council, Commission on Narcotic Drugs, 45th Session, Vienna, 11-15 March, 2002. <http://www.odccp.org/pdf/document_2001-12-21_2.pdf>.

Opium Poppy Cultivation and Heroin Processing in Southeast Asia. U.S. Drug Enforcement Administration, DEA 20026, March 2001. <http://www.usdoj.gov/dea/pubs/intel/20026/20026.html>.

"Opium Throughout History." The Opium Kings. PBS Frontline. <http://www.pbs.org/wgbh/pages/frontline/shows/heroin/etc/history.html>.

The Price Dynamics of Southeast Asian Heroin. U.S. Drug Enforcement Administration, Intelligence Brief, February 2001. <http://www.usdoj.gov/dea/pubs/intel/01004-intelbrief.pdf>.

Treatment Episode Data Set (TEDS): 1994-1999. National Admissions to Substance Abuse Treatment Services. DASIS Series S-14, DHHS Publication No. (SMA) 01-3550. Rockville, MD: Substance Abuse and Mental Health Services Administration (SAMHSA), 2001. <http://www.samhsa.gov/oas/teds/99TEDS/99Teds.pdf>.

Organizations

Drug Enforcement Administration (DEA), 2401 Jefferson Davis Highway, Alexandria, VA, USA, 22301, (800) 882-9539, <http://www.usdoj.gov/dea/index.htm>.

National Institute on Drug Abuse (NIDA), National Institutes of Health, 6001 Executive Boulevard, Room 5213, Bethesda, MD, USA, 20892-9561, (301) 443-1124, (888) 644-6432, [email protected], <http://www.nida.nih.gov/>.

Office of National Drug Control Policy (ONDCP); Drug Policy Information Clearinghouse, P.O. Box 6000, Rockville, MD, USA, 20849-6000, (301) 519-5212, (800) 666-3332, [email protected], <http://www.whitehousedrugpolicy.gov/>.

United Nations Office for Drug Control and Crime Prevention (UNODCCP); Vienna International Centre, P.O. Box 500, Vienna, Austria, A-1400, 43 1 26060 0, 43 1 26060 5866, [email protected], <http://www.undcp.org/>.

Kathy S. Stolley, Ph.D.

Opium

What Kind of Drug Is It?

Opium is the sticky white sap that flows from ripening seed pods of the Papaver somniferum plant. The plant's Latin name means "poppy" (Papaver) "that induces sleep" (somniferum). The word opium comes from the Greek word for sap. For more than 6, 000 years, humans have cultivated opium poppies and have used opium to relieve pain and to induce euphoria, a heightened sense of happiness and well-being. As of 2005, opium poppy plants are grown legally to supply painkilling, cough suppressing, and antidiarrheal medicines to people all over the world. Illegally, the plants are grown to produce cooked opium, morphine, and heroin—highly addictive substances that are abused for their mind-altering effects.

All of the heroin, morphine, codeine, and thebaine used in the world begins as opium. Raw opium, removed from the plant, is first refined by cooking. It is then chemically altered in various ways to produce the other products. In its crudest form, opium is smoked or eaten by people to get high. In fact, farmers who grow it illegally sometimes become high just by collecting the sap. More commonly, though, raw opium is passed through a series of chemical processes that isolate its morphine. The morphine is the plant's most psychoactive, or mind-altering, ingredient. Then the morphine is further refined into heroin. (Entries for codeine, heroin, and morphine are available in this encyclopedia.)

Official Drug Name: Opium; laudanum (tincture with alcohol); paregoric (tincture with camphor); Dover's powder.

Also Known As: Ah-pen-yen, Aunti, Aunti Emma, big O, black, black pill, black stuff, black hash (mixture with hashish), black Russian, block, Buddha (mixture with marijuana), chandoo/chandu, Chinese molasses, Chinese tobacco, dopium, Dover's deck, dream gun, dream stick, dreams, easing powder, fi-do-nie, gee, God's medicine, gondola, goric, great tobacco, gum, guma, hop/hops, joy plant, midnight oil, O, O.P., ope, pen yan, pin gon, pin yen, pox, skee, toxy, toys, when-shee, ze, zero

Drug Classifications: Schedule II, opiate

Morphine, codeine, and heroin are relatively recent alterations of basic opium. For much of its long history, opium was the primary drug of use and abuse. Its use has been recorded in many cultures in Europe, Asia, Africa, and the United States. Its power and strength were such that Italian explorer Christopher Columbus (1451–1506) was instructed to bring back opium as he set off on his first voyage to the New World. When Europeans came to the Americas, they brought poppy seeds with them and began growing opium in the Western Hemisphere. More than 150 years ago, the drug caused a major war between Great Britain and China. In the early twenty-first century, the United States—and the United Nations—spent many millions of dollars trying to destroy illicit, or illegal, poppy fields.

Overview

Archaeologists have found evidence of opium poppy cultivation dating back more than 6, 000 years. As early as 4, 000 bce, the plant was grown in the Fertile Crescent, an area then known as Mesopotamia. The region is now the countries of Iran and Iraq. Poppy seeds and seed pods have been found in Stone Age deposits in Switzerland. The ancient Sumerians called the plant hul gil, or "joy plant." A document that survives from the Egyptian city of Thebes, written in 1552 bce, lists more than 700 medicinal uses for opium.

It is likely that opium has always been grown for its mind-altering properties, but it is important to note that the plant provides food as well. The small black poppy seeds on the top of bagels and cakes come from the plant, and poppy seed oil is also used in cooking. In his book Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse, Paul M. Gahlinger noted that eating poppy seeds can result in positive drug tests for morphine in the urine. However, the seeds do not contain enough opium to produce a high, no matter how many one consumes.

Known and Used Worldwide

At some point deep in human history, farmers learned to cut the ripening poppy pods. This allows the sap to flow out and harden into a dark-colored gum. That gum is raw opium.

Opium use was widespread in ancient Greece and Rome. In his 800 bce poem The Odyssey, Homer described a medicine called nepenthe that could erase pain as well as the sorrow of grief. These ancient peoples credited certain gods with showing humankind the wonders of opium. The Greek god Morpheus, god of dreams, is often depicted in statues sleeping among poppy flowers.

Ancient cultures also knew of the drug's dangers. The Romans used opium as a poison, recognizing that an overdose could cause a victim to stop breathing. Legend says that the famous General Hannibal (247 bce–c. 183 bce) used opium to commit suicide.

When trade routes were established between the Middle East and Asia in the fifth century ce, opium made its way into the Far East. The cultures there began to grow it for its painkilling effects, and the plant thrived in many areas of Western Asia. Europeans knew opium from the cultural influences of the Greeks and Romans. Christopher Columbus was instructed to find new sources of the plant when he set sail in 1492. A more widespread use of the drug in Europe dates from 1524, when Swiss doctor Paracelsus (1493–1541) mixed opium with alcohol and named the resulting product laudanum, Latin for "to be praised." One of opium's drawbacks as a medicine was its bitter, unpleasant taste. Mixing the drug with wine, spices, and sweeteners made its taste more tolerable, which meant more people started using it. It remained in the mainstream until the twentieth century.

Opium Pipes and Patent Medicines

Columbus did not discover opium in the Americas. However, he did learn about tobacco and the pipes used to smoke it from the native peoples he met. He returned to Europe with both the pipes and the tobacco. Within 100 years, Europeans had taken to both. It is likely that opium had been smoked in the Eastern Hemisphere prior to the introduction of the Native American-style pipe.

However, the long stem typical of American pipes made smoking opium a more pleasant experience by dulling the harshness of the

smoke. Users of smoked opium quickly learned that this method of taking the drug heightened the euphoria—and hastened dependence.

Opium addiction developed in various ways on different continents. In Europe and America, people ate opium or became dependent on patent medicines that mixed opium with alcohol, sugary syrups, or camphor (known as paregoric today). Patent medicines, including tonics and elixirs, contained "secret" ingredients and promised to cure various diseases. They were also called "cure all" medicines, but most failed to deliver the promised cure.

A Different Type of Drug War

In the Far East, particularly China, the smoking of refined opium became a public health problem as early as 1746. By the 1830s, crime had become widespread in the nation as its men, in particular, sought out the drug. Families starved when their

providers fell victim to addiction. In response, the Chinese government banned the use and importation of opium.

This ban angered the British, who believed they already had a trade imbalance with China. The Chinese exported much tea to Great Britain and America, so the British wanted China to buy their opium in return. When China refused to allow opium imports, the British declared war and sailed their military fleet to Canton, arriving in June of 1840.

Thus began the first of two "Opium Wars," known in Great Britain as "The War for Free Trade." The conflicts occurred from 1839 through 1842 and again from 1856 to 1860. When the wars ended, the combination of peasant rebellion and British military might had brought China to its knees.

Gahlinger estimates that by 1900, a quarter of the Chinese population—and half of all its adult males—were addicted to smoked opium. Those who did not fall victim to the drug became bitter toward Western capitalism and its emphasis on private ownership, free trade, and competition. The Chinese believed the West had encouraged the opium epidemic. Their bitterness played no small role in China's move toward communism in the twentieth century. In the communist system of government, the means of production are owned by the state.

Opium Dens

Beginning in the mid-nineteenth century, Chinese laborers came to the United States to help build railroads in the Western states. Some of these immigrants brought their opium habits with them. Opium "dens" began to spring up around the country, especially in the big cities. Opium dens were usually darkly lit establishments where people went to use the drug. Many dens were set up in the Chinatown section of major cities, but were visited by people of various ethnicities. By the 1890s, the practice of smoking opium in dens had spread, especially among younger American men.

Refinements in the pipe led to the practice of reclining on boards or sofas on one hip while smoking or experiencing the effects of the drug. This practice gave birth to the phrase "on the hip," meaning someone with an opium habit. The phrase was shortened in the twentieth century to "hip," and the term is still used in 2005 to describe someone who is adventurous and perhaps a bit too willing to break the rules. The word "hippie" also has its origin from the way opium was smoked in dens.

Addiction on the Rise in the 1800s and 1900s

As the twentieth century dawned in the United States, civic leaders came to realize that the country had its own drug problem. By one estimate, New York City had more than 300 opium dens. Others pointed to the overuse of then-legal medicines that contained variations of opium—either heroin, codeine, or morphine. It was actually possible to buy a "soothing syrup" for fussy infants that contained opiates. Children also became addicted to the medicines and sometimes died of an overdose.

The Western world was not ignorant of the dangers posed by opium. As early as 1821, British writer Thomas de Quincey (1785–1859) described the horrors of addiction and withdrawal in his book Confessions of an English Opium Eater. The isolation of morphine from its parent substance led to widespread addiction in the soldiers who returned from the American Civil War (1861–1865). Many soldiers were given morphine to ease injuries they received in battle. Later, the introduction of heroin as an

over-the-counter remedy in 1898 made a bad situation worse. People addicted to opium and morphine were encouraged to take heroin as a "cure"—and found themselves more deeply addicted than ever. By 1900, reformers such as Dr. Hamilton Wright were calling for an international agreement on regulation of the. narcotics trade.

The first in a series of international conventions on the then-legal trade of opium occurred February 1, 1909, in Shanghai, China. The thirteen countries that attended the International Opium Commission could not agree on how best to regulate the growth, sale, and distribution of opium and its by-products. A second conference, held on January 23, 1912, in The Hague in the Netherlands, was only slightly more successful. Participating countries signed an agreement requiring each country to "try to" control the trade of narcotics, including not only opium, but also cocaine. (An entry for cocaine is available in this encyclopedia.)

The United States Takes Further Action

Within its own borders, the United States had already taken steps to stop opium smoking. The Smoking Opium Exclusion Act of 1909 made the importation of opium illegal, except for legal pharmaceutical use. Five years later, the Harrison Narcotics Act of 1914 put an end to over-the-counter patent ("cure-all") medicines containing opiates and made it more difficult to obtain substances such as heroin and morphine from doctors. These two laws, combined with an atmosphere of discrimination against Asian Americans, effectively curbed the use of smoked opium in dens.

In 1970 the U.S. Controlled Substances Act named opium a Schedule II drug. This means that it has some valid medical uses but also has the potential for misuse and addiction. In Europe and the United States, the vast majority of opium appeared on the street in its alternate forms—morphine, codeine, or heroin. These other opium-based products are all still abused in America today, while pure opium abuse only occurs in some minority populations of Southeast Asian origin. The Drug Abuse Warning Network (DAWN) recorded more than 82, 000 emergency room visits due to drug abuse in 2000—only 167 of these were for opium or opium combined with other drugs. There was no mention of opium-related emergency department visits in the DAWN 2003 interim report, which featured the latest information available as of August 2005. Opium use has largely been replaced by heroin use in the United States. When opium is abused, it is usually mixed with other drugs.

A Word about Opioids

Semisynthetic and synthetic narcotics are produced that have opiate-like effects. These narcotics are collectively known as opioids. They include methadone, the designer drug fentanyl, and a number of commonly prescribed medicines such as Darvon, Demerol, Dilaudid, Orlaam, OxyContin, Percodan, Talwin, and Vicodin. Darvocet is an opioid that also contains acetaminophen.

What Is It Made Of?

Opium contains as many as fifty substances called alkaloids—naturally occurring chemicals with mind-altering characteristics. The main derivatives of opium are morphine, codeine, and thebaine. Morphine and codeine are used as painkillers, cough

suppressants, and, in some cases, as cures for diarrhea. Thebaine is added to synthetic (laboratory-made) painkillers called opioids.

Opium comes from a flowering plant that must be started from seed each growing season. It takes about 120 days for the plant to grow, flower, and produce the seeds needed for next year's crop. When it flowers, the opium poppy plant is beautiful. It is like the field of poppies in the film The Wizard of Oz that puts Dorothy, Toto, and the Cowardly Lion to sleep. Opium poppy flowers range from white to pink to deeper shades of red and purple. The plant does best in soil that contains some sand and loam, and it can thrive in highland meadows as well as warm, dry climates.

The plant flowers after ninety days and stands between three- and five-feet tall. When the flower petals fall off the pods, farmers begin the opium harvest. Where the plant is grown legally, machines are used to grind up whole fields into poppy straw. It is from this straw that legal morphine, codeine, and thebaine are produced. More than 1, 000 tons of morphine are produced legally from opium every year, from poppies grown on government-regulated farms in India, Turkey, and the Australian province of Tasmania.

Illegal Farming

In the illegal poppy fields, opium is collected by hand. Farmers use special knives to slice the pods that still remain on the plant. If done carefully, the slicing forces the pods to leak a white fluid for several days. Overnight, the fluid thickens and turns into a dark-colored paste. In the morning the farmer passes through the field and collects the paste from each pod. A few of the largest pods are left to ripen without being sliced. From these the farmers will collect the seeds for the next year's harvest.

Illegal hand-collected opium yields about seven to thirteen pounds per acre of poppies. Once the fluid has been harvested from the plant, it is allowed to dry in the sun until it becomes a thick, dark-brown, sticky gum. This is raw opium. Even at this stage people have smoked or eaten it to get high. Usually, however, the raw opium is boiled with water and strained through cloth to remove plant debris and further concentrate the psychoactive substances. This "cooked" opium will not spoil, even if kept for years.

The vast majority of illegal opium is then converted into morphine, which is then turned into heroin. These processes occur in mobile laboratories in the countries in which the poppies are grown. These countries include Burma, Laos, Vietnam, Thailand, Pakistan, Afghanistan, Colombia, Mexico, and Lebanon. In these nations, political corruption and police bribes allow farmers and chemists to work with little regard for the law.

Illegal poppy farming can be bad for the environment. Farmers use slash-and-burn techniques to clear fields of native wild plants in order to grow the crop. They may fertilize poppies with human waste, chicken droppings, or other fertilizers that leave toxins in the soil. The techniques used to refine opium into morphine and heroin also produce toxic chemical waste that is dumped into waterways or left in empty fields. Law enforcement efforts to curb poppy production have included the spraying of fields with plant-killers, including Agent Orange, a poisonous substance linked to human illness.

How Is It Taken?

When pure opium is used as a drug, it is usually smoked, sometimes in combination with tobacco. It is also eaten. More often, opium is collected and refined into morphine and heroin, because these drugs act on the brain more quickly, and they are easier to inject than opium. Doctors occasionally prescribe paregoric, a liquid combination of opium and camphor, for stomach upset, diarrhea, or irritable bowel syndrome. Paregoric is a liquid that is taken by mouth.

Are There Any Medical Reasons for Taking This Substance?

The medical reasons for taking opium—for pain relief, cough suppression, and diarrhea—are better addressed by more modern medications such as morphine, codeine, and synthetic painkillers. Except for paregoric, which is rarely used, doctors do not prescribe pure opium.

Usage Trends

Although opium is not used as readily in its pure form anymore, its production has not decreased. The fall of the Taliban government in Afghanistan in 2001 enabled farmers in that rugged country to begin cultivating poppy plants again. Under the Taliban, opium production was strictly controlled; some farmers were severely punished for not following the Taliban's rules. The Taliban were forced from power when U.S. and coalition forces invaded Afghanistan after terrorists attacked the United States on September 11, 2001. Terrorists had been allowed to train in Afghanistan.

Once the Taliban fell, opium crops began to thrive again. Increased poppy production throughout Afghanistan, Pakistan, and Southeast Asia in an area known as the golden triangle has led to lower prices, higher quality, and larger quantities of heroin in Russia, Europe, and the United States. More farmers also began growing opium poppies in Mexico, Central America, and South America as well, sensing that the market for heroin is rising while the market for cocaine is declining.

Substances Produced from Opium

Raw opium can be separated into three natural substances: morphine, codeine, and thebaine. Morphine undergoes further chemical treatment to produce heroin. Codeine is the world's most widely used medicine. Thebaine is one of the ingredients in oxycodone, a painkiller better known as OxyContin.

Opium use occurs mostly where it is grown, although the farmers that produce it are not eager consumers of their cash crop. Some sources say that up to a quarter of raw opium is used by the people who grow it, their neighbors, and those who process it into morphine and heroin. Other sources say that opium farmers are less likely to abuse the drug than people involved in the purification of opium into morphine and heroin. Sometimes the drug is still used for its medicinal qualities, especially the control of diarrhea and chronic, or long-lasting, pain.

Effects on the Body

The power of opium's effects depends on how it is delivered into the body. It works fast when smoked, because the opiate chemicals pass into the lungs, where they are quickly absorbed by blood vessels and sent to the brain. Opium's effects occur more slowly when it is eaten or mixed in a liquid, because then the drug has to pass through the stomach and upper intestines, and into the liver before moving on to the brain. The process of digestion weakens the drug as it passes through the various organs before being absorbed by the bloodstream.

An opium high is very similar to a heroin high. The user experiences a rush of pleasure, followed by an extended period of relaxation, freedom from anxiety, and the relief of physical pain. Breathing slows and the pupils of the eyes become like pinpoints. In the brain, opium binds to the receptors that search for pleasure-enhancing endorphins and painkilling enkephalins. Because opium floods these receptors, it produces a higher state of pleasure than the body can produce on its own. Opium also inhibits muscle movement in the bowels, leading to constipation, or the inability to have a bowel movement. It works on the part of the brain that controls coughing and—especially when smoked—can dry out the mouth and the mucous membranes in the nose. The effects of a dose of opium last about four hours.

A Hard Cycle to Break

Continued use of opium produces two effects: 1) tolerance, or the need for greater and greater doses of a substance to achieve the same original effect; and 2) dependence, a physical and psychological craving for the drug. When people take higher doses, or take opium more often, they run the risk of overdosing. An overdose can kill because people just stop breathing and quickly die of asphyxiation. (It was this effect that led the ancient Romans to use opium as a poison.) Dependence occurs when the user begins to experience withdrawal symptoms when the drug's effects wear off. These symptoms occur because, in the presence of opium, the brain stops making its own pleasure-enhancing compounds. So, the rest of the body adjusts to the presence of the drug as well.

When the user quits taking opium, the body rebounds with a set of withdrawal symptoms that mimic a bout of the flu. The symptoms include watery eyes, runny nose, sneezing or yawning, muscle pains and involuntary motion, anxiety and agitation, nausea, diarrhea, insomnia, and cold sweats. Some people experience goosebumps, which is where the term "quitting cold turkey" came into being. These unpleasant symptoms can last from three to five days.

If quitting opiates was as easy as overcoming a bout of the flu, addiction would not be a problem. However, most opium users also suffer an extended period of dysphoria (diss-FOR-ee-yuh), a long-lasting period of anxiety, depression, and lessened enjoyment of life. It is dysphoria that usually leads the opium user back to the drug for relief—and the whole cycle of abuse starts again. Addiction to opium can turn good citizens into criminals as they search for ways to obtain the drug. In the regions of the world where illegal opium is grown, farmers who wish to make an honest living are often bullied into growing poppies by corrupt officials, or forced to grow them out of economic need. Even if they do not use the drug themselves, they are trapped by the environment of crime that opiate addiction creates.

Reactions with Other Drugs or Substances

Opium causes slowed breathing and difficulties with motor coordination. During a high, the user might not move at all, or move more slowly. For this reason, opium should never be used with any other legal or illegal drug that causes sedation. A combination of opium and alcohol can lead to fatal breathing problems. Opium should not be used with tranquilizers, antidepressants, sleeping pills, or anti-anxiety medications such as benzodiazepines. Opium should not be used when taking certain prescriptions that affect liver function, including medicines for tuberculosis, such as Rifampin, and medicines for seizures and epilepsy, including Dilantin. Some antibiotics can increase the level of opium in the bloodstream.

Illegal opium combinations include the "Buddha," a mixture of marijuana and opium or heroin, and "black Russian" or "black hash," a mixture of opium and hashish. These mixtures can create high levels of disorientation and paranoia, or a feeling of heightened discomfort. According to the Drug Abuse Warning Network, most emergency room visits related to opiate abuse are overdoses or problems stemming from combining use of an opiate with another substance, such as marijuana, alcohol, or cocaine. Combining drugs of any sort with opium is very dangerous. An overdose of opium can be treated with naloxone (Narcan), a drug that quickly rids the body of any opiates. For the habitual opium user, a dose of Narcan will provoke the entire spectrum of withdrawal symptoms—but it can also save someone who has stopped breathing.

Treatment for Habitual Users

Opiate addiction is very hard to treat, and often an abuser will fail to stay clean several times before finding the motivation to stay free of the drug. Symptoms of withdrawal can be kept in check with drugs such as methadone and buprenorphine, administered by a licensed doctor or clinic. The recovering addict should also work with therapists to address underlying psychological issues that might have led to the drug use originally. Self-help groups such as Narcotics Anonymous provide a sympathetic peer group, telephone hotlines, and the support of other recovering users. Most important, the opium user may need to stay away from the people, places, and situations that contributed to the drug abuse in order to avoid temptation.

Raw or cooked opium is rare in the United States. However, the growing supply of heroin and the illegal use of opiate painkillers ensure that drug rehabilitation programs will need to continue to address the health issues associated with the opium poppy.

Consequences

Opium production is a problem that wrecks lives in many parts of the world. Farmers in Southeast Asia, Pakistan, and Afghanistan are forced—by economic need or by powerful drug lords—to grow great quantities of illegal poppies. These poppies supply the opium that becomes the heroin that hooks recreational drug users in Europe, Russia, the United States, and just about everywhere else. It is rare to find an American opium user, but in 2003 the National Survey on Drug Use and Health (NSDUH) observed that 119, 000 teenagers between the ages of twelve and eighteen reported using heroin at least once. Since heroin is just opium that has been chemically altered to work more quickly and more powerfully, it is safe to say that all the consequences of heroin abuse can be traced to opium abuse.

Afghanistan and Opium Production

The Taliban rulers of Afghanistan imposed severe penalties on anyone caught growing illegal opium poppies. Since the Taliban regime fell in 2001, poppy cultivation in Afghanistan has skyrocketed. According to a 2005 article in the Christian Science Monitor, Afghanistan produces almost 90 percent of the world's illegal opium. Most of it is refined into heroin and sent to Europe, Russia, and the United States.

The result? Heroin is cheaper, higher in purity, and easier to obtain than ever before.

The United States and the United Nations are working with the Afghan government to reduce illegal drug trafficking in Afghanistan. International aid workers report that corruption based on poppy production is so widespread that police officers and local officials are often paid more to overlook poppy fields than they can make in legal salaries. Lawmakers who try to curb poppy production run the risk of assassination.

The consequences of trying to support a drug habit include criminal behavior such as theft, armed robbery, drug dealing, and prostitution. They also include health issues such as the possibility of contracting human immunodeficiency virus (HIV), the virus that leads to AIDS, or hepatitis viruses from shared needles; malnutrition from a lack of appetite; and loss of quality of life. Addictive opiates tear families apart and deprive people of jobs, college loans, driver's licenses, and social status. Users face criminal records, lengthy detoxification programs, and long-lasting cravings for the drug they are trying to kick.

Opium Chronology

4000 bce      Opium poppies are cultivated in the Fertile Crescent (now Iran and Iraq) by the ancient cultures of Mesopotamia.

1552 bce      An ancient Egyptian papyrus text from the city of Thebes lists 700 medical uses for opium.

183 bce      Carthaginian General Hannibal uses a fatal dose of opium to commit suicide.

600-900 ce      Arabic traders introduce opium to China.

1524      Swiss doctor Paracelsus mixes opium with alcohol and names the product laudanum.

1821      Thomas de Quincey (1785–1859) publishes Confessions of an English Opium Eater.

1839–1842/1856–1860      Great Britain and China engage in the "Opium Wars" when China tries to forbid opium imports.

1896      More than 300 opium "dens" operate in New York City. Users recline "on the hip" as they smoke the drug through long-stemmed pipes.

1909      The first International Opium Commission is held in Shanghai, China on February 1.

1909      The Smoking Opium Exclusion Act is passed.

1914      The Harrison Narcotics Act is enacted in the United States.

1942      The Opium Poppy Control Act makes it illegal to grow opium poppies in the United States, even as garden flowers.

1970      The Comprehensive Drug Abuse Prevention and Control Act names opium a Schedule II controlled substance, recognizing its uses in pain relief as well as its potential for addiction and abuse.

2005      After the fall of the Taliban government in 2001, opium poppy production begins to soar in Afghanistan, accounting for almost 90 percent of the illegal heroin created worldwide.

How does opium affect world politics? In December of 2004, Mark Steven Kirk, a Republican congressman from Illinois, returned from Afghanistan to report that notorious terrorist Osama bin Laden, the leader of the al Qaeda terrorist network, has used cash earned from opium production to pay for his personal bodyguards, weapons, and secret hiding places. Al Qaeda has paid Pakistani drug lords to help keep bin Laden hidden from U.S. forces. Afghan drug dealers have also worked with bin Laden to provide shelter on their side of the border. According to Kirk, the purchase of a packet of heroin in the United States helps America's worst enemies avoid arrest and prosecution half a world away.

The Law

Opium is a Schedule II controlled substance. Its only legal use is in a few rarely used prescription drugs, such as paregoric. Any other possession or sale of opium carries strict penalties that vary from state to state but almost always include heavy fines, permanent criminal records, mandatory detoxification, drug testing, and loss of privileges such as driver's licenses. Second offenses almost always result in lengthy jail sentences. Third offenses can earn someone a lifetime behind bars.

To the dismay of some gardeners, it is also illegal to grow opium poppies in the United States, even in small numbers. A single poppy plant can yield up to 80 milligrams of raw opium. (Other species of poppy remain available to the backyard gardener.) In July of 2004, UPI NewsTrack reported that three people were arrested and prosecuted in Pella, Iowa, for growing 22, 000 poppy plants among rows of vegetables on a farm. The people were charged with manufacturing a controlled substance, even though the poppies had not yet ripened.

Elsewhere in the world, agents from the United Nations, various European countries, and the United States work with government officials in Afghanistan, Pakistan, and other poppy-producing regions, to kill poppy plants. Poppy reduction programs require the cooperation of governments where the illegal activity takes place. They also must offer some financial alternative to the farmers who earn money from the opium harvest. Many difficult issues must be faced if the notorious opium poppy—the source of so many beneficial medicines—is to be restricted to legal production.

For More Information

Books

Booth, Martin. Opium: A History. New York: St. Martin's Press, 1998.

Courtwright, David T. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press, 2001.

Gahlinger, Paul M. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. Las Vegas, NV: Sagebrush Press, 2001.

Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy, 2nd ed. New York: W.W. Norton, 2003.

Musto, David F. The American Disease: Origins of Narcotic Control. New York: Oxford University Press, 1999.

Periodicals

Baldauf, Scott. "Afghanistan's New Jihad Targets Poppy Production: A U.S., European, and Afghan Initiative Has Cleared 80 Percent of the Opium Plants from One Province." Christian Science Monitor (May 16, 2005): p. 7.

Baldauf, Scott, and Faye Bowers. "Afghanistan Riddled with Drug Ties." Christian Science Monitor (May 13, 2005): p. 1.

"Opium Found Growing in Rural Iowa Garden." UPI NewsTrack (July 16, 2004).

"World Coca Production Down: Opium Soars." UPI NewsTrack (March 4, 2005).

Web Sites

"2003 National Survey on Drug Use and Health (NSDUH)." Substance Abuse and Mental Health Services Administration (SAMHSA). http://www.drugabusestatistics.samhsa.gov (accessed August 16, 2005).

"Afghans See Future in Poppy Crop." Join Together, October 15, 2004. http://www.jointogether.org/sa/news/summaries/reader/0%2C1854%2C577684%2C00.html (accessed August 16, 2005).

"Congress: Drug War Falters in Afghanistan." Join Together, July 13, 2005. http://www.jointogether.org/sa/news/summaries/reader/0%2C1854%2C577684%2C00.html (accessed August 16, 2005).

"Drugs of Abuse" (2005 edition). U.S. Drug Enforcement Administration. http://www.usdoj.gov/dea/pubs/abuse/doa-p.pdf (accessed August 16, 2005).

"Emergency Department Trends from the Drug Abuse Warning Network: Preliminary Estimates January-June 2001, with Revised Estimates 1994-2000." Substance Abuse and Mental Health Services Administration (SAMHSA). http://www.samhsa.gov (accessed August 12, 2005).

"FAQ about Opium." Drug Rehab America.net (Narconon of Southern California). http://www.drugrehabamerica.net/FAQ-opium.htm (accessed August 16, 2005).

"Opium." U.S. Drug Enforcement Administration. http://www.usdoj.gov/dea/concern/opium.html (accessed August 16, 2005).

"The Opium Kings: Opium Throughout History." Frontline. http://www.pbs.org/wgbh/pages/frontline/shows/heroin/etc/history.html (accessed August 16, 2005).

"Origin and History of the Opium Poppy." U.S. Drug Enforcement Administration. http://www.usdoj.gov/dea (accessed August 12, 2005).

See also: Cocaine; Codeine; Heroin; Hydromorphone; Marijuana; Methadone; Morphine; Oxycodone

Opium

Opium, or Papaver somniferum, has been cultivated and consumed by human beings since at least the third millennium b.c.e., when inhabitants of Mesopotamia began growing and ingesting it. From its likely origins in ancient Mesopotamia, opium use spread westward to Egypt and other parts of the eastern Mediterranean by the first millennium b.c.e., and eastward into Persia, India, and China by the first millennium c.e.

The European explorations of the fifteenth and sixteenth centuries encountered a preexisting opium trade in Mughal India, centered principally in areas surrounding Calcutta and Bombay (Mumbai). The Portuguese gradually entered the trade, progressively displacing Indians and Arabs from the increasingly lucrative China market. By the seventeenth and eighteenth centuries, the Dutch, English, and French had joined the opium commerce, which came to involve all of Asia and parts of Europe and its colonies around the globe as the nineteenth century unfolded.

At that point, opium had become a crucial commodity that had a major impact on the economic, social, and political circumstances in India, China, and Great Britain. The twentieth century witnessed the spread of opium cultivation to the Golden Triangle (Burma [Myanmar], Thailand, and Laos), to the Golden Crescent (Iran, Afghanistan, and Pakistan), and even to Columbia. At the same time, consumption of opium and its most popular derivatives, morphine and heroin, extended to every corner of the globe.

Medically, opium serves as an analgesic, relieving pain, especially for those who did not or do not have access to modern therapeutic procedures. People with respiratory disorders, particularly tuberculosis, self-medicated with opiates to control coughing. Opium produces constipation and was thus taken to treat diarrhea and dysentery, common symptoms of numerous maladies that were otherwise untreatable in premodern times. In addition, people believed that opium helped to mitigate the symptoms of malaria and to energize exhausted laborers.

In addition to medical usage, people consumed opiates to demonstrate social status. When the price of opium soared, only the well-to-do could afford such a luxury. In the nineteenth century particularly and later as well, many intellectuals, from China to England, viewed opium as an agent of enlightenment that could expand the powers of the mind and bring tranquility to the soul. As English author Thomas de Quincey (1785–1859) put it, "Whereas wine disorders the mental faculties, opium introduced amongst them the most exquisite order, legislation and harmony." French writer Jean Cocteau (1889–1963) claimed that opium smoking generated "the ultimate siesta." The drug also served as a sort of social lubricant, bringing together friends and neighbors at community opium establishments or "dens," much as people in the early twenty-first century meet at coffee houses, tea houses, or local taverns.

Most recreational users claim that opium alters one's mood, produces a feeling of euphoria, reduces the stress of everyday life, and acts as an aphrodisiac (though some consumers admit to reduced sexual performance). For both medical and recreational users, the perceptions of opium's powers may well outstrip the actual performance of the drug or even produce a result opposite to the one desired.

GLOBAL OPIUM PATTERNS, 1800–1950

The vast majority of opium production and consumption during the nineteenth and the first half of the twentieth century occurred in Asia. Britain, India, and China accounted for most drug activity there. National governments, local drug lords and officials, opium growers and merchants, colonial opium monopolies, and drug prohibitionists clashed over the suitable role opium should play on a continent whose inhabitants had increasingly become attracted to the drug.

By early twentieth century, pharmaceutical companies in the Europe, North America, and Japan began producing morphine and the precursor chemicals needed for the manufacture of opium derivatives for sale in the nonindustrial world, chiefly in China. Decades of global prohibitionist activism, World War II (1939–1945), postwar decolonization, and the 1949 Communist revolution in China destroyed traditional opium trafficking and consumption patterns. These circumstances, plus an emerging tolerance for drug use in most of the industrial world by the 1960s, set the stage for new centers of opium production and consumption.

Nineteenth-century opium trafficking was chiefly an Asian phenomenon. Nearly all opium growing was done in Turkey, Persia, India, and China, while most consumption took place in China, though people in other parts of Asia, Europe, and North America also became regular opiate users. Opium probably had the largest impact on China, where the Qing/Manchu government (1644–1911) had historically prohibited the drug, a ban that brought China into conflict with Britain, which supplied more than 90 percent of the foreign-produced drug.

Chinese demand for opium resulted in an outflow of silver to pay for it. That in turn increased the price of silver, which peasants had to purchase with copper in order to pay their taxes. Just as important, the Chinese tribute system of international relations, which regulated foreign access to China, began to break down. The British East India Company—the only British organization permitted by the Chinese to conduct trade in their country, and then only in Canton (Guangzhou)—lost its London monopoly on the China trade in 1834, thus permitting (under British law) any British company to enter the China market. But even as mercantilism gave way to free trade in Britain, China continued to insist on conducting foreign trade through the tribute system. These points of disagreement—the impact of drugs and the system of international relations—produced the First Opium or Anglo-Chinese War (1839–1842).

China's defeat and the ensuing Treaty of Nanking (Nanjing, 1842), which made no reference to the opium trade, opened China to the outside world and the European system of international relations. China resisted opening its doors while the drug trade continued, generating the Second Opium War (1856–1860), another defeat for China, and yet another set of treaties, one of which—the Treaty of Tientsin (Tianjin, 1858)—allowed the import of opium upon the paying of a tariff. By this time, China was well on the way to becoming the world's largest opium producer. By the end of the century, probably more than ten million Chinese were addicted to the drug and millions more were periodic users. Millions of farmers had become producers of the drug, and tens of thousands of transporters and retailers emerged to get the product to users, while government officials at all levels reaped the taxation (some legal, some illegal) rewards.

Beyond China, the British government used opium profits to cover the expenses of governing India, while millions of Indian farmers produced opium for the burgeoning global market, which included all the colonies in Southeast Asia, particularly those locations where large concentrations of ethnic Chinese lived. But the drug had also caught on in England and the United States, where Americans became enthusiastic consumers of patent medicines, most of which contained some form of opium. In addition, colonial regimes in Southeast Asia came to depend on opium taxation to finance their administrative costs.

But even while global opium production and consumption soared, an international opium prohibition movement emerged to check nonmedical use of opiates and other drugs. In 1905 the British government informed China that it would consider ending its exports of opium to China if Beijing would undertake a serious anti-opium campaign. This offer by London represented the culmination of a decades-long prohibitionist crusade in England and America, led by missionaries and assorted other reformers, much in the spirit of the progressive movement then in full swing in the United States. Should Britain be convinced of a serious Chinese effort, then London would end its export of opium to China by 1917.

Although Beijing launched an anti-opium movement in 1906 that initially succeeded beyond almost everyone's expectations, and though the British promised and did in fact bring an end to opium exports as prearranged, Chinese politics ultimately doomed the effort. First, the Manchu Qing government feared mobilizing the common people in the antidrug campaign for fear it could easily become a nationalist anti-Manchu movement. Next, the Empress Dowager Cixi (1835–1908), the nation's principal leader, died in 1908, and three years later China's dynastic government collapsed forever. Successor regimes had little interest in the campaign, and by 1916 the country had fallen into the hands of warlords, almost all of whom used opium to finance their organizational operations. Moreover, those political movements dedicated to crushing warlordism, ending foreign privileges in China, and modernizing the country—the Nationalists (Guomindang) and the Communists—both relied on opium revenue to some extent from the 1920s to the 1940s, even as they attacked the practice officially.

Meanwhile, several international anti-opium conferences held before and after World War I (1914–1918) to bring about an end to illicit drug trafficking began alerting the wider world to the perils of drug use. In the United States, the Harrison Act of 1914 began a prohibitionist drug campaign in a country that had liberally and legally consumed opiates. Great Britain agreed to end its export of opium to colonies in Southeast Asia by 1936, a pledge it honored. The League of Nations, created in 1919 by the Treaty of Versailles to deal with thorny international issues, sponsored numerous anti-opium conferences, which generated anti-opium treaties.

Between the world wars, heroin was quickly replacing opium as the drug of choice in much of China, and although all the industrial nations provided the necessary chemicals to produce heroin in China, by the mid-1930s Japan came to dominate the traffic in heroin and its precursor drugs there. A growing split surfaced between Tokyo on the one side and London, Washington, D.C., and Nanjing (China's capital from 1928 to 1949) on the other, which resulted in Japanese trafficking becoming a prominent rationale with which to brand Japan an outlaw nation. World War II and various independence movements destroyed traditional drug marketing patterns in Asia, and the Chinese Communist victory in 1949 and its subsequent genuine antidrug campaign obliterated nearly overnight the largest consumer market for opium (at least until the 1980s). By the mid-twentieth century, the vast majority of the world's opium was used to produce legitimate medicines.

OPIUM ACTIVITIES SINCE 1950

Nonetheless, there remained a demand for opiates, particularly in the industrial world. With India and China no longer producing the drug, other centers of cultivation and new patterns of trafficking emerged to fill the vacuum. Drug users proliferated in the 1960s as counter-cultural movements across the globe extolled the benefits of getting high, often with opiates. Two principal production sites surfaced to meet the growing demand for opium, the Golden Triangle and the Golden Crescent. The countries of these regions were relatively poor, possessed vast remote and mountainous regions difficult for a government to access or control, and had all experienced considerable political instability. By the 1990s, Columbia entered the opium growing business.

After World War II, the United Nations and member governments supported drug prohibition movements, at least verbally. Like the League of Nations, the United Nations sponsored antidrug conferences, promoted antidrug treaties, and disseminated antidrug measures. In practice, however, the United Nations merely served as a launching platform for its members' antidrug public relations campaigns.

By the 1970s, the United States had commenced its "war on drugs," a reaction to the growing popular notion that drug use had somehow become an acceptable part of one's lifestyle. Popular culture began addressing drug issues, one example being the motion picture The French Connection (dir. William Friedkin, 1971), which chronicled the movement of illicit heroin from Marseilles, France, to the New York consumer market and the marginally successful police effort to thwart such trafficking. "Just Say No" campaigns in the United States and elsewhere aimed to reduce drug use, and did realize some success in the 1980s and 1990s. By the late twentieth century, though opiates still attracted addicts and recreational users, other illicit hard drugs, such as cocaine and methamphetamines, began to capture a larger share of the illegal drug market.

International affairs have continued to have an impact on the drug trade. The Cold War (1945–1991) between the United States and the Soviet Union tended to undermine global antidrug operations because Washington often found itself allied with drug traffickers. Thus the U.S. government turned a blind eye to the drug activities of Chinese nationalist remnants in Burma, where they plied their trade into the 1970s, and worked closely with the Hmong of Laos (also in the opium business) during the Vietnam War (1957–1975). In addition, the United States supported the mujahideen (Islamic guerilla fighters) in Afghanistan, who cultivated and marketed opium to help finance their war against the Soviet Union, which had invaded and occupied their country in the late 1970s and 1980s. After the Soviet withdrawal from Afghanistan in the 1980s and the American defeat of the militant Islamic Taliban government in 2001, opium cultivation once again became a significant source of income for Afghan tribes. This policy of overlooking the drug-related activities of America's conditional allies extended to Latin America, where Washington was predisposed to support governments that opposed Soviet or Cuban activities in the region.

These political marriages of convenience date back to World War II, when the United States worked with drug traffickers in Burma in an effort to defeat the Japanese, and extend into the early twenty-first century, when the U.S. government worked with drug traffickers in Afghanistan to remove the Taliban and capture the Saudi-born terrorist Osama bin Laden (b. 1957). As long as consumers demand illegal opiates for recreational purposes, poverty will drive producers to meet those demands. And as long as governments advance agendas deemed more critical than illicit drug eradication, and prohibitionists continue to dominate drug policy in governments around the world, producers and consumers of opium will continue to achieve their agendas.

see also China, First Opium War to 1945; China, to the First Opium War; Opium Wars.

BIBLIOGRAPHY

Bello, David Anthony. Opium and the Limits of Empire: Drug Prohibition in the Chinese Interior, 1729–1850. Cambridge, MA: Harvard University Press, 2005.

Booth, Martin. Opium: A History. London: Simon and Schuster, 1996.

Brook, Timothy, and Bob Takashi Wakabayashi, eds. Opium Regimes: China, Britain, and Japan, 1839–1952. Berkeley: University of California Press, 2000.

Courtwright, David. Forces of Habit: Drugs and the Making of the Modern World. Cambridge, MA: Harvard University Press, 2001.

Madancy, Joyce A. The Troublesome Legacy of Commissioner Lin: The Opium Trade and Opium Suppression in Fujian Province, 1820s to 1920s. Cambridge, MA: Harvard University Press, 2003.

Reins, Thomas D. "Reform, Nationalism, and Internationalism: The Opium Reform Movement in China and the Anglo-American Influence, 1900–1908." Modern Asian Studies 25 (1) (1991): 101-142.

Trocki, Carl A. Opium, Empire, and the Global Political Economy: A Study of the Asian Opium Trade, 1750–1950. New York: Routledge, 1999.

Walker, William O. Opium and Foreign Policy: The Anglo-American Search for Order in Asia, 1912–1954. Chapel Hill: University of North Carolina Press, 1991.

Walker, William O., ed. Drugs in the Western Hemisphere: An Odyssey of Cultures in Conflict. Wilmington, DE: Scholarly Resources, 1996.

Opium

Before concerted international efforts appeared in the first decades of the twentieth century to crack down on opium, the substance was widely available around the world.

In Europe, opium could be dissolved in beer, wine, or vinegar or simply taken as an infusion prepared out of boiled poppy heads, while powdered opium was used in suppositories and raw opium was rolled into pills and preparations such as laudanum. In the Middle East and South Asia, it was more often than not ingested orally. In China and parts of South East Asia, however, opium was frequently mixed with tobacco. Javanese opium, for instance, was blended with roots of local plants and hemp, minced, boiled with water in copper pans, and finally mixed with tobacco. This blend was called madak.

Madak was first introduced to Taiwan (Formosa) between 1624 and 1660. The mixture was prepared by the owners of smoking houses and brought prices significantly higher than for pure tobacco. Opium house owners also provided the smoking implement: a bamboo tube with a filter made of coir fibers, produced from local coconut palms. The habit of smoking madak spread throughout the coastal provinces of south China, even though it never exceeded the popularity of tobacco.

A precise chronology of madak is not possible in the absence of reliable source material, although the first references to the blend date from the early eighteenth century and come from Fujian and Guangdong, the same ports of entry as for tobacco. "The opium is heated in a small copper pan until it turns into a very thick paste, which is then mixed with tobacco. When the mixture is dried, it can be used for smoking by means of a bamboo pipe, while palm fibers are added for easier inhalation." The earliest description of pure opium smoking dates from 1765.

The reasons for a shift away from madak toward pure opium after the 1760s are complex. One hypothesis is that pure opium was used to enhance sexual performance. Another explanation is that an early edict against the smoking of madak by the Yongzheng emperor in 1729 prompted local users to resort to pure opium instead, the use of which could be justified for medical reasons. It is also possible that the smoking of pure opium served as a marker of social status, as large amounts of money could be spent in one evening on pure opium. The quality of Patna opium—produced in India under British control—improved after poppy cultivation in Bengal was monopolized by the East India Company in 1793, a factor which may also have prompted some madak smokers to smoke opium on its own.

Throughout the eighteenth century, however, madak remained widespread, as pure opium would only become the norm in the nineteenth century with the lowering of the cost of opium and the spread of local poppy cultivation in China. Tobacco thus allowed opium to become part of a thriving smoking culture well before the "First Opium War" between Britain and China (1839–1842), which revolved partly around the issue of the opium trade.

See Also Alcohol, Tobacco, and Other Drugs.

▌ FRANK DIKÖTTER

BIBLIOGRAPHY

Dikötter, Frank, Lars Laamann, and Xun Zhou. Narcotic Culture: A History of Drugs in China. Chicago: Chicago University Press, 2004.

Newman, Richard K. "Opium Smoking in Late Imperial China: A Reconsideration." Modern Asian Studies 29 (October 1995): 765–794.

Spence, Jonathan D. "Opium Smoking in Ch'ing China." In Conflict and Control in Late Imperial China. Edited by Frederic Wakeman and Carolyn Grant. Berkeley: University of California Press, 1975.

Opium

Opium is a drug that is derived from the poppy plant. Its pain-relieving qualities have been known since ancient times. Opium was used by prehistoric inhabitants of Switzerland, by Egyptians by about 1590 b.c., and by ancient Greek physicians around 400 b.c.. Opium was introduced to India and China around 600 b.c. by Arabian traders.

A Popular Drug

From the 1600s through the 1800s opium was one of the principal drugs in Western medicine. It was particularly promoted by the English physician Thomas Sydenham (1624-1689) to relieve pain, induce sleep, and treat strangulated bowel obstruction. Sydenham developed laudanum, a preparation of opium dissolved in sherry and flavored with saffron.

Opium was an ingredient of many of the popular patent medicines. While some of these products provided good medical treatment, many more were nothing more than opium-or alcohol-based solutions that numbed the body. Opium was also widely prescribed to consumptives (people suffering from tuberculosis) to relieve coughing and promote a sense of well-being. Opium use became widespread among artists and writers involved in the Romantic movement of the nineteenth century. In the days before ether was used as an anesthesia, opium was used to deaden the pain during surgery. Massive doses were usually the norm.

Opium Derivatives

Morphine, the main active ingredient in opium, was discovered in 1805 by German chemist Friedrich Serturner (1783-1841). Codeine, another pain-killer derived from opium, was discovered a few years later by French chemist Pierre-Jean Robiquet (1780-1840). After the hypodermic syringe was invented in 1853, Alexander Wood (1817-1884) of Edinburgh, Scotland, developed a method of injecting morphine to relieve neuralgia (a severe sharp pain along the course of a nerve).

Morphine injection for relief of pain was enthusiastically embraced by the medical community. Doctors even taught their patients how to inject themselves. Morphine injection greatly increased the amounts of the drug that users were taking as compared with laudanum.

Gradually, the addictive properties of opium and morphine were recognized. Regular use resulted in dependency, and stopping use caused uncomfortable withdrawal symptoms. The recognition of these addictive effects and the discovery of ether as an anesthetic greatly reduced the use of opium. Despite the addictive qualities of morphine, it continues to be used. When prescribed properly and carefully it remains a very important and effective pain reliever. Ironically, the search for a morphine substitute that would kill pain but be nonaddictive resulted in the discovery of heroin.

[See also Anesthesia ]