What Is Laudanum? Definition, Uses, Risks, and Why It Matters Today

Key Points

Laudanum is a medication produced from opium and has a long and complicated history, which is essential to comprehending how society’s understanding of opioids has evolved. In past centuries, laudanum was regarded as a universal remedy for many medical issues, but today it is a powerful drug with the potential to cause addiction.

In this article, you will learn what laudanum is, how it was used, the health effects of laudanum on society, and why laudanum is not used frequently today. Additionally, we will examine the potential for laudanum addiction and the treatment of addiction to opioids through modern, evidence-based (practical application of the findings of the best available current research) methods that support long-term recovery for individuals and the people they know affected by opioid use disorder.

What Is Laudanum? Definition and Composition

Definition

Laudanum is a tincture of opium produced by dissolving opium in ethanol (or alcohol). Opium is produced from the sap of the opium poppy plant and contains many naturally occurring opioid compounds. Historically, laudanum usually contained approximately 10 percent opium by weight, which equates to roughly 1 percent morphine content.

Today, opium tincture is referred to as laudanum and illustrates the chemical nature of laudanum, rather than the commercial name that laudanum once had.

What Is Laudanum Made Of?

In order to determine what the active ingredient in laudanum is, it is essential to define the chemical composition of laudanum. The active ingredients in laudanum include several opium alkaloids (such as morphine and codeine), which are combined with alcohol (ethanol) and dissolved in laudanum. Morphine can be administered orally or via intravenous, intramuscular, or subcutaneous injection. Codeine is typically administered orally. The alkaloid compounds in the drug interact directly with receptors to reduce pain and manage symptoms [1].

Since the concentration of the active ingredient in laudanum varies significantly, laudanum has historically had a very high overdose risk compared to all modern pharmaceuticals that have a standard formulation.

Origin of the Term

The term “laudanum” is thought to derive from the Latin word laudare, meaning “to praise.” This is indicative of the high regard in which laudanum was held when it was first discovered.

Historical Context of Laudanum

Early Origins

Laudanum was first made and used in the 16th century and subsequently gained extensive popularity throughout Europe, as it became recognized as the best way to treat pain and was considered a medical breakthrough.

Widespread Use in the 17th to 19th Centuries

During the 17th to 19th centuries, laudanum was widely used to treat a variety of illnesses and conditions. Some of the many conditions for which laudanum was prescribed included pain, cough, diarrhea, insomnia, anxiety, and to calm infants and children. While historians note that calming newborns with tinctures was a common but dangerous household practice, at the time it was considered safe [2, 3].

Laudanum was available over the counter and was included as an ingredient in many pharmaceutical and household medicinal products (patent medicines). To the extent that individuals across all walks of life consumed laudanum, it is clear that dependence and unintentional misuse were present among all social classes.

Transition to Regulation

As medical professionals began to see signs of addiction and overdose, governments instituted more significant developments of attitudes towards laudanum and the regulation of laudanum. The first example of regulation was included in the 1914 Harrison Narcotics Act in the United States, which included drugs made from opium [4]. These regulations marked a turning point in how opioids were prescribed and monitored.

What Is Laudanum Used For Historically?

To better understand how laudanum was used, it is necessary to examine what we recognize today as modern medicine.

Pain Relief

Laudanum has historically been used to manage pain, and the morphine contained in laudanum was what made it so effective, but also was the source of its potential for establishing a dependence.

Cough Suppression and Sedation

Physicians and alternative practitioners utilized laudanum as a treatment to suppress excessive cough and to sedate patients. The sedative effect of laudanum is attributed to opioids’ depressing activity in the CNS (the brain and spinal cord), slowing breathing, and promoting drowsiness.

Treatment of Diarrhea

Laudanum has been historically used to treat severe diarrhea. In rare modern contexts, opium tincture may still be used under strict medical supervision for this purpose.

Other Historical Uses

Laudanum was used for insomnia and as a general treatment to alleviate pain and discomfort. However, as the practice became commonplace, many individuals had developed tolerance, meaning higher doses were needed to achieve the same effect.

Modern Medical View of Laudanum

Why Laudanum Is Rarely Used Today

In modern medicine, laudanum is largely obsolete. Safer, more precise opioid medications and non-opioid alternatives are available. These newer treatments have standardized dosing and more straightforward safety guidelines.

Is Laudanum Still Used?

A common question is, is laudanum still used? In the United States, laudanum is classified as a Schedule II: High potential for abuse, which may lead to severe psychological or physical dependence. These drugs have a currently accepted medical use in treatment in the U.S. or a currently accepted medical use with severe restrictions. Today, laudanum is only prescribed in sporadic cases, typically for severe diarrhea that does not respond to other treatments.

Regulatory Status

The strict regulation of laudanum reflects lessons learned from its history. These controls aim to reduce misuse, dependence, and overdose risk.

Side Effects and Health Risks

Acute Side Effects

Short-term side effects of laudanum may include nausea, constipation, sedation, and cognitive impairment.

Overdose Risk

One of the most serious dangers of laudanum is shortness of breath and respiratory depression (shallow breathing that leads to a buildup of carbon dioxide and a lack of oxygen), which is a slowed breathing rhythm that can result in a fatality [5, 3]. Since laudanum is highly concentrated, many small dosing mistakes can cause death from overdose.

Comparison to Modern Opioids

Compared to modern opioids, laudanum has less predictable dosing and greater risks associated with it, leading to increased chances of an accidental overdose when it is used without proper medical oversight.

Laudanum and Addiction

Addiction Potential

Due to laudanum’s potent opioids and ability to create a physiological dependence in the brain after repeated exposure, people can have great difficulty ending their relationship with laudanum with additional support once the brain’s chemistry has changed.

Signs of Dependence

People can show signs of becoming dependent on opioids through intense cravings, increasing tolerance, withdrawal symptoms, and disruption of their daily lives, work, or relationships. Common withdrawal symptoms include anxiety and physical pain, gastrointestinal issues, and extreme discomfort [6].

Historical Impact of Addiction

Many people became dependent on laudanum without even realizing they were. It was viewed through a medical lens, and as such, the associated dangers were not considered. As a result, laudanum came to be abused long before the term Opioid Use Disorder was even established.

Why Laudanum Is Dangerous Today

Limited Medical Use

Laudanum is no longer used for the treatment of pain or other common medical conditions due to the potency and risk of death from overdose.

Opioid Epidemic Context

The historical perspective of laudanum provides an essential foundation in understanding the ongoing opioid epidemic. There are significant public health implications associated with the chronic misuse of opioids, and many of today’s issues surrounding the prescribing of opioids and the need to establish comprehensive treatment.

Cultural Myths

Many people believe that natural products are safer than synthetic medications. However, laudanum demonstrates that a product derived from nature can be just as dangerous, particularly when it affects the CNS.

Opioid Use Disorder and Treatment Pathways at SOBA NJ

SOBA NJ, understands the impact of opioid addiction on both the individual and their family and how it often co-occurs with other mental health issues, such as depression, anxiety, and post-traumatic stress disorder (PTSD).

Recognizing Opioid Use Disorder

Patterns of misuse regarding laudanum are similar to those identified with other opioids, including loss of control over substance use, continued use or abuse despite adverse consequences, and difficulty stopping use.

Evidence-Based Treatment Options

At SOBA NJ, the mental health and addiction treatment provided to clients is evidence-based (the practical application of the findings of the best available current research), meaning that care options are based on the best available scientific research. According to the Centers for Disease Control, comprehensive clinical care for OUD typically includes FDA-approved medications like buprenorphine or methadone [7, 1].

Integrated Mental Health Support

Successful, safe recovery must address both mental health and substance use disorder concurrently. To achieve this, specific therapies such as cognitive-behavioral therapy (CBT) (a form of talk therapy that focuses on identifying and changing unhelpful behaviors) help recognize and change maladaptive behaviors. In contrast, dialectical behavior therapy (DBT) (a form of talk therapy that helps people manage intense emotions and behaviors) assists in managing overwhelming emotions and behaviors. These types of therapies are components of many comprehensive care plans.

Laudanum: An Early Opioid

Understanding laudanum is essential to understanding the evolution of opioid prescribing practices and establishing the need for safe, regulated medical care. At one time, laudanum was considered a “cure-all.” Today, laudanum is recognized as a potent and highly dangerous opioid that presents a risk for overdose and dependence. Even though it is not commonly used anymore, its historical use lays the groundwork for our current approaches to ensuring that we prescribe opioids safely and appropriately, and how we continue to treat individuals who are currently opioid dependent.

If you or someone you know has an addiction to opioids or another underlying mental health issue, compassionate, evidence-based support can provide you with helpful information for taking the following steps on the road to recovery. SOBA NJ is here for you and the people you know, helping them along the way to recovery.

Frequently Asked Questions About Laudanum