"God's Own Medicine"
Sir William Osler
Opium is an extract of the exudate derived from seedpods of the opium poppy, Papaver somniferum. The poppy plant was cultivated in the ancient civilisations of Persia, Egypt and Mesopotamia. Archaeological evidence and fossilised poppy seeds suggest that Neanderthal man may have used the opium poppy over thirty thousand years ago. Less controversially, the first known written reference to the poppy appears in a Sumerian text dated around 4,000 BC. The flower was known as hul gil, plant of joy. Papaver somniferum is the only species of Papaver used to produce opium. It is believed to have evolved through centuries of breeding and cultivation from a Mediterranean-growing wild strain, Papaver setigerum.
Homer conveys its effects in The Odyssey. In one episode, Telemachus is depressed after failing to find his father Odysseus. But then Helen..."...had a happy thought. Into the bowl in which their wine was mixed, she slipped a drug that had the power of robbing grief and anger of their sting and banishing all painful memories. No one who swallowed this dissolved in their wine could shed a single tear that day, even for the death of his mother or father, or if they put his brother or his own son to the sword and he were there to see it done..."In some parts of the contemporary Middle East, chilled glasses of poppy tea are served to mourners at funerals to ease their grief.
Papaver somniferum has long been popular in Europe. Fossil remains of poppy-seed cake and poppy-pods have been found in Neolithic Swiss lake-dwellings dating from over 4,000 years ago. Poppy images appear in Egyptian pictography and Roman sculpture. Representations of the Greek and Roman gods of sleep, Hypnos and Somnos, show them wearing or carrying poppies. Throughout Egyptian civilisation, priest-physicians promoted the household use of opium preparations. Such remedies were called "thebacium" after the highly potent poppies grown near the capital city of Thebes. Egyptian pharaohs were entombed with opium artefacts by their side. Opium could also readily be bought on the street-markets of Rome. By the eighth century AD, opium use had spread to Arabia, India and China. The Arabs both used opium and organised its trade. For the Prophet had prohibited the use of alcohol, not hashish or opiates.
Classical Greek physicians either ground the whole plant or used opium extract. Galen lists its medical indications, noting how opium..."...resists poison and venomous bites, cures chronic headache, vertigo, deafness, epilepsy, apoplexy, dimness of sight, loss of voice, asthma, coughs of all kinds, spitting of blood, tightness of breath, colic, the lilac poison, jaundice, hardness of the spleen stone, urinary complaints, fever, dropsies, leprosies, the trouble to which women are subject, melancholy and all pestilences."
Later authorities were scarcely less enthusiastic. Physicians commonly believed that the poppy plant was of divine origin; opium was variously called the Sacred Anchor Of Life, Milk Of Paradise, the Hand Of God, and Destroyer Of Grief. Thomas Sydenham, the 17th-century pioneer of English medicine, writes...."Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium."This may be overstating God's benevolence; but by relieving emotional as well as physical pain, opiates have been understandably popular. Robert Burton, scholar, priest and author of Anatomy of Melancholy, commended laudanum - essentially opium dissolved in wine - for those who were insomniacs..."...by reason of their continual cares, fears, sorrows, dry brains [which] is a symptom that much crucifies melancholy men..."Indeed opium was probably the world's first authentic antidepressant. Unlike other pain-relieving agents such as ethyl alcohol, ether or the barbiturates, opium doesn't impair sensory perception, the intellect or motor co-ordination. Pain ceases to be threatening, intrusive and distressing; but it can still be sensed and avoided. At lower dosages, opium may be pleasantly stimulating rather than soporific. In the East, opium was typically treated as a social drug; and opium-smoking was a tool for conviviality. Nowadays a life of habitual opioid use evokes images of stupor and mindless oblivion, yet ironically Coleridge coined the word intensify to describe opium's effects on consciousness.
A significant advance in opium-processing occurred in the sixteenth century. In freebase form, the alkaloids found in opium are significantly less soluble in water than in alcohol. Philippus Aureolus Theophrastus Bombastus von Hohenheim (1490-1541), better known as Paracelsus, claimed: "I possess a secret remedy which I call laudanum and which is superior to all other heroic remedies". He concocted laudanum [literally: "something to be praised"] by extracting opium into brandy, thus producing, in effect, tincture of morphine. His original witches' brew contained extra ingredients such as crushed pearls, henbane and frog-spawn. It was steeped in alchemical mumbo-jumbo: Paracelsus called opium itself "the stone of immortality". Thomas Sydenham, however, went on to standardise laudanum in the now classic formulation: 2 ounces of opium; 1 ounce of saffron; a drachm of cinnamon and cloves - all dissolved in a pint of Canary wine.
Laudanum can be habit-forming. Yet the sometimes spectacular ill-effects noted by early modern writers when coming off laudanum probably owed more to its ethyl alcohol content than its opium. As their opioid tolerance increased, so did users' consumption of tinctures: De Quincey's florid withdrawal signs on abstaining suggest an alcoholic's delirium tremens rather than a junky's cold-turkey.
By the nineteenth century, vials of laudanum and raw opium were freely available at any English pharmacy or grocery store. One nineteenth-century author declared: "[Laudanum] Drops, you are darling! If I love nothing else, I love you." Another user, the English gentleman quoted in Jim Hogshire's Opium for the Masses (1994), enthused that opium felt akin to a gentle and constant orgasm.
British opium imports rose from a brisk 91,000lb in 1830 to an astonishing 280,000lb in 1860. Despite British control of Indian production, most domestic imports came from Turkey. This was because of the superior morphine content - 10-13% - of Turkish opium; opium's varying potency depends on its particular growing conditions. For obscure reasons, opium was most popular among the rural peasantry of the Fens. The British Medical Association estimated that sparsely populated Cambridgeshire and its environs consumed around half of Britain's annual opium imports. This consumption was topped up by generous use of poppy-tea brewed from homegrown poppies.
Youngsters were introduced to the pleasures of opiates at their mothers' breast. Harassed baby-minders - and overworked parents - found opium-based preparations were a dependable way to keep their kids happy and docile; this was an era before Ritalin. Sales of Godfrey's Cordial, a soothing syrup of opium tincture effective against colic, were prodigious. But Godfrey's Cordial had its competitors: Street's Infants' Quietness, Atkinson's Infants' Preservative, and Mrs Winslow's Soothing Syrup.
Opium was viewed as a medicine, not a drug of abuse. Contemporary medical theory didn't allow that one could become addicted to a cure. However, the chemists and physicians most actively investigating the properties of opium were also its dedicated consumers; and this may conceivably have coloured their judgement.
Writers of distinction certainly consumed opium in copious quantities. Samuel Taylor Coleridge (1772-1834) wrote Kubla Khan in a dream-like trance while under its spell; opium promotes vivid dreams and rich visual imagery as well as gentle euphoria..."In Xanadu did Kubla KhanFellow English author Thomas de Quincey (1785-1859) writes of "the marvellous agency of opium, whether for pleasure or for pain". De Quincey seems to have treated opium as a mood-brightening smart-drug. The author of Confessions of an English Opium-Eater (1821) draws invidious comparisons with alcohol. He attributes a heightening of his mental powers to opium use...
A stately pleasure-dome decree
Where Alph, the sacred river, ran
Down to a sunless sea
I would build that dome in air,
That sunny dome, those caves of ice!
And all who heard should see them there,
And all should cry, Beware! Beware!
His flashing eyes, his floating hair!
Weave a circle round him thrice,
And close your eyes with holy dread,
For he on honey-dew hath fed,
And drunk the milk of Paradise.""Whereas wine disorders the mental faculties, opium introduces amongst them the most exquisite order, legislation and harmony. Wine robs a man of self-possession; opium greatly invigorates it....Wine constantly leads a man to the brink of absurdity and extravagance; and, beyond a certain point, it is sure to volatilize and disperse the intellectual energies; whereas opium seems to compose what has been agitated, and to concentrate what had been distracted. ...A man who is inebriated...is often...brutal; but the opium eater...feels that the diviner part of his nature is paramount; that is, the moral affections are in a state of cloudless serenity; and over all is the great light of majestic intellect...."De Quincey states that not he himself, but opium, should be regarded as the true hero of his essay. Opium was his "Divine Poppy-juice, as indispensable as breathing". By reputation, opium users have dull wits, idle lives and diminished sensibility. This was not de Quincey's verdict. He made a habit of going to the opera under its influence - and found his experience of music delightfully enhanced..."Now opium, by greatly increasing the activity of the mind, generally increases, of necessity, that particular mode of its activity by which we are able to construct out of the raw material of organic sound an elaborate intellectual pleasure...It is sufficient to say, that a chorus, etc of elaborate harmony displayed before me, as in a piece of arras work, the whole of my past life - not as if recalled by an act of memory, but as if present and incarnated in the music; no longer painful to dwell upon, but the detail of its incidents removed...and its passions exalted, spiritualized, and sublimed..."Opium induces gentle, subtle, dream-like hallucinations very different from the fierce and unpredictable weirdness of LSD. Baudelaire (1821-67) likens opium to a woman friend, "...an old and terrible friend, and, alas! like them all, full of caresses and deceptions." Across the Atlantic, in 1842, William Blair describes his experiences with opium in a New York magazine..."While I was sitting at tea, I felt a strange sensation, totally unlike any thing I had ever felt before; a gradual creeping thrill, which in a few minutes occupied every part of my body, lulling to sleep the before-mentioned racking pain, producing a pleasing glow from head to foot, and inducing a sensation of dreamy exhilaration (if the phrase be intelligible to others as it is to me) similar in nature but not in degree to the drowsiness caused by wine, though not inclining me to sleep; in fact far from it, that I longed to engage in some active exercise; to sing, dance, or leap...so vividly did I feel my vitality - for in this state of delicious exhilaration even mere excitement seemed absolute elysium - that I could not resist the tendency to break out in the strangest vagaries, until my companions thought me deranged...After I had been seated [at the play I was attending] a few minutes, the nature of the excitement changed, and a 'waking sleep' succeeded. The actors on the stage vanished; the stage itself lost its reality; and before my entranced sight magnificent halls stretched out in endless succession with galley above gallery, while the roof was blazing with gems, like stars whose rays alone illumined the whole building, which was tinged with strange, gigantic figures, like the wild possessors of lost globe...I will not attempt farther to describe the magnificent vision which a little pill of 'brown gum' had conjured up from the realm of ideal being. No words that I can command would do justice to its Titanian splendour and immensity..."Opium was also well known in Chinese antiquity. One 10th century poem celebrates how the opium poppy can be made into a drink "fit for Buddha". Ancient peoples either ate parts of the flower or converted them into liquids to drink. But by the 7th century, the Turkish and Islamic cultures of western Asia had discovered that the most powerful medicinal effects could be obtained by igniting and smoking the poppy's congealed juices; and the habit spread. The widespread use of opium in China dates to tobacco-smoking in pipes introduced by the Dutch from Java in the 17th century. Whereas Indians ordinarily ate opium, the Chinese smoked it. The Chinese mixed Indian opium with tobacco, two products traded by the Dutch. Pipe-smoking was adopted throughout the region. Predictably enough, this resulted in increased opium-smoking, both with and without tobacco. Old encrusted opium-pipes were still valuable because they contained a residue of charcoal and raw opium known as "dross". Dross could be recycled with tobacco plus various adulterants and sold to the poor. Styles of opium pipe reflected the relative wealth or poverty of their owners. Pipes ranged from bejewelled, elaborately ornamented works of art to simple constructions of clay or bamboo.
By the late-1700s, the British East India Company controlled the prime Indian poppy-growing areas on the Ganges plain between Patna and Benares. The company dominated the Asian opium trade; but they did not create it. "Take your opium" was a standard greeting in some Indian cities even before the Europeans arrived. By 1800, however, the British East India Company had a virtual monopoly, controlling supply and setting prices. Dealers, merchants and users alike lovingly assessed the quality and potency of their merchandise with the ardour of a wine connoisseur. According to The Chinese Repository, discerning purchasers of the raw product looked for opium of..."...moderately firm texture, capable of receiving an impression from the finger; of a dark yellow color when held in the light, but nearly black in the mass, with a strong smell, and free from grittiness..."Opium was already heavily used in China as a recreational drug. The Imperial Chinese court had banned its use and importation, but large quantities were still being smuggled into the country. In 1839, the Qing Emperor, Tao Kwang, ordered his minister Lin Tse-hsu to take action. Lin petitioned Queen Victoria for help; but he was ignored. In reaction, the Emperor instructed the confiscation of 20,000 barrels of opium and detained some foreign traders. The British retaliated by attacking the port-city of Canton.
Thus began the First Opium War, launched by the biggest, richest and perhaps most aggressive drug cartel the world has ever known, the British Empire. The Chinese were defeated. They were forced to sign the Treaty of Nanjing in 1842. The British required that the opium trade be allowed to continue; that the Chinese pay a large settlement and open five new ports to foreign trade; and that China cede Hong Kong to Britain.
Peace didn't last. The Second Opium War began and ended in 1856 over western demands that opium markets be expanded. The Chinese were again defeated. In 1858, by the Treaty of Tientsin, opium importation to China was formally legalised. God-fearing British traders claimed that the hard-working Chinese were entitled to "a harmless luxury"; the opium trade in less respectable hands would be taken over by "desperadoes, pirates and marauders". Soon opium poured into China in unprecedented quantities. By the end of the nineteenth century, it has been estimated that over a quarter of the adult male Chinese population were addicted.
In North America, the initial history of Papaver somniferum was somewhat more peaceful. During the first few centuries of European settlement, opium poppies were widely cultivated. Early settlers dissolved the resin in whisky to relieve coughs, aches and pains.
The plant had further uses. Papaver somniferum produces lots of small black seeds. Poppy-seeds are an ingredient of typical bird-seed and a common garnish on rolls. Poppy-seeds can also be ground into flour; used in salad-dressings; added to sauces as flavouring or thickening-agents; and the oil can be expressed and used in cooking. Poppy-heads are infused to make a traditional sedative drink.
Many distinguished early Americans grew Papaver somniferum. Rightly or wrongly, they would today be treated as felons. Thomas Jefferson cultivated opium poppies at his garden in Monticello. The seeds from its plants, including the poppies, were sold at the gift-shop of Thomas Jefferson Center for Historic Plants until 1991 - when a drug-bust at the nearby University of Virginia panicked the Board of Directors into ripping up the plants and burning the seeds. The cultivation of Papaver somniferum is banned in the USA under the Opium Poppy Control Act of 1942. Amateur horticulturists, however, continue to value the beautiful red, yellow and white flowers as adornments to their gardens.
Until the nineteenth century, the only opioids used medicinally or recreationally took the form of crude opium. Opium is a complex chemical cocktail containing sugars, proteins, fats, water, meconic acid, plant wax, latex, gums, ammonia, sulphuric and lactic acids, and numerous alkaloids, most notably morphine (10%-15%), codeine (1%-3%), noscapine (4%-8%), papaverine (1%-3%), and thebaine (1%-2%). All of the latter, apart from thebaine, are used medicinally as analgesics. The opioid analgesics are of inestimable value because they reduce or abolish pain without causing a loss of consciousness. They also relieve coughs, spasms, fevers and diarrhea.
Even thebaine, though without analgesic effect, is of immense pharmaceutical worth. This is because it can be used to produce semi-synthetic opioid morphine analogues such as oxycodone (Percodan), dihydromorphenone (Dilaudid), hydrocodone (Vicodin) and etorphine (Immobilon). Classes of morphine analogue include the diphenylpropylamines (e.g. methadone), the 4-phenylpiperidines (e.g. meperidine), the morphinans (e.g. levorphanol) and 6,7-benzomorphans (e.g. metazocine). Although seemingly structurally diverse, all these compounds either possess a piperidine ring or contain the critical part of its ring structure. Etorphine, for instance, is a very potent analogue of morphine. On one occasion a team of researchers, working in the 1960s under Professor Bentley of Macfarlan Smith and Co, drank mid-morning tea that had been stirred with a contaminated rod. They were soon laid out. The scientists had unwittingly drunk a drug later developed as etorphine. Etorphine is over 1000 times more powerful than morphine; it is used in dart-guns as Immobilon to subdue elephants and rhinos. Fortunately the scientists recovered.
Morphine was first isolated from opium in 1805 by a German pharmacist, Wilhelm Sertürner. Sertürner described it as the Principium Somniferum. He named it morphium - after Morpheus, the Greek god of dreams. Today morphine is isolated from opium in substantially larger quantities - over 1000 tons per year - although most commercial opium is converted into codeine by methylation. On the illicit market, opium gum is filtered into morphine base and then synthesized into heroin.
Doctors had long hunted for effective ways to administer drugs without ingesting them. Taken orally, opium is liable to cause unpleasant gastric side-effects. The development of the hypodermic syringe in the mid-nineteenth century allowed the injection of pure morphine. Both in Europe and America, members of high society and middle-class professionals alike would jack up daily; poor folk couldn't afford to inject drugs. Morphinism became rampant in the USA after its extensive use by injured soldiers on both sides of the Civil War. In late nineteenth-century America, opiates were cheap, legal and abundant. In the judgement of one historian, America became "a dope fiend's paradise". Moreover it was believed that injecting morphine wasn't addictive. Quitting habitual opium use can cause malaise, flu-like symptoms, and depression; morphine seemed an excellent cure. In China, for instance, early twentieth century missionaries handed out anti-opium remedies in such profusion that the pills became known as "Jesus Opium"; their active ingredient was morphine.
Soldiers, missionaries and patent-medicine salesmen were not alone in eulogising its properties. A leading American medical textbook (1868) revealed that opiates..."...cause a feeling of delicious ease and comfort, with an elevation of the whole moral and intellectual nature...There is not the same uncontrollable excitement as from alcohol, but an exaltation of our better mental qualities, a warmer glow of benevolence, a disposition to do great things, but nobly and beneficently, a higher devotional spirit, and withal a stronger self-reliance, and consciousness of power. Nor is this consciousness altogether mistaken. For the intellectual and imaginative faculties are raised to the highest point compatible with individual capacity...Opium seems to make the individual, for a time, a better and greater man...."Early optimism about morphine's non-addictive nature proved sadly misplaced. Women in particular came to be seen as especially vulnerable to opiate dependence. The most likely candidate for addiction, according to American doctor R Batholow, was..."...a delicate female, having light blue eyes and flaxen hair, [who] possesses, according to my observations, the maximum susceptibility..."Racist stereotypes, rampant xenophobia and lurid images of white slave-traders abounded too. In the 1850s and 1860s, tens of thousands of Chinese had emigrated to the USA to help build the western railroads and work the California mines. Opium-smoking was an integral part of Chinese culture; and its effects offered a merciful relief from dirty and backbreaking work. But the medical tide was turning. Dr Hamilton Wright, newly appointed US opium commissioner, blamed "the Chinese vice" for corrupting the nation's youth...."One of the most unfortunate phases of the habit of smoking opium in this country [was] the large number of women who have become involved and were living as common-law wives or cohabiting with Chinese in the Chinatowns of our various cities..."Meanwhile Dr John Witherspoon, later President of the American Medical Association, exhorted the medical community to..."...save our people from the clutches of this hydra-headed monster which stalks abroad through the civilized world, wrecking lives and happy homes, filling our jails and lunatic asylums, and taking from these unfortunates, the precious promise of eternal life..."So the search began for a powerful non-addictive alternative to opium and morphine. In 1874, English pharmacist C.R. Alder Wright had boiled morphine and acetic acid to produce diacetylmorphine, C17H17NO (C2H3O2)2. Diacetylmorphine was synthesized and marketed commercially by the German pharmaceutical giant, Bayer. In 1898, Bayer launched the best-selling drug-brand of all time, Heroin.
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