By Anthony McDaniel, M.D.
Opium (poppy tears, lachryma papaveris) is the dried latex obtained from the opium poppy (Papaver somniferum). Opium contains up to 12% morphine, an alkaloid, which is frequently processed chemically to produce heroin for the illegal drug trade. The latex also includes codeine and non-narcotic alkaloids such as papaverine, thebaine and noscapine. The traditional method of obtaining the latex is to scratch ("score") the immature seed pods (fruits) by hand; the latex leaks out and dries to a sticky yellowish residue that is later scraped off the fruit. The modern method is to harvest and process mature plants by machine. "Meconium" historically referred to related, weaker preparations made from other parts of the poppy or different species of poppies.
The production of opium itself has basically not changed since ancient times. However, through selective breeding of the Papaver somniferum plant, the content of the phenanthrene alkaloids morphine, codeine, and to a lesser extent thebaine, has been greatly increased. In modern times, much of the thebaine, which often serves as the raw material for the synthesis for hydrocodone, hydromorphone, and other semi-synthetic opiates, originates from extracting Papaver orientale or Papaver bracteatum. Opium for illegal use is often converted into heroin, which is less bulky, making it easier to smuggle, and which multiplies its potency to approximately twice that of morphine. Heroin can also be taken by intravenous injection, intranasally, or smoked (vaporized) and inhaled.
In the industrialized world, the United States is the world's biggest consumer of prescription opioids, with Italy one of the lowest because of tighter regulations on prescribing narcotics for pain relief. Most opium imported into the United States is broken down into its alkaloid constituents, and whether legal or illegal, most current drug use occurs with processed derivatives such as heroin rather than with pure and untouched opium. Intravenous injection of opiates is most used: by comparison with injection, "dragon chasing" (heating of heroin with barbital on a piece of foil), and madak and "ack ack" (smoking of cigarettes containing tobacco mixed with heroin powder) are only 40% and 20% efficient, respectively. One study of British heroin addicts found a 12-fold excess mortality ratio (1.8% of the group dying per year). Most heroin deaths result not from overdose per se, but combination with other depressant drugs such as alcohol or benzodiazepines.
The smoking of opium does not involve the burning of the material as might be imagined. Rather, the prepared opium is indirectly heated to temperatures at which the active alkaloids, chiefly morphine, are vaporized. In the past, smokers would utilize a specially designed opium pipe which had a removable knob-like pipe-bowl of fired earthenware attached by a metal fitting to a long, cylindrical stem. A small "pill" of opium about the size of a pea would be placed on the pipe-bowl, which was then heated by holding it over an opium lamp, a special oil lamp with a distinct funnel-like chimney to channel heat into a small area. The smoker would lie on his or her side in order to guide the pipe-bowl and the tiny pill of opium over the stream of heat rising from the chimney of the oil lamp and inhale the vaporized opium fumes as needed. Several pills of opium were smoked at a single session depending on the smoker's tolerance to the drug. The effects could last up to twelve hours. Opium in its rawest form contains half the potency of synthetically compared drugs; such as oxycodone, morphine patches, or trentanol.
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