Laudanum was an opium tincture that was a widespread “cure-all” in the Victorian era. By the mid-20th century, laudanum was replaced by more sophisticated and effective opioid medications, but it’s still used in rare cases for certain conditions.
Learn more about this historical opiate tincture, its origin and uses, and the risks of laudanum and other opiates.
Key Points
- Laudanum was a historical opiate tincture made of opium powder dissolved in alcohol.
- Laudanum became popular in the Victorian era as a “cure-all” treatment for everything from headaches to female problems.
- With the advent of more sophisticated and effective opiate and opioid medications, laudanum fell out of favor in modern medicine.
- Like other opiates and opioids, laudanum is highly addictive and carries similar risks to these drugs.
What is Laudanum? History and Traditional Uses
Laudanum was first created in the 16th century by alchemist Paracelsus. He created a medical tincture of gold, pearls, and other items, but opium was the primary ingredient.[1] The name was coined from the Latin laudare, which means “to praise.” He discovered that the active ingredients in opium were more soluble in alcohol than water, which was a welcome alternative to galenicals, concoctions made from botanicals, and other ingredients based on the teachings of the physician Galen.[2]
A standardized form was developed in the 17th century, which differed from Parcelsus’s solution. It consisted of a 10% solution of opium powder—roughly 1% of morphine—in alcohol. It was prepared by dissolving extracts from the opium poppy in ethanol.
Laudanum is reddish-brown and extremely bitter. It was used as a pain medication and cough suppressant, much like prescription opioids today, and its use skyrocketed during the 1800s. It’s a staple of the Victorian era, with mentions in everything from Mary Shelley’s Frankenstein to Harriet Beecher Stowe’s Uncle Tom’s Cabin. At the time, laudanum was widely available.
Laudanum would gain popularity in the US with the American Revolution. Alexander Hamilton was given laudanum after his duel with Aaron Burr, and millions of ounces of opium tinctures were given to the Union Army alone during the American Civil War.[3] Many soldiers returned home addicted to opium.
Modern Uses of Laudanum
After laudanum’s widespread use in the Victorian era, it became a regular medication in the 20th century. With cholera, dysentery, and other illnesses rampant, laudanum’s anti-diarrheal effects made it a popular drug.
However, the early 20th century brought a better understanding of the addictive properties of opium, leading to increased regulation of narcotics. Many home remedies and patent medications were under review because of their unknown compositions.
The Food and Drug Act of 1906 in the US required that certain drugs be accurately labeled with contents and dosage, including cocaine, heroin, alcohol, morphine, and cannabis.[4] These drugs remained legally available without a prescription as long as the labels were transparent. Britain and Canada instituted similar requirements in the following few years.
In 1914, the Harrison Narcotics Tax Act restricted the manufacturing and distribution of opiates, including laudanum.[5] Pharmacists and physicians had access to laudanum tincture in several different formulas.
Slowly, opiate use became limited to pain treatment, and these drugs, along with laudanum, were no longer a “cure-all.” Pharmaceutical companies were successful in synthesizing opioids, such as oxycodone and oxymorphone, which could be used along with opiates like morphine and codeine, rendering laudanum obsolete.
Laudanum was regulated as a Schedule II substance with the Uniformed Controlled Substances Act in the 1970s, leading to more restrictions.[6] Now, the drug is prescribed almost exclusively as an orphan drug – or drug for rare medical conditions – to treat severe diarrhea that hasn’t responded to other treatments.[7] However, it may be prescribed off-label for neonatal withdrawal syndrome and pain.
Effects and Risks of Laudanum
Laudanum was used in similar ways to opium. It was given without a prescription for pain, persistent cough, headaches, insomnia, and “female disorders,” or pain related to menstruation and menopause.
Recreationally, laudanum was touted as a tool to enhance creativity, likely because of its euphoric effects. Many famous artists, authors, and poets, including Samuel Taylor Coleridge and Elizabeth Barrett Browning, engaged in laudanum use during the Victorian era.
With opium as the main ingredient, laudanum was no less addictive back then. Its opiate components lead to similar effects, including euphoria from the drug binding to the opioid receptors and releasing dopamine. Constipation is common with laudanum and other opiates. It also has a high percentage of alcohol, which compounds the depressant effects of opiates and causes respiratory depression. Other side effects of laudanum may include irregular breathing, extreme itching, pinpoint pupils, dysphoria (sadness), and shortness of breath.[8]
Laudanum use has a high risk of dependence and addiction. It can contain several opiates and opioids, including opium, morphine, and codeine. The addiction potential for both opiates and alcohol is extremely high.
Laudanum Overdose
Fatal overdose is possible with laudanum. Because of both opium and alcohol, laudanum overdose can cause similar symptoms as mixing opioids with alcohol, including severe respiratory depression, collapse, and death.
If you suspect someone is overdosing on laudanum, call 911 immediately. An overdose can be reversed with rapid medical help. Wait with them until help arrives, and administer naloxone if available. Naloxone can reverse the respiratory depression caused by opiates.
Is Laudanum Addictive?
Laudanum contains two highly addictive drugs: opium and alcohol. Though laudanum has been used historically and was available without a prescription, the medical community and public were not aware of the disease of addiction. Its use as a “cure-all” led to many people using it to treat common ailments, which could cause physical dependence and addiction quickly.
Though there are more sophisticated and readily available opiates and opioids, people may abuse laudanum for its pain-relieving or euphoric effects. It can be treated similarly to other opioid use disorders and alcohol use disorders, however.
The first step in addiction treatment is medical detox, especially with drugs that have severe and potentially dangerous withdrawal complications like alcohol and opioids. This setting provides medical supervision to alleviate withdrawal symptoms, reduce discomfort, and prevent complications.
Detox is not enough on its own, however. Once withdrawal is complete, it’s best to enter a drug addiction treatment program specific to opiate and opioid use disorder. Though treatment plans are individualized, treatment may include a combination of medication-assisted therapy, behavioral therapies, and traditional treatments like individual and group counseling.
Get Help for Addiction
Though laudanum is no longer as common as it was during the Victorian era, it’s still prescribed as a last-line treatment for severe diarrhea and other conditions. The potency of both opium and alcohol makes laudanum highly addictive. If you or a loved one struggles with a laudanum addiction, it’s important to seek help as soon as possible.