Opiates (e.g., morphine, codeine, and thebaine) exert their main effects on the brain and spinal cord. Their principal action is to relieve or suppress pain. The drugs also alleviate anxiety; induce relaxation, drowsiness, and sedation; and may impart a state of euphoria or other enhanced mood. Opiates also have important physiological effects: they slow respiration and heartbeat, suppress the cough reflex, and relax the smooth muscles of the gastrointestinal tract. Opiates are addictive drugs; they produce a physical dependence and withdrawal symptoms that can only be assuaged by continued use of the drug. With chronic use, the body develops a tolerance to opiates, so that progressively larger doses are needed to achieve the same effect. The higher opiates—heroin and morphine—are more addictive than opium or codeine. Opiates are classified as narcotics because they relieve pain, induce stupor and sleep, and produce addiction. The habitual use of opium produces physical and mental deterioration and shortens life. An acute overdose of opium causes respiratory depression which can be fatal. Other methods of preparation (besides smoking), include processing into regular opium tincture ( tinctura opii), laudanum, paregoric ( tinctura opii camphorata), herbal wine (e.g., vinum opii), opium powder ( pulvis opii), opium sirup ( sirupus opii) and opium extract ( extractum opii). [123] Vinum opii is made by combining sugar, white wine, cinnamon, and cloves. Opium syrup is made by combining 97.5 part sugar syrup with 2.5 parts opium extract. Opium extract ( extractum opii) finally can be made by macerating raw opium with water. To make opium extract, 20 parts water are combined with 1 part raw opium which has been boiled for 5 minutes (the latter to ease mixing). [123]

Hamarneh Sami (1972). "Pharmacy in medieval Islam and the history of drug addiction". Medical History. 16 (3): 226–237. doi: 10.1017/s0025727300017725. PMC 1034978. PMID 4595520. Speer, William (1870). The oldest and the newest empire: China and the United States. Hartford, Conn., S. S. Scranton and company; Philadelphia, Parmelee & co.; [etc., etc.] a b Aurin, Marcus (January 1, 2000). "Chasing the Dragon: The Cultural Metamorphosis of Opium in the United States, 1825–1935". Medical Anthropology Quarterly. 14 (3): 414–441. doi: 10.1525/maq.2000.14.3.414. JSTOR 649506. PMID 11036586. The standard medical use of opium persisted well into the 19th century. US president William Henry Harrison was treated with opium in 1841, and in the American Civil War, the Union Army used 175,000lb (80,000kg) of opium tincture and powder and about 500,000 opium pills. [1] During this time of popularity, users called opium "God's Own Medicine". [36] Pablo Bartholomew (1996). "Opium for the masses: photo essay on cultivation of opium in India". Archived from the original on July 1, 2007 . Retrieved June 15, 2007.

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Finn AK, Whistler JL (December 2001). "Endocytosis of the mu opioid receptor reduces tolerance and a cellular hallmark of opiate withdrawal". Neuron. 32 (5): 829–39. doi: 10.1016/S0896-6273(01)00517-7. PMID 11738029. S2CID 16396686. Ahmad, Diana L. The Opium Debate and Chinese Exclusion Laws in the Nineteenth-century American West (University of Nevada Press, 2007). Drugs and Racism in the Old West. Forbes, Andrew; Henley, David (2011). Traders of the Golden Triangle. Chiang Mai: Cognoscenti Books. ASIN B006GMID5K

Protocol for Limiting and Regulating the Cultivation of the Poppy Plant, the Production of, International and Wholesale Trade in, and Use of Opium Santella, Thomas M.; Triggle, D. J. (2009). Opium. Facts On File, Incorporated. p.8. ISBN 9781438102139.MacPherson, Duncan (1843). Two years in China. Narrative of the Chinese expedition, from its formation in April, 1840, to the treaty of peace in August, 1842. London, Saunders. Smoking of opium declined in the 20th century, partly because it had been supplanted by more-potent derivatives and partly because of determined efforts in China and other developing countries to eradicate it. In the late 1990s, drug-control programs headed by the United Nations and by individual governments contributed to a reduction in opium poppy cultivation in the Golden Triangle. However, the region subsequently became a major producer of other illicit substances, including methamphetamines. Hardening of Canadian attitudes toward Chinese opium users and fear of a spread of the drug into the white population led to the effective criminalization of opium for nonmedical use in Canada between 1908 and the mid-1920s. [92]

Lomax, Elizabeth (1973). "The Uses and Abuses Of Opiates In Nineteenth-Century England". Bulletin of the History of Medicine. 47 (2): 167–176. ISSN 0007-5140. JSTOR 44447528. PMID 4584236 . Retrieved May 31, 2022. Opium timeline". The Golden Triangle. Archived from the original on April 20, 2009 . Retrieved September 13, 2009. Ouchterlony, John (1844). The Chinese war: an account of all the operations of the British forces from the commencement to the Treaty of Nanking. London: Saunders and Otley.

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Zhang, Sarah (January 9, 2019). "Why a Medieval Woman Had Lapis Lazuli Hidden in Her Teeth". The Atlantic . Retrieved May 10, 2020. a b c M J Brownstein (June 15, 1993). "A brief history of opiates, opioid peptides, and opioid receptors". Proceedings of the National Academy of Sciences of the United States of America. 90 (12): 5391–5393. Bibcode: 1993PNAS...90.5391B. doi: 10.1073/pnas.90.12.5391. PMC 46725. PMID 8390660. Derks, Hans: History of the Opium Problem: The Assault on the East, ca. 1600–1950. Sinica Leidensia, 105. Leiden: Brill, 2012. ISSN 0169-9563. ISBN 978-90-04-22158-1 Both analgesia and drug addiction are functions of the mu opioid receptor, the class of opioid receptor first identified as responsive to morphine. Tolerance is associated with the superactivation of the receptor, which may be affected by the degree of endocytosis caused by the opioid administered, and leads to a superactivation of cyclic AMP signaling. [155] Long-term use of morphine in palliative care and the management of chronic pain always entails a risk that the patient develops tolerance or physical dependence. There are many kinds of rehabilitation treatment, including pharmacologically based treatments with naltrexone, methadone, or ibogaine. [156]