Yes, opium is still used today, both as a regulated pharmaceutical product and as a traditional substance in parts of the world. In the United States, opium tincture remains available by prescription as a controlled substance, primarily for treating severe diarrhea. Globally, 19 countries are authorized to legally cultivate opium poppies for pharmaceutical purposes, and traditional opium use persists in several regions of Asia and Latin America.
Opium Tincture as a Modern Prescription Drug
The most direct form of pharmaceutical opium still in use is opium tincture, sometimes called deodorized tincture of opium. It’s a liquid containing 10 mg of morphine per milliliter, derived from powdered opium dissolved in alcohol. Doctors prescribe it for diarrhea that hasn’t responded to other treatments, particularly in patients with conditions like short bowel syndrome or inflammatory bowel disease.
Opium works on the gut by activating opioid receptors along the intestinal wall, which slows down the muscular contractions that move food through the digestive tract. This gives the intestines more time to absorb water, firming up stools. It’s the same mechanism that makes constipation a common side effect of any opioid painkiller, but in this case, the effect is the entire point.
The drug carries a Schedule II classification in the U.S., the same category as oxycodone and fentanyl, meaning it has recognized potential for abuse and dependence. Interestingly, the FDA has not formally approved opium tincture through its modern safety and effectiveness review process, yet it remains legally available by prescription as a legacy product with a long history of clinical use.
Opium Tincture vs. Paregoric
There’s a related product called paregoric (camphorated tincture of opium) that was once widely used for the same purpose, especially in infants with diarrhea. The key difference is potency: paregoric contains only 0.4 mg of morphine per milliliter, while opium tincture contains 10 mg per milliliter. That’s a 25-fold difference in the same volume of liquid. Confusion between these two products has caused serious medication errors over the years, which is one reason pharmacists flag it as a recurring safety concern.
Paregoric also contains 45% alcohol, glycerin, and benzoic acid. Neither product is recommended for children today. The Mayo Clinic notes that appropriate studies on opium tincture in pediatric patients have not been performed, and its use in children is not recommended due to their heightened sensitivity to opioid effects.
Where Opium Is Still Grown Legally
Under international drug control treaties overseen by the United Nations, 19 countries are currently authorized to grow opium poppies for medical and scientific purposes. The largest legal producers include India, Turkey, Australia, Spain, and France. These countries cultivate poppies to extract morphine, codeine, and other alkaloids that serve as the raw material for a wide range of pharmaceutical painkillers. Nearly every opioid medication used in hospitals and pharmacies worldwide traces back to compounds originally found in the opium poppy.
India is notable because it’s one of the few countries that still produces opium gum, the raw sap collected from scored poppy pods, rather than relying solely on the “poppy straw” method where entire dried plants are processed in factories. This traditional harvesting method requires intensive manual labor and is tightly regulated by the Indian government, which licenses individual farmers and monitors their yields.
Traditional and Cultural Use Around the World
Outside of formal medicine, raw opium continues to be used in several parts of the world for cultural, social, and folk remedy purposes. In Southeast Asia, opium use for health and cultural reasons remains significant in Thailand, Vietnam, and Laos, regions with centuries-long histories of poppy cultivation. In Latin America, opium is part of the local economies of indigenous communities in Colombia, Guatemala, and Mexico, though much of the cultivation in these areas feeds the illicit drug trade rather than traditional use.
One particularly concerning practice is the use of opium as a folk remedy for fussy or sick children. Cases of pediatric opium poisoning have been documented in traditional poppy-growing regions and among immigrant communities in England and the United States, where families may follow practices passed down through generations without understanding the risks of dosing a child with a potent opioid.
Risks of Pharmaceutical Opium
Because opium tincture contains a significant dose of morphine, the risks mirror those of any opioid. Long-term use can lead to physical dependence, and stopping abruptly can trigger withdrawal symptoms. Doctors typically taper the dose gradually if a patient needs to discontinue it. The drug should never be used for diarrhea caused by poisoning, because slowing gut motility in that situation traps toxins in the body longer.
Opium tincture also interacts dangerously with certain other medications, particularly a class of antidepressants called MAO inhibitors, and with drugs designed to block opioid receptors. Elderly patients are more sensitive to its effects and face a higher risk of excessive sedation or respiratory depression. For all of these reasons, opium tincture is typically reserved for cases where safer anti-diarrheal medications like loperamide have failed.
Why Opium Hasn’t Disappeared
Opium occupies an unusual space in modern medicine. It’s ancient, minimally processed compared to synthetic opioids, and lacks the formal FDA approval stamp that newer drugs carry. Yet it persists because its complex mix of alkaloids, over 20 active compounds working together, sometimes produces effects that isolated single-molecule drugs don’t replicate as well. For patients with intractable diarrhea, this centuries-old preparation can be the thing that finally works when modern alternatives fall short.
The global pharmaceutical supply chain also depends on opium poppies as a raw material. Even patients who have never heard of opium tincture may be taking medications, from codeine cough syrup to hospital-grade morphine, that began as alkaloids extracted from the same plant. In that broader sense, opium’s role in modern medicine is far larger than the niche prescription product that still bears its name.