# tincture of opium



## rosabud (Apr 19, 2004)

my daughter can't take lotronex and is pretty much an invalid from severe pain, diarrhea and fatigue. her doctor prescribed tincture of opium. Do opiates work the same way as lotronex, that is do they affect seratonin Or does opium just slow everything down? She hasn't been given much guidance on how to take it. (except be careful not to take too much) If anyone knows, is it better to divide it up into several times a day? Better at night or morning? And is tincture of opium a pain killer too? (seems like it would be) Also does anyone find that the opium itself is hard on the stomach? Also for those of you who've taken it long term, have there been side effects? Thanks for any info.


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## Kathleen M. (Nov 16, 1999)

Nope. Opium (and Imodium and Codiene, etc) all work differently than LotornexOpium and derivatives effect a different set of receptors. So they work on nerves as well. They effect the Central Nervous System which can relieve pain and the Enteric Nervous System which slows things down and can be constipating/reduce diarrhea.Imodium is one that stays in the GI tract to the point that you get very few CNS effects.I don't know of studes with opium in IBS, but with Imodium which should work similarly daily divided doses, usually one morning and one in evening seem to be the most effective way to take it for IBS-D.K.


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## Law Student (Apr 22, 2000)

Are you sure your daughter has been prescribed Opium Tincture and not Paregoric (Camphorated Tincture of Opium)? There's a huge difference -- opium tincture is 25 times as strong as paregoric, so the potential for overdosage with opium tincture is very real. I'm astounded that the doctor or pharmacist did not provide VERY clear instructions as to the dosage and frequency of opium tincture, as mistakes can be fatal. Paregoric has a very distinct odour of camphor -- like mothballs. Also, paregoric drops turn milky-white when introduced in water. The pharmacist should have provided you with a dropper or an oral syringe with opium tincture, as it is usually dosed in milliliters (cubic centimeters, or cc's) or drops (gtts.). Paregoric is dosed in teaspoons or tablespoons.Anyhow, the USUAL adult dosage of opium tincture is 0.6 mL (10 minims, or 10 drops from an eye-dropper) four times a day. The doses are usually taken 10-20 minutes before meals. I would not exceed 1.0mL four times a day without express directions from a doctor or pharmacist.As a general rule, the least amount of opium should be taken to control the diarrhea. You may want to start out with 3-4 drops in water before meals to see if that works, and then slowly increase until diarrhea is brought under control.I have taken opium tincture for over two years without significant adverse effects. During the first couple of days of therapy, I was somewhat drowsy. However, after that, I have experienced no untoward effects. Yes, opium is a painkiller. Opium Tincture contains most of the opioid alkaloids, i.e. morphine, codeine, thebaine, etc. Each milliliter (1/5th teaspoon) of opium tincture has the equivalent of 10mg of morphine.However, the doses of opium tincture taken to control diarrhea are much lower than those used to control pain. Of course, opium tincture could be used to control pain, but no doctor would advise it -- there are far safer alternatives available in tablet or injectable form.If I were you, I would contact your pharmacist and ask:1. Was I prescribed Opium Tincture or Paregoric? 2. [If you were not provided with a dropper or oral syringe, ask for one!]3. Inform the pharmacist of all the other drugs, if any, your daughter is taking, and ask what the usual dosage of opium tincture is under the circumstances. [The USUAL dose may be lowered in patients taking tranquilizers or other CNS depressants; conversely, the USUAL dose may be increased in patients already tolerant to opiates (e.g., if your daughter has been taking narcotic painkillers for a substantial period of time).*I don't want to sound alarmist, but you must be VERY careful in dosing opium tincture. The following article illustrates why.*


> quote:Botched Prescription Fatal Donna Marie Altieri died at 51 and the doctor concluded from heart attack. Son Daren knew that mother had never had heart trouble and an autopsy was ordered. That was in June last year and now the results are in. Mrs. Altieri died of morphine poisoning. Altieri had a history of depression and asthma and had been plagued with severe diarrhea. Her physician prescribed Camphorated Tincture of Opium. The prescription was filled at CVS pharmacy with the much more powerful Opium Tincture. The patient died. CVS blamed the doctor for not using the common name Paregoric. The tragic death of Mrs. Altierti points up the importance of ï¿½read the labelï¿½. Be ever viigilant.


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## rosabud (Apr 19, 2004)

Thanks ao much for the help.It's tincture of opium. thanks so much for the warning. She will be careful about the dosage! One worried and perhaps foolish question. There seem to be days when this remedy doesn't help. But when I read this board, people usualy describe opium as the best pain and d reliever there is. Shouldn't it work for just about everyone with pain and d?


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## Kathleen M. (Nov 16, 1999)

No medication with IBS ever seems to work 100% every day in all situations.IBS has a tendancy to vary in intensity. So most people, even those with very good control, usually have days when the medication/diet/lifestyle etc that normally controls the IBS will not control it.It might be worth keeping a log and see if you can figure out what triggers the IBS to be worse. Is there a food associated with this? Is it particularly stressful events? Once you figure out the trigger you can either do avoidance (do not eat the food) or develop better coping strategies if it is something like stress.K.


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## Albion (Feb 14, 2001)

Opium is the best drug for diarrhea, but it takes time to titrate the dosage. It may take several weeks to find the "right" dose that works for each individual. Also, as Kath M. said, no medication works all of the time. As I mentioned previously, the doses of opium tincture used to control diarrhea are well below the normal doses that would be used to control pain; hence, the opium should stop the diarrhea, but it may not stop the pain from cramps, etc. You may need to find another drug, such as Bentyl (an anti-spasmodic), Donnatal, Librax, whatever, that will relieve other symptoms that are causing pain. Of course, opium _could_ be used in higher doses to control pain, but I would strongly advise against it, because taking high doses of morphine regularly can lead to dependence, addiction, tolerance and a whole host of other problems.I also agree with Kath that your daughter should investigate alternative therapies, because opium tincture by itself controls only diarrhea. Also, other modalities might allow your daughter to get relief from diarrhea without relying too heavily on opium.I'm in a somewhat unique situation-- I have IBS with diarrhea, but I rarely, if ever, have pain -- maybe 1x or 2x a month. So, the opium has been a Godsend for me, because it basically has controlled my IBS. However, most people have other symptoms regularly along with diarrhea or constipation-- such as cramping, bloating, gas, etc. that cause pain.


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## echris (Jul 19, 2000)

I have taken DTO (deodorized tincture of opium) for the better part of the last 20 years without any negative side effects. But, it is not a miracle drug. I also have Celiac disease. If I eat foods with gluten in them, I will get the big D, regardless of whether or not I take my DTO. For many years, I took both DTO and Librax. In really hot weather, seems like I do not sweat like normal people do (if on the two meds), so I have to be careful about spending much time outside when it is in the upper 90's or more).I usually take a couple of drops right before a meal. The number of drops (as low as one and as high as six) depends upon my symptoms that day.


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## Kathleen M. (Nov 16, 1999)

The antispasmodic in the Librax will reduce sweating as a side effect. People taking anticholinergic meds have to be careful about overheating.K.


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## rosabud (Apr 19, 2004)

Thanks to all for the information.It's a big help. I was confused when the opium didn't always help. I think I did believe it was a miracle drug. Also one doctor said that if opium didn't work well perhaps there was something besides IBS going on. He thought it might be bacteria, but I think we'll look into celiac as well.


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