Consumptiom of Opium

In the industrialized world, the USA is the world's biggest consumer of prescription opioids, with Italy one of the lowest. 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 "ack ack" (smoking of cigarettes containing 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.

An Akha man smokes a pipe. Although this pipe was described as an opium pipe by the photographer, a true opium pipe requires an external heat source. Still, opium can be smoked by mixing it with tobacco, as in madak and ack ack.The smoking of opium does not involve the pyrolysis 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.

In Eastern culture, opium is more commonly used in the form of paregoric to treat diarrhea. This is a weaker solution than laudanum, an alcoholic tincture which was prevalently used as a pain medication and sleeping aid. Tincture of opium has been prescribed for, among other things, severe diarrhea. Taken thirty minutes prior to meals, it significantly slows intestinal motility, giving the intestines greater time to absorb fluid in the stool