Apothecary vessel for storage of opium as a pharmaceutical, Germany, 18th or 19th century
Mediterranean region contains the earliest archeological evidence of human use; the oldest known seeds date back to more than 5000 BCE in the
 with purposes such as food,
ritual. Evidence from ancient Greece indicates that opium was consumed in several ways, including inhalation of vapors, suppositories,
medical poultices, and as a combination with hemlock for suicide.
Arab Empires all made widespread use of opium, which was the most potent form of
pain relief then available, allowing ancient surgeons to perform prolonged surgical procedures. Opium is mentioned in the most important
medical texts of the ancient world, including the
Ebers Papyrus and the writings of
Avicenna. Widespread medical use of unprocessed opium continued through the
American Civil War before giving way to
morphine and its successors, which could be injected at a precisely controlled dosage.
Ancient use (pre-500 CE)
Poppy crop from the
in India (probably Papaver somniferum
Opium has been actively collected since prehistoric times, though western scholars typically estimate this to be around 1500 BCE. Indian scholars maintain that the verses and the history contained in them have been orally transmitted thousands of years before. A common name for males in Afghanistan is "Redey", which in
Pashto means "poppy".
 This term may be derived from the Sanskrit words rddhi and hrdya, which mean "magical", "a type of medicinal plant", and "heart-pleasing", respectively. The upper Asian belt of Afghanistan, Pakistan, northern India, and Burma still account for the world's largest supply of opium.
At least 17 finds of Papaver somniferum from
Neolithic settlements have been reported throughout Switzerland, Germany, and Spain, including the placement of large numbers of poppy seed capsules at a burial site (the Cueva de los Murciélagos, or "Bat Cave", in Spain), which have been carbon-14 dated to 4200 BCE. Numerous finds of P. somniferum or P. setigerum from
Bronze Age and
Iron Age settlements have also been reported.
 The first known cultivation of opium poppies was in
Mesopotamia, approximately 3400 BCE, by
Sumerians, who called the plant hul gil, the "joy plant".
 Tablets found at
Nippur, a Sumerian spiritual center south of
Baghdad, described the collection of poppy juice in the morning and its use in production of opium.
 Cultivation continued in the Middle East by the
Assyrians, who also collected poppy juice in the morning after scoring the pods with an iron scoop; they called the juice aratpa-pal, possibly the root of Papaver. Opium production continued under the
Opium was used with
poison hemlock to put people quickly and painlessly to death, but it was also used in medicine. The
Ebers Papyrus, c. 1500 BCE, describes a way to "stop a crying child" using grains of the poppy plant strained to a pulp.
Spongia somnifera, sponges soaked in opium, were used during surgery.
 The Egyptians cultivated opium thebaicum in famous poppy fields around 1300 BCE. Opium was traded from Egypt by the
Minoans to destinations around the
Mediterranean Sea, including Greece,
Carthage, and Europe. By 1100 BCE, opium was cultivated on
Cyprus, where surgical-quality knives were used to score the poppy pods, and opium was cultivated, traded, and smoked.
 Opium was also mentioned after the
Persian conquest of Assyria and Babylonian lands in the 6th century BCE.
From the earliest finds, opium has appeared to have ritual significance, and anthropologists have speculated ancient priests may have used the drug as a proof of healing power.
 In Egypt, the use of opium was generally restricted to priests, magicians, and warriors, its invention is credited to Thoth, and it was said to have been given by Isis to Ra as treatment for a headache.
 A figure of the Minoan "goddess of the narcotics", wearing a crown of three opium poppies, c. 1300 BCE, was recovered from the Sanctuary of Gazi, Crete, together with a simple smoking apparatus.
 The Greek gods
Nyx (Night), and
Thanatos (Death) were depicted wreathed in poppies or holding them. Poppies also frequently adorned statues of
Isis, symbolizing nocturnal oblivion.
Islamic societies (500–1500 CE)
As the power of the
Roman Empire declined, the lands to the south, and east of the Mediterranean Sea became incorporated into the
Islamic Empires. Some Muslims believe
hadiths, such as in
Sahih Bukhari, prohibits every intoxicating substance, though the use of intoxicants in medicine has been widely permitted by scholars.
De Materia Medica, the precursor of
pharmacopoeias, remained in use (with some improvements in Arabic versions
) from the 1st to 16th centuries, and described opium and the wide range of its uses prevalent in the ancient world.
Between 400 and 1200 CE, Arab traders introduced opium to China.
Muhammad ibn Zakariya al-Razi ("Rhazes", 845–930 CE) maintained a laboratory and school in
Baghdad, and was a student and critic of
Galen; he made use of opium in anesthesia and recommended its use for the treatment of melancholy in Fi ma-la-yahdara al-tabib, "In the Absence of a Physician", a home medical manual directed toward ordinary citizens for self-treatment if a doctor was not available.
Abu al-Qasim al-Zahrawi ("Abulcasis", 936–1013 CE) relied on opium and
mandrake as surgical anaesthetics and wrote a treatise,
al-Tasrif, that influenced medical thought well into the 16th century.
The Persian physician
Abū ‘Alī al-Husayn ibn Sina ("Avicenna") described opium as the most powerful of the stupefacients, in comparison to mandrake and other highly effective herbs, in
The Canon of Medicine. The text lists medicinal effects of opium, such as analgesia, hypnosis, antitussive effects, gastrointestinal effects, cognitive effects, respiratory depression, neuromuscular disturbances, and sexual dysfunction. It also refers to opium's potential as a poison. Avicenna describes several methods of delivery and recommendations for doses of the drug.
 This classic text was translated into Latin in 1175 and later into many other languages and remained authoritative until the 19th century.
Şerafeddin Sabuncuoğlu used opium in the 14th-century Ottoman Empire to treat
sciatica, and other painful ailments.
Reintroduction to Western medicine
Latin translation of
's Canon of Medicine
Pseudo-Apuleius's 5th-century work from the 10th and 11th centuries refer to the use of wild poppy
Papaver agreste or
Papaver rhoeas (identified as P. silvaticum) instead of P. somniferum for inducing sleep and relieving pain.
The use of
laudanum was introduced to Western medicine in 1527, when Philippus Aureolus Theophrastus Bombastus von Hohenheim, better known by the name Paracelsus, returned from his wanderings in Arabia with a famous sword, within the pommel of which he kept "Stones of Immortality" compounded from opium thebaicum, citrus juice, and "quintessence of gold".
 The name "Paracelsus" was a pseudonym signifying him the equal or better of
Aulus Cornelius Celsus, whose text, which described the use of opium or a similar preparation, had recently been translated and reintroduced to medieval Europe.
The Canon of Medicine, the standard medical textbook Paracelsus burned in a public bonfire three weeks after being appointed professor at the
University of Basel, also described the use of opium, though many Latin translations were of poor quality.
Laudanum was originally the 16th-century term for a medicine associated with a particular physician that was widely well-regarded, but became standardized as "
tincture of opium", a solution of opium in
ethanol, which Paracelsus has been credited with developing. During his lifetime, Paracelsus was viewed as an adventurer who challenged the theories and mercenary motives of contemporary medicine with dangerous chemical therapies, but his therapies marked a turning point in Western medicine. In the 1660s, laudanum was recommended for pain, sleeplessness, and diarrhea by
 the renowned "father of English medicine" or "English Hippocrates", to whom is attributed the quote, "Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium."
 Use of opium as a cure-all was reflected in the formulation of
mithridatium described in the 1728
Chambers Cyclopedia, which included true opium in the mixture. Subsequently, laudanum became the basis of many popular
patent medicines of the 19th century.
Compared to other chemicals available to 18th century regular physicians, opium was a benign alternative to the arsenics, mercuries, or emetics, and it was remarkably successful in alleviating a wide range of ailments. Due to the constipation often produced by the consumption of opium, it was one of the most effective treatments for cholera, dysentery, and diarrhea. As a cough suppressant, opium was used to treat bronchitis, tuberculosis, and other respiratory illnesses. Opium was additionally prescribed for rheumatism and insomnia.
During the 18th century, opium was found to be a good remedy for nervous disorders. Due to its sedative and tranquilizing properties, it was used to quiet the minds of those with psychosis, help with people who were considered insane, and also to help treat patients with insomnia.
 However, despite its medicinal values in these cases, it was noted that in cases of psychosis, it could cause anger or depression, and due to the drug's euphoric effects, it could cause depressed patients to become more depressed after the effects wore off because they would get used to being high.
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 79,000 kilograms (2.8×106 oz) of opium tincture and powder and about 500,000 opium pills.
 During this time of popularity, users called opium "God's Own Medicine".
One reason for the increase in opiate consumption in the United States during the 19th century was the prescribing and dispensing of legal opiates by physicians and pharmacists to women with "female complaints" (mostly to relieve menstrual pain and
 Because opiates were viewed as more humane than punishment or restraint, they were often used to treat the mentally ill. Between 150,000 and 200,000 opiate addicts lived in the United States in the late 19th century and between two-thirds and three-quarters of these addicts were women.
Opium addiction in the later 19th century received a hereditary definition. Dr. George Beard in 1869 proposed his theory of
neurasthenia, a hereditary nervous system deficiency that could predispose an individual to addiction. Neurasthenia was increasingly tied in medical rhetoric to the "nervous exhaustion" suffered by many a white-collar worker in the increasingly hectic and industrialized U.S. life—the most likely potential clients of physicians.
Recreational use in Europe, the Middle East and the US (15th to 19th centuries)
An artist's view of an Ottoman opium seller
Opium is said to have been used for recreational purposes from the 14th century onwards in Muslim societies. Ottoman and European testimonies confirm that from the 16th to the 19th centuries Anatolian opium was eaten in Constantinople as much as it was exported to Europe.
 From drinking it, dervishes claimed the drugs bestowed them with visionary glimpses of future happiness.
 Indeed, Turkey supplied the West with opium long before China and India.
In 1573, for instance, a Venetian visitor to the Ottoman Empire observed many of the Turkish natives of Constantinople regularly drank a "certain black water made with opium" that makes them feel good, but to which they become so addicted, if they try to go without, they will "quickly die".
Thomas de Quincey's
Confessions of an English Opium-Eater (1822), one of the first and most famous
literary accounts of opium addiction written from the point of view of an addict, details the pleasures and dangers of the drug. In the book, it is not Ottoman, nor Chinese, addicts about whom he writes, but English opium users: "I question whether any Turk, of all that ever entered the paradise of opium-eaters, can have had half the pleasure I had."
 De Quincey writes about the great English Romantic poet,
Samuel Taylor Coleridge (1772–1834), whose "
Kubla Khan" is also widely considered to be a poem of the opium experience. Coleridge began using opium in 1791 after developing
rheumatic fever, and became a full addict after a severe attack of the disease in 1801, requiring 80–100 drops of
Extensive textual and pictorial sources also show that poppy cultivation and opium consumption were widespread in
In China, recreational use began in the 15th century,tobacco pipe, opium was only taken orally; when smoked, the drug has a far more potent effect, and its addictive effect is greatly magnified. Opium prohibition in China began in 1729, yet was followed by nearly two centuries of increasing opium use. China had a positive balance sheet in trading with the British, which led to a decrease of the British silver stocks. Therefore, the British tried to encourage Chinese opium use to enhance their balance, and they delivered it from Indian provinces under British control. In India, its cultivation, as well as the manufacture and traffic to China, were subject to the
British East India Company (BEIC), as a strict monopoly of the British government.
 Indian farmers were forced by the British East India company to grow poppy against their wishes, often using a combination of strong arm tactics and debt.
 There was an extensive and complicated system of BEIC agencies involved in the supervision and management of opium production and distribution in India.
A massive destruction of opium by an emissary of the Chinese
Daoguang Emperor in an attempt to stop opium imports led to the
First Opium War (1839–1842), in which Britain defeated China. After 1860, opium use continued to increase with widespread domestic production in China. By 1905, an estimated 25 percent of the male population were regular consumers of the drug. Recreational use of opium elsewhere in the world remained rare into late in the 19th century, as indicated by ambivalent reports of opium usage.
but was limited by its rarity and expense. Opium trade became more regular by the 17th century, when it was mixed with tobacco for smoking, and addiction was first recognized. Prior to the arrival of the
Global regulation of opium beganopium dens in San Francisco, California. This led rapidly to town ordinances in the 1870s and the formation of the
International Opium Commission in 1909. During this period, the portrayal of opium in literature became squalid and violent. British opium trade was largely supplanted by domestic Chinese production. Purified
morphine and heroin became widely available for injection and
patent medicines containing
opiates reached a peak in recreational use. Opium was
prohibited in many countries during the early 20th century, leading to the modern pattern of opium production as a precursor for illegal
recreational drugs or tightly regulated legal prescription drugs. Illicit opium production, now dominated by
Afghanistan, was decimated in 2000, when production was banned by the
Taliban, but has increased steadily since the fall of the Taliban and western occupation in 2001 and over the course of the
war in Afghanistan.
 Worldwide production in 2006 was 6610 metric tons
—about one-fifth the level of production in 1906.
with the stigmatization of Chinese immigrants and
Recreational use in China
An opium den in 18th-century China through the eyes of a Western artist
The earliest clear description of the use of opium as a
recreational drug in China came from Xu Boling, who wrote in 1483 that opium was "mainly used to aid masculinity, strengthen sperm and regain vigor", and that it "enhances the art of alchemists, sex and court ladies". He also described an expedition sent by the
Chenghua Emperor in 1483 to procure opium for a price "equal to that of gold" in
Zhejiang, Sichuan and
Shaanxi, where it is close to the western lands of
Xiyu. A century later,
Li Shizhen listed standard medical uses of opium in his renowned
Compendium of Materia Medica (1578), but also wrote that "lay people use it for the art of sex," in particular the ability to "arrest seminal emission". This association of opium with sex continued in China until the end of the 19th century.
Opium smoking began as a privilege of the elite and remained a great luxury into the early 19th century. However, by 1861,
Wang Tao wrote that opium was used even by rich peasants, and even a small village without a rice store would have a shop where opium was sold.
A Chinese opium house, photograph 1902
Smoking of opium came on the heels of tobacco smoking and may have been encouraged by a brief ban on the smoking of tobacco by the Ming emperor. The prohibition ended in 1644 with the coming of the
Qing dynasty, which encouraged smokers to mix in increasing amounts of opium.
 In 1705,
Wang Shizhen wrote, "nowadays, from nobility and gentlemen down to slaves and women, all are addicted to tobacco." Tobacco in that time was frequently mixed with other herbs (this continues with
clove cigarettes to the modern day), and opium was one component in the mixture. Tobacco mixed with opium was called
madak (or madat) and became popular throughout China and its seafaring trade partners (such as Taiwan,
Java, and the Philippines) in the 17th century.
 In 1712,
Engelbert Kaempfer described
addiction to madak: "No commodity throughout the
Indies is retailed with greater profit by the
Batavians than opium, which [its] users cannot do without, nor can they come by it except it be brought by the ships of the Batavians from
Fueled in part by the 1729 ban on madak, which at first effectively exempted pure opium as a potentially medicinal product, the smoking of pure opium became more popular in the 18th century. In 1736, the smoking of pure opium was described by
Huang Shujing, involving a pipe made from bamboo rimmed with silver, stuffed with palm slices and hair, fed by a clay bowl in which a globule of molten opium was held over the flame of an oil lamp. This elaborate procedure, requiring the maintenance of pots of opium at just the right temperature for a globule to be scooped up with a needle-like skewer for smoking, formed the basis of a craft of "paste-scooping" by which servant girls could become prostitutes as the opportunity arose.
Chinese Diaspora (1800s to 1949) first began during the 19th-century due to famine and political upheaval, as well as rumors of wealth to be had outside of Southeast Asia. Chinese emigrants to cities such as San Francisco, London, and New York brought with them the Chinese manner of opium smoking, and the social traditions of the
Indian Diaspora distributed opium-eaters in the same way, and both social groups survived as "
lascars" (seamen) and "
coolies" (manual laborers). French sailors provided another major group of opium smokers, having gotten the habit while in
French Indochina, where the drug was promoted and monopolized by the colonial government as a source of revenue.
 Among white Europeans, opium was more frequently consumed as
laudanum or in
patent medicines. Britain's All-India Opium Act of 1878 formalized ethnic restrictions on the use of opium, limiting recreational opium sales to registered Indian opium-eaters and Chinese opium-smokers only and prohibiting its sale to workers from Burma.
 Likewise, American law sought to contain addiction to immigrants by prohibiting Chinese from smoking opium in the presence of a white man.
Because of the low social status of immigrant workers, contemporary writers and media had little trouble portraying opium dens as seats of vice,
white slavery, gambling, knife- and revolver-fights, and a source for drugs causing deadly overdoses, with the potential to addict and corrupt the white population. By 1919, anti-Chinese riots attacked
Chinatown of London. Chinese men were deported for playing
keno and sentenced to hard labor for opium possession. Due to this, both the immigrant population and the social use of opium fell into decline.
 Yet despite lurid literary accounts to the contrary, 19th-century London was not a hotbed of opium smoking. The total lack of photographic evidence of opium smoking in Britain, as opposed to the relative abundance of historical photos depicting opium smoking in North America and France, indicates the infamous
Limehouse opium-smoking scene was little more than fantasy on the part of British writers of the day, who were intent on scandalizing their readers while drumming up the threat of the "yellow peril".
Prohibition and conflict in China
Opium prohibition began in 1729, when the
Yongzheng Emperor, disturbed by
madak smoking at court and carrying out the government's role of upholding
Confucian virtues, officially prohibited the sale of opium, except for a small amount for medicinal purposes. The ban punished sellers and
opium den keepers, but not users of the drug.
 Opium was banned completely in 1799, and this prohibition continued until 1860.
During the Qing dynasty, China opened itself to foreign trade under the
Canton System through the port of
Guangzhou (Canton), with traders from the
East India Company visiting the port by the 1690s. Due to the growing British demand for Chinese tea and the Chinese Emperor's lack of interest in British commodities other than silver, British traders resorted to trade in opium as a high-value commodity for which China was not self-sufficient. The English traders had been purchasing small amounts of opium from India for trade since
Ralph Fitch first visited in the mid-16th century.
 Trade in opium was standardized, with production of balls of raw opium, 1.1–1.6 kg (2.4–3.5 lb), 30% water content, wrapped in poppy leaves and petals, and shipped in chests of 60–65 kg (132–143 lb) (one
 Chests of opium were sold in auctions in
Calcutta with the understanding that the independent purchasers would then smuggle it into China.
After the 1757
Battle of Plassey and 1764
Battle of Buxar, the
British East India Company gained the power to act as
Bengal, Bihar, and
company rule in India). This allowed the company to exercise a
monopoly over opium production and export in India, to encourage
ryots to cultivate the cash crops of
indigo and opium with cash advances, and to prohibit the "hoarding" of rice. This strategy led to the increase of the land tax to 50 percent of the value of crops and to the doubling of East India Company profits by 1777. It is also claimed to have contributed to the starvation of 10 million people in the
Bengal famine of 1770. Beginning in 1773, the British government began enacting oversight of the company's operations, and in response to the
Indian Rebellion of 1857, this policy culminated in the establishment of direct rule over the
presidencies and provinces of British India. Bengal opium was highly prized, commanding twice the price of the domestic Chinese product, which was regarded as inferior in quality.
Some competition came from the newly independent United States, which began to compete in Guangzhou, selling Turkish opium in the 1820s. Portuguese traders also brought opium from the independent Malwa states of western India, although by 1820, the British were able to restrict this trade by charging "pass duty" on the opium when it was forced to pass through Bombay to reach an
 Despite drastic penalties and continued prohibition of opium until 1860, opium importation rose steadily from 200 chests per year under the
Yongzheng Emperor to 1,000 under the
Qianlong Emperor, 4,000 under the
Jiaqing Emperor, and 30,000 under the
 The illegal sale of opium became one of the world's most valuable single commodity trades and has been called "the most long continued and systematic international crime of modern times".
 Opium smuggling provided 15 to 20 percent of the
British Empire's revenue and simultaneously caused scarcity of
silver in China.
In response to the ever-growing number of Chinese people becoming addicted to opium, the Qing
Daoguang Emperor took strong action to halt the import of opium, including the seizure of cargo. In 1838, the Chinese Commissioner
Lin Zexu destroyed 20,000 chests of opium in Guangzhou.
 Given that a chest of opium was worth nearly
US$1,000 in 1800, this was a substantial economic loss. The British queen
Victoria, not willing to replace the cheap opium with costly silver, began the
First Opium War in 1840, the British winning Hong Kong and trade concessions in the first of a series of
The opium trade incurred intense enmity from the later British Prime Minister
William Ewart Gladstone.
 As a member of Parliament, Gladstone called it "most infamous and atrocious" referring to the opium trade between China and British India in particular.
 Gladstone was fiercely against both of the
Opium Wars Britain waged in China in the
First Opium War initiated in 1840 and the
Second Opium War initiated in 1857, denounced British violence against Chinese, and was ardently opposed to the British trade in opium to China.
 Gladstone lambasted it as "Palmerston's Opium War" and said that he felt "in dread of the judgments of God upon England for our national iniquity towards China" in May 1840.
 A famous speech was made by Gladstone in Parliament against the
First Opium War.
 Gladstone criticized it as "a war more unjust in its origin, a war more calculated in its progress to cover this country with permanent disgrace".
 His hostility to opium stemmed from the effects of opium brought upon his sister Helen.
 Due to the First Opium war brought on by Palmerston, there was initial reluctance to join the government of Peel on part of Gladstone before 1841.
Following China's defeat in the
Second Opium War in 1858, China was forced to legalize opium and began massive domestic production. Importation of opium peaked in 1879 at 6,700 tons, and by 1906, China was producing 85 percent of the world's opium, some 35,000 tons, and 27 percent of its adult male population regularly used opium—13.5 million people consuming 39,000 tons of opium yearly.
 From 1880 to the beginning of the Communist era, the British attempted to discourage the use of opium in China, but this effectively promoted the use of morphine, heroin, and cocaine, further exacerbating the problem of addiction.
Scientific evidence of the pernicious nature of opium use was largely undocumented in the 1890s, when Protestant
missionaries in China decided to strengthen their opposition to the trade by compiling data which would demonstrate the harm the drug did. Faced with the problem that many Chinese associated Christianity with opium, partly due to the arrival of early Protestant missionaries on opium clippers, at the 1890 Shanghai Missionary Conference, they agreed to establish the Permanent Committee for the Promotion of Anti-Opium Societies in an attempt to overcome this problem and to arouse public opinion against the opium trade. The members of the committee were
John Glasgow Kerr, MD, American Presbyterian Mission in Canton;
B.C. Atterbury, MD, American Presbyterian Mission in Peking; Archdeacon
Arthur E. Moule, Church Missionary Society in Shanghai; Henry Whitney, MD, American Board of Commissioners for foreign Missions in Foochow; the Rev. Samuel Clarke, China Inland Mission in Kweiyang; the Rev.
Arthur Gostick Shorrock, English Baptist Mission in Taiyuan; and the Rev.
Griffith John, London Mission Society in Hankow.
 These missionaries were generally outraged over the British government's
Royal Commission on Opium visiting India but not China. Accordingly, the missionaries first organized the
Anti-Opium League in China among their colleagues in every mission station in China. American missionary
Hampden Coit DuBose acted as first president. This organization, which had elected national officers and held an annual national meeting, was instrumental in gathering data from every Western-trained medical doctor in China, which was then published as
William Hector Park compiled Opinions of Over 100 Physicians on the Use of Opium in China (Shanghai: American Presbyterian Mission Press, 1899). The vast majority of these medical doctors were missionaries; the survey also included doctors who were in private practices, particularly in Shanghai and Hong Kong, as well as Chinese who had been trained in medical schools in Western countries. In England, the home director of the
China Inland Mission,
Benjamin Broomhall, was an active opponent of the opium trade, writing two books to promote the banning of opium smoking: The Truth about Opium Smoking and The Chinese Opium Smoker. In 1888, Broomhall formed and became secretary of the Christian Union for the Severance of the British Empire with the Opium Traffic and editor of its periodical, National Righteousness. He lobbied the
British Parliament to stop the opium trade. He and
James Laidlaw Maxwell appealed to the London Missionary Conference of 1888 and the Edinburgh Missionary Conference of 1910 to condemn the continuation of the trade. When Broomhall was dying, his son Marshall read to him from
The Times the welcome news that an agreement had been signed ensuring the end of the opium trade within two years.
Map showing the amount of opium produced in China in 1908: The quote "We English, by the policy we have pursued, are morally responsible for every acre of land in China which is withdrawn from the cultivation of grain and devoted to that of the poppy; so that the fact of the growth of the drug in China ought only to increase our sense of responsibility." is by
Lord Justice Fry
Official Chinese resistance to opium was renewed on September 20, 1906, with an antiopium initiative intended to eliminate the drug problem within 10 years. The program relied on the turning of public sentiment against opium, with mass meetings at which
opium paraphernalia were publicly burned, as well as coercive legal action and the granting of police powers to organizations such as the Fujian Anti-Opium Society. Smokers were required to register for licenses for gradually reducing rations of the drug. Action against opium farmers centred upon a highly repressive incarnation of law enforcement in which rural populations had their property destroyed, their land confiscated and/or were publicly tortured, humiliated and executed.
 Addicts sometimes turned to missionaries for treatment for their addiction, though many associated these foreigners with the drug trade. The program was counted as a substantial success, with a cessation of direct British opium exports to China (but not Hong Kong)
 and most provinces declared free of opium production. Nonetheless, the success of the program was only temporary, with opium use rapidly increasing during the disorder following the death of
Yuan Shikai in 1916.
 Opium farming also increased, peaking in 1930 when the
League of Nations singled China out as the primary source of illicit opium in East and Southeast Asia. Many
 local powerholders facilitated the trade during this period to finance conflicts over territory and political campaigns. In some areas food crops were eradicated to make way for opium, contributing to famines in Kweichow and Shensi Provinces between 1921 and 1923, and food deficits in other provinces.
Beginning in 1915, Chinese nationalist groups came to describe the period of military losses and
Unequal Treaties as the "Century of National Humiliation", later defined to end with the conclusion of the
Chinese Civil War in 1949.
In the northern provinces of
Suiyuan in China,
Chinese Muslim General
Ma Fuxiang both prohibited and engaged in the opium trade. It was hoped that Ma Fuxiang would have improved the situation, since Chinese Muslims were well known for opposition to smoking opium.
 Ma Fuxiang officially prohibited opium and made it illegal in Ningxia, but the
Guominjun reversed his policy; by 1933, people from every level of society were abusing the drug, and Ningxia was left in destitution.
 In 1923, an officer of the
Bank of China from
Baotou found out that Ma Fuxiang was assisting the drug trade in opium which helped finance his military expenses. He earned US$2 million from taxing those sales in 1923. General Ma had been using the bank, a branch of the Government of China's exchequer, to arrange for silver currency to be transported to Baotou to use it to sponsor the trade.
The opium trade under the
Chinese Communist Party was important to its finances in the 1940s.
Peter Vladimirov's diary provided a first hand account.
 Chen Yung-Fa provided a detailed historical account of how the opium trade was essential to the economy of Yan'an during this period.
Mitsui were involved in the opium trade during the Japanese occupation of China.
Mao Zedong government is generally credited with eradicating both consumption and production of opium during the 1950s using unrestrained repression and social reform. Ten million addicts were forced into compulsory treatment, dealers were executed, and opium-producing regions were planted with new crops. Remaining opium production shifted south of the Chinese border into the
Golden Triangle region.
 The remnant opium trade primarily served Southeast Asia, but spread to American soldiers during the
Vietnam War, with 20 percent of soldiers regarding themselves as addicted during the peak of the epidemic in 1971. In 2003, China was estimated to have four million regular drug users and one million registered drug addicts.
Prohibition outside China
There were no legal restrictions on the importation or use of opium in the United States until the San Francisco Opium Den Ordinance, which banned dens for public smoking of opium in 1875, a measure fueled by anti-Chinese sentiment and the perception that whites were starting to frequent the dens. This was followed by an 1891 California law requiring that narcotics carry warning labels and that their sales be recorded in a registry; amendments to the California Pharmacy and Poison Act in 1907 made it a crime to sell opiates without a prescription, and bans on possession of opium or
opium pipes in 1909 were enacted.
At the US federal level, the legal actions taken reflected constitutional restrictions under the
enumerated powers doctrine prior to reinterpretation of the
commerce clause, which did not allow the federal government to enact arbitrary prohibitions, but did permit arbitrary taxation.
 Beginning in 1883, opium importation was taxed at US$6 to US$300 per pound, until the Opium Exclusion Act of 1909 prohibited the importation of opium altogether. In a similar manner, the
Harrison Narcotics Tax Act of 1914, passed in fulfillment of the
International Opium Convention of 1912, nominally placed a tax on the distribution of opiates, but served as a de facto prohibition of the drugs. Today, opium is regulated by the
Drug Enforcement Administration under the
Controlled Substances Act.
Following passage of a Colonial Australian law in 1895, Queensland's
Aboriginals Protection and Restriction of the Sale of Opium Act 1897 addressed opium addiction among
Aboriginal people, though it soon became a general vehicle for depriving them of basic rights by administrative regulation. By 1905 all Australian states and territories had passed similar laws making prohibitions to Opium sale. Smoking and possession was prohibited in 1908.
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.
In 1909, the
International Opium Commission was founded, and by 1914, 34 nations had agreed that the production and importation of opium should be diminished. In 1924, 62 nations participated in a meeting of the Commission. Subsequently, this role passed to the
League of Nations, and all signatory nations agreed to prohibit the import, sale, distribution, export, and use of all narcotic drugs, except for medical and scientific purposes. This role was later taken up by the
International Narcotics Control Board of the United Nations under
Article 23 of the
Single Convention on Narcotic Drugs, and subsequently under the
Convention on Psychotropic Substances. Opium-producing nations are required to designate a
government agency to take physical possession of licit opium crops as soon as possible after harvest and conduct all wholesaling and exporting through that agency.
Regulation in Britain and the United States
Before the 1920s, regulation in Britain was controlled by the pharmacists. Pharmacists that were found to have prescribed opium for illegitimate causes and anyone found to have sold opium without proper qualifications would be prosecuted.
 Due to the passing of the Rolleston Act in Britain in 1926, doctors could prescribe opiates such as morphine and heroin on their own accord if they felt their patients demonstrated a medical need. Because addiction was viewed as a medical problem rather than an indulgence, doctors were permitted to allow patients to wean themselves off opiates rather than cutting off any opiate use altogether.
 The passing of the Rolleston Act put the control of opium use in the hands of medical doctors instead of pharmacists. Later in the 20th century, the addiction to opiates, especially heroin in young people, continued to rise and so the sale and prescription of opiates was limited to doctors in treatment centers. If these doctors were found to be prescribing opiates without just cause, then they could lose their license to practice or prescribe drugs.
 The abuse of opium in the United States began in the late 19th century and was largely stigmatized with Chinese immigrants. During this time the use of opium had little negative connotation and was used freely until 1882 when a law was passed to confine opium smoking to specific dens.
 Until the full ban on opium based products came into effect just after the turn of the century, physicians in the US considered opium a miracle drug that could help with many ailments. Therefore, the ban on said products was more a result of negative connotations towards its use and distribution by Chinese immigrants who were heavily persecuted during this particular period in history.
 As the 19th century progressed however, there was a doctor by the name of
Hamilton Wright that worked to decrease the use of opium in the US by submitting the Harrison Act to congress. This act put taxes and restrictions on the sale and prescription of opium, as well as trying to stigmatize the opium poppy and its derivatives as "demon drugs", to try and scare people away from them.
 This act and the stigma of a demon drug on opium, led to the criminalization of people that used opium-based products. It made the use and possession of opium and any of its derivatives illegal to use. The restrictions were recently redefined by the Federal Controlled Substances Act of 1970.
20th century historical use
During the Communist era in Eastern Europe, poppy stalks sold in bundles by farmers were processed by users with household chemicals to make kompot ("
Polish heroin"), and poppy seeds were used to produce koknar, an opiate.
Globally, opium has gradually been superseded by a variety of purified, semi-synthetic, and synthetic
opioids with progressively stronger effects, and by other
general anesthetics. This process began in 1804, when
Friedrich Wilhelm Adam Sertürner first isolated morphine from the opium poppy.
 The process continued until 1817, when Sertürner published the isolation of pure
morphine from opium after at least thirteen years of research and a nearly disastrous trial on himself and three boys.
 The great advantage of purified morphine was that a patient could be treated with a known dose—whereas with raw plant material, as
Gabriel Fallopius once lamented, "if soporifics are weak they do not help; if they are strong they are exceedingly dangerous." Morphine was the first pharmaceutical isolated from a natural product, and this success encouraged the isolation of other alkaloids: by 1820, isolations of
quinine were reported. Morphine sales began in 1827, by
Heinrich Emanuel Merck of Darmstadt, and helped him expand his family pharmacy into the
Merck KGaA pharmaceutical company.
Codeine was isolated in 1832 by
Pierre Jean Robiquet.
The use of
diethyl ether and
general anesthesia began in 1846–1847, and rapidly displaced the use of opiates and
tropane alkaloids from
Solanaceae due to their relative safety.
Heroin, the first semi-synthetic opioid, was first synthesized in 1874, but was not pursued until its rediscovery in 1897 by
Felix Hoffmann at the
Bayer pharmaceutical company in
Elberfeld, Germany. From 1898 to 1910 heroin was marketed as a non-addictive morphine substitute and cough medicine for children. Because the lethal dose of heroin was viewed as a hundred times greater than its effective dose, heroin was advertised as a safer alternative to other opioids.
 By 1902, sales made up 5 percent of the company's profits, and "heroinism" had attracted media attention.
thebaine derivative similar to
codeine, was introduced by Bayer in 1916 and promoted as a less-addictive analgesic. Preparations of the drug such as
oxycodone with paracetamol and
extended release oxycodone remain popular to this day.
A range of synthetic
opioids such as
fentanyl (late 1950s), and derivatives thereof have been introduced, and each is preferred for certain specialized applications. Nonetheless, morphine remains the drug of choice for American
combat medics, who carry packs of
syrettes containing 16 milligrams each for use on severely wounded soldiers.
 No drug has been found that can match the painkilling effect of
opioids without also duplicating much of their addictive potential.