Reddish-brown in color and extremely bitter, laudanum contains several opium alkaloids, including morphine and codeine.

[3] One researcher has documented that "Laudanum, as listed in the London Pharmacopoeia (1618), was a pill made from opium, saffron, castor, ambergris, musk and nutmeg".

In the 18th century several physicians published works about it, including John Jones, who wrote The Mysteries of Opium Revealed (1700), which was described by one commentator as "extraordinary and perfectly unintelligible".

[7][8] The most influential work was by George Young, who published a comprehensive medical text entitled Treatise on Opium (1753).

Young countered this by emphasising the risks '...that I may prevent such mischief as I can, I here give it as my sincere opinion... that opium is a poison by which great numbers are daily destroyed.'

[3][10] As it gained popularity, opium, and after 1820, morphine, was mixed with a wide variety of agents, drugs and chemicals including mercury, hashish, cayenne pepper, ether, chloroform, belladonna, whiskey, wine and brandy.

"[4]: 104 During the late 18th and early 19th centuries, patients undergoing surgery were often administered laudanum and alcohol, and had their hands restrained and bodies held down while the operation was performed.

[11] By the 19th century, laudanum was used in many patent medicines to "relieve pain ... to produce sleep ... to allay irritation ... to check excessive secretions ... to support the system ... [and] as a soporific".

[12][13] The limited pharmacopoeia of the day meant that opium derivatives were among the most effective of available treatments, so laudanum was widely prescribed for ailments from colds to meningitis to cardiac diseases, in both adults and children.

[14] Initially a working-class drug, laudanum was cheaper than a bottle of gin or wine, because it was treated as a medication for legal purposes and not taxed as an alcoholic beverage.

In the 1850s, "cholera and dysentery regularly ripped through communities, its victims often dying from debilitating diarrhoea", and dropsy, consumption, ague and rheumatism were all too common.

[4]: 44–49 An 1869 article in Scientific American describes a farmer growing and harvesting poppy in Indian Springs, Georgia, and subsequently selling the raw material to a local pharmacist who prepared laudanum.

For example, a 1901 medical book published for home health use gave the following two "Simple Remedy Formulas" for "dysenterry" [sic]: (1) Thin boiled starch, 2 ounces; Laudanum, 20 drops; "Use as an injection [meaning as an enema] every six to twelve hours"; (2) Tincture rhubarb, 1 ounce; Laudanum 4 drachms; "Dose: One teaspoonful every three hours."

"[16] The early 20th century brought increased regulation of all manner of narcotics, including laudanum, as the addictive properties of opium became more widely understood, and "patent medicines came under fire, largely because of their mysterious compositions".

[4]: 126 The Harrison Narcotics Tax Act of 1914 restricted the manufacture and distribution of opiates, including laudanum, and coca derivatives in the US.

Opii Camphorated U.S.P (Paregoric)" for $2.00 per pint; (3) Opium, Concentrated (Deodorized and Denarcotized) "Four times the strength of tincture, Used when Tinct.

Toward the middle 20th century, the use of opiates was generally limited to the treatment of pain, and opium was no longer a medically accepted 'cure-all'.

There is probably no single reference that lists all the pharmaceutical variations of laudanum that were created and used in different countries during centuries since it was initially formulated.

The reasons are that in addition to official variations described in pharmacopeias, pharmacists and drug manufacturers were free to alter such formulas.

In the United States, opium tincture is marketed and distributed by several pharmaceutical firms, each producing a single formulation of the drug, which is deodorized.

[29] Its "grandfathered" status protects opium tincture from being required to undergo strict FDA drug reviews and subsequent approval processes.

Bottles of opium tincture are required by the FDA to bear a bright red "POISON" label given the potency of the drug and the potential for overdose (see discussion about confusion with Paregoric below).

The quantity of the papaverine and codeine alkaloids in opium tincture is too small to have any demonstrable central nervous system effect.

[citation needed] Opium tincture is indicated for the treatment of severe fulminant (intense, prolific) diarrhea that does not respond to standard therapy (e.g., Imodium or Lomotil).

[34] The opium tincture is gradually tapered over a 3- to 5-week period, at which point the newborn should be completely free of withdrawal symptoms.

Overdose and death may occur with a single oral dose of between 100 and 150 mg of morphine in a healthy adult who has no tolerance to opiates.

"[38] Despite the risk of confusion, opium tincture, like many end-stage medications, is indispensable for intractable diarrhea for terminally ill patients, such as those with AIDS and cancer.

Long-term use can also lead to abnormal liver function tests; specifically, prolonged morphine use can increase ALT and AST blood serum levels.

The primary concern is re-establishing a viable airway and institution of assisted or controlled ventilation if the patient is unable to breathe on their own.

[citation needed] Intravenous naloxone or nalmefene, quick-acting opioid antagonists, are the first-line treatment to reverse respiratory depression caused by an overdose of opium tincture.