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. [47] Smoking, snorting or orally ingesting heroin does not produce an intense "rush" as might be experienced with intravenous (IV) injection.

Giving up opium after using it for a long time is challenging because the body must get used to functioning without it. Withdrawing from opium is similar to withdrawing from other opioid drugs. Musto, David F. The American Disease: Origins of Narcotic Control. New York: Oxford University Press, 1987. Afghan opium poppy cultivation plunges by 95 percent under Taliban: UN". Al Jazeera . Retrieved November 7, 2023. a b Rewriting history, A response to the 2008 World Drug Report, Transnational Institute, June 2008 Richard Askwith; The Sunday Times (September 13, 1998). "How aspirin turned hero" . Retrieved May 2, 2007.Karl A. Sporer, M.D. (April 6, 1999). "Acute Heroin Overdose". Annals of Internal Medicine. 130 (7): 584–590. doi: 10.7326/0003-4819-130-7-199904060-00019. PMID 10189329. S2CID 22949289. Habighorst, Ludwig V., Reichart, Peter A., Sharma, Vijay, Love for Pleasure: Betel, Tobacco, Wine and Drugs in Indian Miniatures (Koblenz: Ragaputra Edition, 2007)

Bradley, James (2009). The Imperial Cruise: a secret history of empire and war. Little, Brown and Company. pp. 274–275. ISBN 978-0-316-00895-2. The opium trade under the Chinese Communist Party was important to its finances in the 1940s. [82] Peter Vladimirov's diary provided a first hand account. [83] Chen Yung-fa provided a detailed historical account of how the opium trade was essential to the economy of Yan'an during this period. [84] Mitsubishi and Mitsui were involved in the opium trade during the Japanese occupation of China. [85] Islamic Medical Manuscripts at the National Library of Medicine: a note on pharmaceutics" . Retrieved June 6, 2007. Hideyuki Takano; The Shore Beyond Good and Evil: A Report from Inside Burma's Opium Kingdom (2002, Kotan, ISBN 0-9701716-1-7)Oral ingestion does not usually lead to a "rush", but use of heroin in suppository form may have intense euphoric effects. Chouvy, P.A. (2009). "Opium. Uncovering the Politics of the Poppy, London, I.B. Tauris (Cambridge, Harvard University Press: 2010)". Archived from the original on October 26, 2011. Other synthetic or semisynthetic opium derivatives include fentanyl, methadone, oxycodone and hydrocodone.