Before the 1920s, regulation in Britain was controlled by pharmacists. Pharmacists who were found to have prescribed opium for illegitimate uses and anyone found to have sold opium without proper qualifications would be prosecuted. [94] With the passing of the Rolleston Act in Britain in 1926, doctors were allowed to prescribe opiates such as morphine and heroin if they believed 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. [95] 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, 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. [95] Santella, Thomas M.; Triggle, D. J. (2009). Opium. Facts On File, Incorporated. p.8. ISBN 9781438102139.

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] Derks, Hans: History of the Opium Problem: The Assault on the East, ca. 1600–1950. Sinica Leidensia, 105. Leiden: Brill, 2012. ISSN 0169-9563. ISBN 978-90-04-22158-1 Pablo Bartholomew (1996). "Opium for the masses: photo essay on cultivation of opium in India". Archived from the original on July 1, 2007 . Retrieved June 15, 2007. William Travis Hanes; Frank Sanello (2004). Opium Wars: The Addiction of One Empire and the Corruption of Another. Sourcebooks, Inc. pp.78–. ISBN 978-1-4022-0149-3. 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. [104] By 1902, sales made up 5 percent of the company's profits, and "heroinism" had attracted media attention. [105] Oxycodone, a 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. [ citation needed]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 hysteria). [34] 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. [37] Morewood, Samuel (1838). A philosophical and statistical history of the inventions and customs of ancient and modern nations in the manufacture and use of inebriating liquors; with the present practice of distillation in all its varieties: together with an extensive illustration of the consumption and effects of opium, and other stimulants used in the East, as substitutes for wine and spirits. Dublin, W. Curry and W. Carson. Ladenburg, Thomas (1974). "Chapter 1, The French in Indochina" (PDF). University of Houston. Archived (PDF) from the original on March 1, 2023 . Retrieved March 21, 2023.

Drug Addiction Research and the Health of Women – pg. 33–52" (PDF). Archived from the original (PDF) on August 22, 2008 . Retrieved March 21, 2010. Joyce A. Madancy (April 2004). "The Troublesome Legacy of Commissioner Lin" . Retrieved September 25, 2007.Other methods of preparation (besides smoking), include processing into regular opium tincture ( tinctura opii), laudanum, paregoric ( tinctura opii camphorata), herbal wine (e.g., vinum opii), opium powder ( pulvis opii), opium sirup ( sirupus opii) and opium extract ( extractum opii). [123] Vinum opii is made by combining sugar, white wine, cinnamon, and cloves. Opium syrup is made by combining 97.5 part sugar syrup with 2.5 parts opium extract. Opium extract ( extractum opii) finally can be made by macerating raw opium with water. To make opium extract, 20 parts water are combined with 1 part raw opium which has been boiled for 5 minutes (the latter to ease mixing). [123] Opium production in the Golden Triangle continues at high levels, threatening regional integration". unodc.org . Retrieved April 4, 2016. Eventually, laudanum became readily available and extensively used by the 18th century in Europe, especially England. [33] Compared to other chemicals available to 18th century regular physicians, opium was a benign alternative to arsenic, mercury, 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. [34] Medical textbooks even recommended its use by people in good health, to "optimize the internal equilibrium of the human body". [19] PAPADAKI, P. G. KRITIKOS, S. P. "The history of the poppy and of opium and their expansion in antiquity in the eastern Mediterranean area". Unodc.org. UNODC- Bulletin on Narcotics – 1967 Issue 4 – 002 . Retrieved May 31, 2022. {{ cite web}}: CS1 maint: multiple names: authors list ( link) Musto, David F. The American Disease: Origins of Narcotic Control. New York: Oxford University Press, 1987.