Hello everyone -- just wanted to clarify a couple things regarding opium tincture and paregoric, because confusing the two can be fatal. If you took teaspoons of opium tincture, you could die of overdose. What makes things even more confusing is that paregoric and opium tincture are both used to treat diarrhea.
Paregoric is NOT the same medication as opium tincture. Paregoric, which is also known as camphorated tincture of opium, is 1/25 the strength of opium tincture. Paregoric contains camphor (think moth balls), anise and alcohol, all of which taste terrible.
Opium tincture, on the other hand, contains powdered opium dissolved in alcohol. It also tastes terrible, as opium is very bitter.
Paregoric is usually dosed in teaspoons, while opium tincture is almost always dosed in drops. There have been several instances where pharmacists have accidentally filled opium tincture in place of paregoric, and patients have died from overdose.
Paregoric contains only 0.04 mg of morphine per mL, while opium tincture contains 10 mg of morphine per mL. A teaspoon of opium tincture would contain 5 mL, which would be the equivalent of 50 mg of morphine -- a whopping dose that would cause unconsciousness and even death in someone not tolerant to opiates.
Opium tincture is usually dispensed with a syringe or dropper to make calibrating the dose easier -- the usual dose is 0.6 mL (about
10 drops) every 4-6 hours.
Paregoric is dosed in teaspoons (5 mL) or even tablespoons (15 mL) -- the usual dose being 1-2 teaspoons every 4 hours.
Both drugs are useful for diarrhea, but opium tincture is usually reserved for patients who have failed paregoric and other antidiarrheals.
Opium tincture is a Schedule II drug, along with cocaine, raw opium, morphine and the like. Paregoric is Schedule III, along with Tylenol with codeine, Vicodin, etc. Opium tincture is tightly controlled. No refills are allowed for Schedule II prescript
ions, and special DEA order forms are required. Paregoric may be refilled up to 5 times in 6 months.
I have used both in the past for diarrhea associated with IBS. Opium tincture is by far more effective, and requires only a tiny dose (5 to 10 drops). Of course, both can be habit-forming, but if opium tincture is used as prescribed, the risk of addiction is actually quite low, because the dose needed to control diarrhea is far below the dose required for analgesia. That is, if you take opium tincture as prescribed, you usually will not feel the "high" associated with larger doses of opiates.
Do a google search of "opium tincture," "paregoric," and "confusion" and you'll pull up a ton of links about
the hazards discussed above. Below are two cases from the Institute of Safe Medical Practices.
1. The patient was prescribed camphorated Tincture of Opium to treat chronic diarrhea. The pharmacy dispensed Opium Tincture, which contains 25 times the amount of Morphine as Paregoric. After taking the Opium Tinc ture in the morning, the patient became weak and complained of feeling tired and achy. Later the patient was found unresponsive and could not be revived. The medical examiner's office found that the patient's death was caused by morphine intoxication.
2. A patient was prescribed Opium Tincture camphorated, 5 mL p.o. b.i.d./t.i.d. 2-3x/day until diarrhea stops. That evening, the patient just lay in bed with difficulty breathing. He could not talk or even
open his eyes. Three days later the patient passed away. The foster care had all of the prescript
ions delivered from a community pharmacy. A family member learned that evening pharmacy personnel came back with a new bottle of Opium and took the original bottle. The new bottle was labeled Opium 10% Tincture 0.6 mL 2-3 times a day until diarrhea stops.
Post Edited (Albion) : 3/22/2008 5:22:34 PM (GMT-6)