Paradoxical Diarrhea With Opiates

To the Editor:— The medical profession has literally been "blessed with the fruits" of the unripe seed capsule of the opium poppy,Papaver somniferum, for thousands of years. It has also been plagued with the problem of patients in search of relief from severe diarrhea. The pharmacologically active constituents of opium have been found to be an effective mode of therapy in exhausting diarrheal states, ie, acute dysentery. It is not surprising, therefore, that opium and diarrhea should meet and form an intimate relationship. It is the purpose of this paper to present two cases of chronic diarrhea, which occurred during long term tincture of opium therapy, that were markedly decreased with discontinuation of the drug. Case 1.— A 34-year-old white man was seen at the UCLA Medical Center in 1968, because of a five-year history of cramping pain and watery diarrhea. In 1963 a resection of six feet of