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Views & Reviews Medical Classics

Confessions of an English Opium-Eater

BMJ 2009; 339 doi: (Published 30 September 2009) Cite this as: BMJ 2009;339:b4009
  1. Joshua Hill, general practitioner
  1. 1Morris House Group Practice, London
  1. josh.hill{at}

    Confessions of an English Opium-Eater, an examination of the effects of opium on the mind, was written in 1821 by Thomas de Quincey, friend and contemporary of Coleridge, another famous opium user. It was far ahead of its time, as although opium was easily available and was a mainstay of every household medicine cupboard, there was no mainstream recognition of its psychoactive effects or its addictiveness. These truths had hitherto not been written about, perhaps explaining the book’s explosive popularity, which elevated de Quincey from obscurity to celebrity.

    The book is divided into two sections, “The Pleasures of Opium” and “The Pains of Opium.” The first gives an account of why de Quincey first started using laudanum and the dramatic side effects it produced on his powers of perception. De Quincy was really an opium drinker rather than an opium eater, as the preparation he used was a red mixture containing “tincture of opium” diluted with alcohol. He first took it in desperation after suffering for 24 days with toothache. He was wandering the streets in pain when he bumped into a college friend who suggested that he try it. He describes what happened next:

    “Arrived at my lodgings, it may be supposed that I lost not a moment in taking the quantity prescribed . . . That my pain had vanished, was now a trifle in my eyes . . . in the abyss of divine enjoyment this suddenly revealed. Here was a panacea for all human woes: happiness might now be bought for a penny, and carried around in the waistcoat pocket.”

    De Quincey was adamant that he used opium only as a painkiller, accepting the fortunate side effects as an intellectual stimulant, perhaps enhancing his enjoyment of the theatre or a book rather than as a means to intoxication. Indeed, he considered the use of opium to achieve intoxication and sleep (as, he hinted, Coleridge did) a grave error of judgment.

    However, in “The Pains” he examines how, because of the constant pain of a gastric condition, he was forced to consume ever more of the drug, eventually becoming unproductive, depressed, and moreover suffering terrifying visions. The content of these visions is the main focus of the second section:

    “My dreams were accompanied by deep seated anxiety and gloomy melancholy, such as are wholly incommunicable by words. I seemed every night to descend into chasms and sunless abysses, depths below depths, from which it seemed hopeless that I could ever reascend.”

    De Quincey recognises that traumatic episodes in his childhood, such as the death of his younger sister, led to his depression and were relived in these opium induced nightmares. This acknowledgement of the relevance of his childhood experiences to later life is another example of how this book, written 40 or so years before Sigmund Freud was born, was ahead of its time.

    But the main attraction of Confessions is the sheer beauty of the prose and the descriptions of one man’s inner life, even the most mundane aspects. Indeed, the mere words “pleasure” and “pain” seem insufficient in describing the scale of emotion he manages to convey through his words.


    Cite this as: BMJ 2009;339:b4009


    • Confessions of an English Opium-Eater

    • By Thomas de Quincey

    • Published 1821

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