Dear Dr. ROACH: Can you tell me about the current state of paregoric? Banned by the Food and Drug Administration? Is it available anywhere in the United States? I remember using this product occasionally when I was a teenager in the 1960s. It was a miracle drug to stop diarrhea and was available without a prescription. Mothers would apply some to the gums of their teething babies to relieve the pain.

I don’t see paregoric mentioned in any medication programs these days. Although it appears to be available in other countries, many pharmacists have never heard of it. I don’t understand why this drug, which benefited so many people, was removed from the market. It certainly cannot be more addictive than codeine, which is still widely available.

I’m 74 now and like to have some paregoric on hand when I have diarrhea. — Northwest

ANSWER: Paregoric is an opium derivative, sometimes called camphor tincture of opium. It is an opium extract along with some other traditional ingredients (anise oil, benzoic acid, camphor and glycerin) in an alcohol and water base. It was made a controlled substance in 1970 due to abuse. Even though its production was stopped for a short time, it is still available and I think if your doctor orders it, your pharmacist will also get it. However, paregoric is rarely prescribed because more effective and safer medications for diarrhea (such as loperamide and diphenoxylate-atropine) are available.

Even when I was a medical student and resident, some of the old-time doctors still prescribed paregoric or belladonna tincture and opium for diarrhea or bladder spasms. Other historical opium products include the alcoholic tincture of opium (“laudanum”), which was much more powerful and dangerous than paregoric. They have a greater addictive potential than codeine, which is only 1% as potent as morphine.

Although they are quite safe and effective when used exactly as directed, these medications can be intentionally abused and accidentally given in excessive amounts, resulting in an overdose. Finally, the additional ingredients in paregoric, although conventional, probably do not add any beneficial pharmacological effects. Alcohol can even be harmful to some. Still, they are effective drugs and are occasionally used in unusual situations.