Marcus Aurelius, one of the "five good emperors" and author of 'Meditations', is known to have been addicted to opium; was opium use common among the elites at the time? Would the general public have had access to it? Was there any stigma attached to its use or the dependence on it?

Although opium was fairly widespread in the Roman period, its use seems to have been almost exclusively medical.

Marcus Aurelius took his opium in theriac, which his physician, the great doctor Galen, prescribed as a remedy for his many ailments. According to Galen, in fact, Theriac could do just about anything. It counteracted every poison; quieted internal ailments; dispelled gout, chills, and sciatica; and even provided a hearty boost to the sex drive (On Antidotes 2.9). This marvelous concoction incorporated dozens of ingredients, many of them exotic and expensive spices. A few of these ingredients (such as myrrh) may have had positive effects; a few others (like the viper flesh that formed a key component) cannot have done convalescing digestive systems any favors. The opium, however, was quite potent.

The opium in theriac produced noticeable effects on Marcus. According to Galen, the emperor would order the opium left out of his theriac whenever he felt himself growing tired in the middle of the day. At night, however, he found himself unable to sleep without opiated theriac, and seems to have become dependent on it. We hear about Marcus' use of theriac even during the Marcomannic Wars:

"Yet [Marcus] was so frail in body that at first he could not endure the cold, but even after the soldiers had assembled at his command he would retire before addressing a word to them; and he took but very little food and that always at night. It was never his practice to eat during the daytime, unless it were some of the drug called theriac. This drug he took, not so much because he feared anything [i.e. poison], as because his stomach and chest were in bad condition; and it is reported that this practice enabled him to endure both this and other maladies." (Cass. Dio 71.6)

Interestingly, theriac seems to have become trendy among the Roman elite during Marcus' reign. As Galen reports:

"Marcus being emperor, theriac was prepared by many rich people and because of this, some products hard to procure were left aside [in the making of this medication]. It is remarkable how the rich emulate the imperial tastes (or at least desire to be seen to emulate them). When the first among the men [i.e. the Emperor] died, very few continued to prepare the antidote..." (On Antidotes 1.4)

On a less elevated social plane, opium was widely prescribed by doctors (above all as a sleep aid), and could be readily purchased (Galen mentions a good opium seller just off the Via Sacra in the Roman Forum). The first-century physician Dioscorides describes various preparations of opium:

"[Poppy] leaves and heads (boiled in water and applied with hot cloths) cause sleep. A decoction is taken as a drink against lack of sleep. The heads (pounded into small pieces and mixed into poultices with polenta) are good for inflammation and erysipela [streptococcal skin infection]. It is necessary for those who beat them when they are green to make them into tablets, dry them for storage, and then use them. The heads are boiled alone in water until half, and then boiled again with honey until the dullness is thickened, make a licking medicine soothing for coughs, dripping fluids in the throat, and abdominal afflictions." (4.64)

Despite its many uses, Dioscorides notes, opium use has its dangers:

"A little of it...is a pain-easer, a sleep-causer, and a digester, helping coughs and abdominal cavity afflictions. Taken as a drink too often it hurts (making men lethargic) and it kills." (4.64)

The soporific and hallucinogenic effects of opium seem, in fact, to have been widely recognized. Magical papyri discovered in Egypt, for example, describe how to create an opium-based potion that will cast one's enemies into an "evil sleep."

The Romans do not seem to have recognized, however, that opium was addictive. Although it is clear that some Romans (like Marcus Aurelius) became dependent, we hear nothing about opium addicts or anything resembling a drug subculture. Opium use, accordingly was neither regulated nor stigmatized. If you could afford it, and it was available, it was used without reservation to beckon sleep or dampen pain.