Opium played a very different role in Victorian culture than it does in Western culture today. Laudanum, a tincture of opium (which often included alcohol as well), was commonly used as a painkiller, and many people, both famous and common, became addicted to this form of the drug. Opium was also used as additive to many other drugs, including Godfrey's cordial, a sleeping syrup given to children. These drugs were dispensed by pharmacists, who could prescribe them at their discretion. The drugs could also be bought in opium dens. There were several of these dens in London and in the country's port cities, and most of them were geared toward sailors and other members of the lower classes who were addicted to opium. Although there were fewer opium dens than was commonly believed, their existence captured the public imagination and appeared frequently in literature as places of iniquity – for example, in Sir Arthur Conan Doyle's short story "The Man with the Twisted Lip."
Although laudanum was used as a medicine across the social spectrum, many members of the upper class associated its abuse with Orientals and with the working class. Despite this public perception, many wealthy individuals – especially in the artistic community – abused laudanum, including Charles Dickens and De Quincey's contemporaries Samuel Taylor Coleridge and Elizabeth Barrett Browning. At the time that De Quincey wrote Confessions, there had been little medical research into the effects of opium, a fact that he cites frequently as both annoying and potentially harmful. In fact, he takes great pains to insist that much of what has been published is incomplete at best, and more often completely incorrect. However, his popular memoir drew attention to the drug, and within a few decades, many doctors were openly against its use. (Rosen)