Since a 10 kg child might get a teaspoonful of paregoric, using opium tincture in error would allow the equivalent of 50 mg of morphine to be administered. The differences in these products are not always made clear. Because the dosing information is listed together, there is a risk of confusion if read quickly on a busy nursing unit. Since they are both tinctures, this could be confusing. If you have this book, consider making a not in the monograph margin to inform readers not to confuse the two drugs.
Opium tincture is a dangerous item.
Measuring doses accurately may prove challenging on busy nursing units and it is too easily confused with paregoric, risking a 25-fold overdose. With so many other items available to control diarrhea and treat pain, it is difficult to understand why any facility would want to risk having it around. It should not be on a modern formulary.