To harvest opium, the skin of the ripening pods is scored by a sharp blade. The slashes exude a white, milky latex, which dries to a sticky brown resin that is scraped off the pods as raw opium.

Opium has powerful narcotic properties. Its constituents and derivatives are used as painkillers. Therefore, legal opium production is allowed under the United Nations Single Convention on Narcotic Drugs and other international drug treaties, subject to strict supervision by the law enforcement agencies of individual countries. The leading legal producer of opium is the Gregory process, whereby the entire poppy, excluding roots and leaves, is mashed and stewed in dilute acid solutions. The alkaloids are then recovered via Acid/Base extraction and purified. This process was developed in the UK during World War II, when wartime shortages of many essential drugs encouraged innovation in pharmaceutical processing. The French company Francopia produces 20% to 25% of the world's total requirement for legal opioids, with total sales of approximately €60 million. The UN treaty requires that every country submit annual reports to the International Narcotics Control Board, stating that year's actual consumption of many classes of controlled drugs as well as opioids, and projecting required quantities for the next year. This is to allow trends in consumption to be monitored, and production quotas allotted. The market for export of controlled drugs is fixed by regulation, in part due to the discovery in the 1930s that huge amounts of opioids had been diverted from the legal pharmaceutical market to the black market via a complex web of front companies and forged declarations. The main participants at that time were Swiss pharmaceutical producers and brokers, and the military regime in pre-World War II Japan, who claimed to be consuming thousands of tonnes of opium, morphine and heroin. The products were in fact transported to China, where opium was directly used as part of the Japanese policy of annexation of Manchuria.

A recent proposal from the European Senlis Council hopes to solve the problems caused by the massive quantity of opium produced illegally in Afghanistan, most of which is converted to heroin, and smuggled for sale in Europe and the USA. This proposal is to licence Afghan farmers to produce opium for the world pharmaceutical market, and thereby solve another problem, that of chronic underuse of potent analgesics where required within developing nations. In the industrialised world the USA is the world's biggest consumer of prescription opioids, with Italy one of the lowest. The Italian medical profession seems to have recently accepted that opioids have applications apart from pain relief in terminal cancer. Recorded Italian consumption has increased considerably of late.

To this end Senlis arranged a conference in Kabul, to discuss the idea, but it remains to be seen if this will happen; internal security and corruption issues within Afghanistan make it unlikely that they soon will be able to meet the stringent UN requirements for legal production of opioids for export. If the record of CIA interference with attempts to "buy and burn" illicit Burmese opium harvests in the past is considered (McCoy, 1991), Afghanistan's opium may be a major part of current War on Drugs policies for some time.