The use or abuse of opium, in its three main forms, chandu (prepared opium), morphine, and heroin, covers a span of 160 years, from the founding of “modern” Singapore in 1819—when opium was exchanged as a gift between the Temenggong (Malay Sultan) and Raffles (the founder of Singapore) to 1978—when the first person to be convicted of drug-trafficking was hanged for the offense. For the three distinct products of the opium poppy—smokeable extract of opium (prepared opium or chandu), morphine, and heroin—with their three distinctive modes of administration—smoking, injection, and inhalation—there seem to be three distinct periods when each drug emerged as the main drug of addiction. Opium smoking was known in the earliest days, morphine injection appeared during the first half of the twentieth century, and heroin smoking became popular during the 1970s. The history of opium smoking can be traced among the early settlers of Singapore. These people were multiracial, but the Chinese predominated. Morphine injection became popular among adult Chinese and Indian/Pakistanis after its introduction around the turn of the century. Heroin abuse has become widespread among multiracial groups of young adults during the 1970s. For each product of the opium poppy antecedent factors are examined: the drug, the host, and the environment, especially the presence or absence of favorable or deterrent official, commerical, cultural, or political responses. For opium smoking, there was no preceding drug of abuse, its use having been introduced by a prevailing older tradition. In the case of morphine, its introduction found fertile ground among the abundance of opium smokers and new inductees did not have to cross cultural barriers. In the case of heroin abuse, its introduction was facilitated by a milieu that had been initiated to drugs in a milder form—“pot and pills.” The author examines the nature of drug use from the point of view of an outsider, but retains a vested interest in treating and rehabilitating his patients “for their own good.” Having seen the essential tragedy of their lives, such as elderly men becoming “vagrants” remanded to a “House of Detention,” or the first morphine death from overdose in the first drug dependence clinic for young “pot and pill” users in 1971, he speculates on what might perpetuate opiate drug use among the people of Singapore. The paper concludes with identification of serious questions and profound issues that as yet have not been thoroughly addressed and may continue to remain inadequately treated.