From opium to Oxycontin and fentanyl; the creation of Orientalism as a framework for American military and economic policy

Whenever there is a conversation about drug policy, health recommendations, criminalization, or the efficacy of pharmaceuticals, these are the questions to be asked: where did this “new” medicine originate? How was this medicine originally understood and respected? Where did it come from? Who was the first person or company to make money off of it, and who is making money off of it now? What does this medicine do to the body? What is everything that it does, not just its intended “effects” and “side effects?”

Every medicine developed within the Western healthcare system has a backstory. Often, it has more than one. The story of opium is the story of laudanum, which is also the story of morphine, codeine, heroin, and Oxycontin. Within all these stories is a dance between chemistry, cash, and control. Like all things have the potential to be, opioids have been used as both tools for the relief of pain and struggle–and also as weapons.

Hand drawn illustration of a red and white poppy flower with ruffled green leaves and seed pods.

Opium is an old medicine, created from the sap drawn from poppy pods in those lands surrounding the Mediterranean Sea. For more than seven thousand years, ancestors in Southwest Asia, North Africa, and China have gathered the dried sap as medicine. The sap is a gift, a nervous system support that helps settle inflamed or agitated bodies. Depending on how it is used, raw opium can be relaxing or can induce sleep. Raw opium instills a feeling of euphoria and connection, a feeling of being safe, protected, and without worry. It’s addictive, which means it is a medicine (like all medicines) that should be used with care and wisdom.

Because opium is powerful, it is also political. The primary groups of people who cultivated opium, made money off it, and asserted trade rights for the drug wove back and forth during the spread of the Roman Empire, Christianity, and Islam. The poppy was first brought to China by Arab traders starting in the year 400, and was integrated over multiple generations into the system of Chinese medicine as a pain reliever. For close to a thousand years, the medicine continued to develop in conversation between Chinese and Islamic practitioners. It supported the development of surgery as well as treatments for depression.

Opium was brought to European lands under Alexander the Great, as he conquered Northern and Western Europe. But after 1300, opium disappeared for over two hundred years from European practices and historical records. During the Inquisition, anything from the East (the far side of the Mediterranean) was seen as linked with the devil. Those focused on spreading Christianity as the “one true faith” saw opium as a dangerous drug.

By the year 1500, views in Europe had changed. The Portuguese first came up with the idea of smoking opium rather than taking it orally. Smoking made the experience of the drug far more intense. After the Portuguese established opium trade agreements with China, they marketed it not as a medicine but as a recreational drug; a source of pleasure and escape.

Starting in 1527, opium was marketed across Europe under a new name: laudanum. Also called the “stones of immortality,” laudanum was pitched as a safe and universal painkiller. As its popularity grew, other European countries tried to stake a claim in the market. In 1606, Queen Elizabeth I established trade agreements with opium farmers in India, establishing a local market focused on both pleasure-seeking and medicinal support. By 1733, the British East India Company–the corporation given a royal charter to do the monarchy’s business in the colonies–had a monopoly on the opium trade. All poppy growers in India were forbidden to trade with anyone other than the British East India Company. The opium trade continued to grow as more varieties entered the market.

Laudanum was everywhere in the colonies

Colonial physicians carried a range of forms of opium with them as they moved across newly settled lands. Opiates were advertised as a medicine to settle nervousness, to end the pain of children’s teething, to cure sleeplessness, tantrums, and more. Through the spread of these drugs, “pain management” began to be seen as part of the responsibility of a doctor.

Black and white newspaper advertisement for laudanum with

Prior to the introduction of laudanum, doctors were not expected to stop patients’ pain–nor to make money off of treatments for pain management. Pain was part of life, and selling treatments for pain was seen as a form of charlatanism: lying about a medicine’s effects in order to make a profit. But following the introduction of laudanum and other opium products, an “effective” doctor became seen as one who could make pain go away. “Pain-free” became another way of describing health. Meanwhile, many doctors themselves became addicted to opium, advocating for its wider availability so that they could also access it themselves.

The laudanum market initially grew without standardization or regulation, as prescriptions were not required for medicine. Instead, pharmacists “diagnosed” an illness and then provided “remedies” based on what they thought would work–or based on the marketing that had reached them. Anyone could create a laudanum product and get rich.

Meanwhile, the global opium market continued to expand. In 1750, the British East India Company took over Bengal and Bihar in order to control their opium supply. The British hyperfocus on the opium trade supported the fight for American independence, as Britain decided to cut its losses and withdraw from its colonies on Turtle Island.

By 1800, Britain had extended its monopoly over opium in India to include Turkey and China. Buying from China was complicated. In the early 1700s, the Chinese Emperor, Yung Cheng, had prohibited opium smoking and non-medicinal use after becoming concerned with its impacts. China, at this point, was trading with the Netherlands and elsewhere. Despite the bans on opium use, there remained a large market in China due to the drug’s addictive qualities. British and newly-independent American traders began smuggling opium back into China to sell recreationally, while also monopolizing the harvest of opium fields grown by Chinese (as well as Indian and Turkish) farmers. As happens with many cash crops, British traders sold opium back to China at a higher price than they had purchased it. As the British Empire grew, colonial forces sought new sources for the poppy and created new industries for extracting opium, sometimes selling it back to the very communities that had grown the plant.

A crowned figure lying in bed reaches for another crowned and bearded figure wearing a toga and standing beside them.

In 1805, the ingredient in opium that causes both sleepiness and euphoria was isolated by a German pharmacist’s apprentice. He named the substance “morphine” after Morpheus, the Greek god of sleep and dreams. While the chemistry for modifying opium to isolate morphine was now available, it would take time before this new medicine was marketed. Scientists called morphine "God's own medicine."

American corporations begin trading Opium, leading to the first “Opium War”

As the opium trade continued to grow, multiple American national and corporate interests entered the profitable opium trade. The American Fur Company had been started by John Jacon Astor to compete with two British Canadian colonial companies: the Hudson Bay Company and the North West Company. Astor worked to expand the American Fur Company and establish an opium trade between the United States and China. In the United States, the demand for opium–and other trade goods from China, including silk–was high, whereas Chinese interest in American and Canadian goods remained low. Tension grew between the American Fur Company and the Hudson Bay and North West Companies over trade relations with China. Astor chose to smuggle opium into China for recreational use despite the Chinese ban, becoming the United States’ first multi-millionaire. He then used this fortune to develop New York City, buying a series of farms on Manhattan Island and beginning to build the waterfront as a primary site for global economic trade.

In 1839, Chinese leaders wrote a public letter to Queen Victoria of England calling for an end to the opium trade. England still led in the import of opium to Western consumers, even as American companies were also entering the market. One of the authors of the letter, Lin Zexu, a Chinese philosopher and politician, questioned the morality of Britain’s support of the opium trade due to the harm it caused people. A few years later, he followed up with a call for the seizure of all opium ships. This resulted in the First Opium War between Britain and China. China was defeated in the war and as a result, lost control over Hong Kong. Hong Kong was then organized by the British as a key port for bringing opium out of China and into the West. Opium production exploded, increasing access across the world, including the United States and Canada.

In 1840, while the First Opium War was still being waged, New Englanders brought 24,000 pounds of opium into the United States. The sheer extent of the opium being imported into the country led to the first ever duty regulation established by the United States port system, created solely to manage the importation of opium.

As British imperialism increasingly impacted the Chinese economy by diverting opium profits outside of the country, poverty increased in China and, as a result, waves of Chinese immigrants left to find work. Many of these immigrants settled on the West coast of the United States and Canada. In 1851, the Chinese population in the United States was recorded at just over 2,000 people. Only 40 years later, an additional 350,000 people of Chinese descent were recorded in 1890.

In 1853, Dr. Alexander Wood of Edinburgh opened the possibility of injecting morphine with the creation of the hypodermic needle, leading to a quicker and stronger route for ingesting the drug. Interest in opium continued to grow.

The Second Opium War

The political and economic battle to control the opium trade continued, as Western countries began to join forces to expand their imperial control over China. In 1856, the Second Opium War began, initially fought by Britain, France and China and eventually joined by the United States and Russia. This Western alliance used the language of bringing “freedom of religion” to China as justification for the war, but their strategy focused on retaining and expanding Western control of opium production, including expanding access to key Chinese ports. Lasting four years, this war effectively destroyed the Qing dynasty while also “opening up” China to Western trade and Christian missionaries. It also forced the re-legalization of the opium trade (and opium use) across China.

Meanwhile, back in the States and Canada, xenophobia directed towards Chinese people continued to increase. Chinese people were perceived as both an economic and a cultural threat to the United States. In 1861, Nevada passed a law banning marriage between “Chinese” and white people. At the time, "Chinese" was used to designate anyone of Asian descent. This was the first time that marriage between white and Asian people was outlawed in the United States, joining laws against marriage between white and Black people, also known as "mulattoes," and Indians. Fourteen states soon followed Nevada in passing a slew of anti-miscegenation laws. These began predominantly in the West, where Chinese and other Asian communities were the largest. Along with these laws, Anti-Asian violence increased in communities across the country.

A black and white photo of workers carrying heavy bundles of sugar cane.

In 1862, President Lincoln signed a law prohibiting what he called the “coolie trade.” “Coolie” was a racist term used to refer to Chinese and other Asian people. According to Jung (2000), "the word coolie was first used in the 16th century by European traders across Asia. By the 18th century, the term referred to migrant Indian indentured laborers. In the 19th century, during the British colonial era, the term was adopted by the transportation and employment of Asian laborers via employment contracts on sugar plantations that had been formerly worked by enslaved Africans.”

Lincoln outlawed any “shipment” of Chinese people designed to be "held in service or labor,” such as workers on farms or in private homes. The law was contradictory, however: in order to appeal to the surge of voters espousing anti-Asian racism, the first part of the law attempted to control Chinese immigration, while another section left a door open. This second section stated that "any free and voluntary emigration of any Chinese subject” should proceed unabated so long as a U.S. consul “attested to the voluntary status of the migrant through a written certificate” (Britannica, n.d.), requiring Chinese people to secure the state’s approval in order to work.

Opium Use in the 1800’s

After the Second Opium War ended in 1860, access to opium in the United States expanded at a high rate. By 1865, over 10 million opium pills and over 2.8 million oz. of opium powders and tinctures were distributed to soldiers in the Civil War, both Yankee and Confederate. Opium was given to soldiers as a treatment for fear, anxiety, pain from wounds, sleeplessness, hunger and more.

In order to meet this increase in opium demand, production had to expand. The United States brokered agreements with Mexican and Guatemalan farmers to begin opium production for the U.S. market. U.S. funders paid Chinese opium farmers to develop new strains of opium that could be grown on Mexican and Guatemalan soils, including partnering with local Mexican and Guatemalan farmers to teach them how to grow the poppy. Up until this point, there had been no opium farming economy in the Americas.

After soldiers returned home from the Civil War with their new dependence on opium, physicians met that dependence by increasing the “medical” distribution of opium to the returning veterans. Researchers in the United States and elsewhere continued to further develop opium “products” for market, at the same time as new technology such as the hypodermic needle opened up other pathways for drug use. Chemists looked for ways to improve the drug. Laudanum and morphine both made some people nauseous, negatively impacting the drug’s narcotic effect. In 1874, a British researcher combined morphine with a chemical agent and created heroin, discovering that it was less likely to cause nausea and constipation than other forms of opium.

As opium use and trade continued to grow in the U.S., so did xenophobic violence and anti-Chinese policies. U.S. attitudes toward China continued to be a mixture of need, resentment, and rage. The San Francisco Health Board blamed every single epidemic that erupted between 1870 to 1905 on Chinese immigrants, despite there being no reason to blame this community for the outbreaks of diseases such as smallpox and cholera. Anti-Asian racism continued to rise across the country.

In 1875, the Page Act was passed, becoming one of the United States’ earliest immigration exclusion policies. The Act banned people identified as "criminals," sex workers (largely perceived to be Chinese at this point), and Chinese contract laborers from entering the United States. Advocates for the Act combined an economic argument–reducing “American” (meaning white) competition with Chinese workers–with far more targeted Anti-Asian racism. In particular, the Act purported to protect whiteness by effectively blocking the entry of "unmarried" Asian women, promoting the perception that single Asian women were dangerous to white morality.

The “Yellow Peril”

The concept of “yellow peril” emerged to refer to Asian communities - particularly Chinese immigrants. The phrase is derogatory and xenophobic, used to imply that Asian immigrants are dangerous to Americans. In particular, the “yellow peril” is code for beliefs around Chinese people bringing disease to the United States, expressing a dangerous sexuality, selling and expanding narcotic use, and threatening the white American economy. The notion of a “Yellow Peril” first emerged in Germany in 1870, when the German Kaiser used the phrase “die Gelbe Gefahr” to encourage German imperialism and justify European colonialism in China. The concept soon came to be used by imperial interests across Europe and the United States to justify xenophobic violence and economic policies against China.

In 1875, the same year as the passage of the Page Act, the city of San Francisco passed the nation’s first drug law, banning the smoking of opium in opium dens. Advocates for the Opium Den Ordinance used anti-Chinese racism and xenophobia to justify the law’s passage, blaming opium use on groups they framed as dangerous outsiders. There was zero public discourse at the time, however, about the widespread use of opium by the military as a cure-all for physical, emotional, and mental pain, which was a major driver of dependence on the drug.

At the same time as the Opium Den Ordinance was passed, a new economy of treatment centers and other institutions for dealing with the impact of addiction was emerging. In 1879, the Keeley Institute in Illinois opened in Illinois as the first medical treatment center to treat addiction as a disease rather than a “moral failing.” Within a few years, the Keeley Institute became the largest addiction treatment center in the country. While Keeley asserted a disease model for addiction, the institute continued the practice of blaming “others” for opium addiction. Keeley saw Arab people as the instigators of opium addiction. Through the institute’s marketing and within their treatment language, Arab people were described as “pushing opium dreaming” on otherwise “productive” American citizens (Hickman, 2000).

Orientalism, the framing of “Eastern” cultures as inherently “other” and exotic, has evolved over many generations. It was particularly used to justify the Christian Crusades and the building of a Christian empire. Within the ideology of Orientalism, Christians are seen as innocent, sacred, or pure victims who are under threat by terrifying, scheming of people from the East: i.e., Arab people, Chinese people, and others. Orientalist storylines describe people from Southwest Asia and North Africa as “dreamy” as opposed to “rational” Westerners; “exotic” as opposed to “normal;” pleasure-seeking as opposed to disciplined; spiritual as opposed to practical, and so on. Orientalism exists to create a cultural opposite, by defining a group of people who might almost be like “us”–implicitly defined as Christian Europeans–but not quite. It works alongside anti-Blackness and anti-Indigeneity as a strategy for justifying cultural, economic and political imperialism. And it very neatly blames people seen as pleasure-seeking, dreamy “outsiders” for bringing the “weakness” of addiction–as well as various forms of disease–into the “disciplined” and “principled” Christian West.

Orientalism not only defined policy in the 19th century U.S., but also became a rallying cry for violence. In 1880, Irish immigrants in California rioted against Chinese immigrants, blaming them for the spread of opium, as well as for stealing “American” jobs. These Irish immigrants, newly welcomed into white identity alongside their generations-old oppressors, the British, violently forced Chinese immigrants to leave their jobs and homes in California. Wave after wave of Irish anti-Chinese violence eventually contributed to the passage of the Chinese Exclusion Act.

A stereotypical depiction of an Asian person carrying a tray with pipes; white people lounge in the background smoking and with dazed looks.

“Opium dens” were spaces dedicated to opium use with a kind of harm reduction approach, and were originally located primarily within Chinese communities and for Chinese use. As Chinese community members were targeted, other people stepped in to take over the opium trade. The disruption of Chinese-American economies by xenophobic violence resulted in an increasing number of French and American-born white women stepping in to take over the dens. Even as ownership began to shift toward more white folks, newspapers continued to describe the dens as exclusively Chinese-run, using racist imagery to describe places defined as dirty, dangerous and immoral.

In 1882, xenophobic rage prompted the passing of the Immigration Act of 1882, often known as the “Chinese Exclusion Act.” Immigration at this point was denied to all Chinese workers, with all former contradictions and loopholes removed. The language used to justify this exclusion relied, once again, on anti-Asian racism, fear of disease, and labor unrest. The Act also prohibited entry to the United States by "any lunatic, idiot, or any person unable to take care of himself or herself without becoming a public charge.” Immigrants perceived to be “costly” (by virtue of needing care or support from the state) were thereby also excluded.

This Act marked the beginning of several decades of sweeping exclusions of groups considered "undesirable" by the US government. Written accounts of the threat to the purity of the “Christian ideal” and of whiteness by “exotic” infidels became everyday occurrences in the mainstream. Narratives about the degradation of innocent white women showed up across the media and popular culture. In New York City, Reverend John Liggins printed op-ed pieces framing opium dens as the primary contributor to “the downfall of innocent girls and the debasement of married women” (Liggins, 1883). Stories like this ran in papers across the country.

White people were the primary users of opium in this time period. There was very little use of opium in Black communities in either the North or the South. Authors of Southern newspaper articles wrote that there were hardly any Black people who were "opium eaters." Unlike white soldiers, Black soldiers were not given opiates to deal with battle wounds and pain due to the racist assumption that Black people have a higher tolerance for pain, which prevented the rise of opiate addiction in Black communities.

In 1886, JD Roberts, a white doctor in North Carolina and the author of a popular book on Black people and medicine, wrote that: "Black bodies lacked 'the same delicate nervous organization' as whites, and thus 'd[id] not demand the form of stimulant conveyed in opium' as did whites. Black people also had a 'general ignorance' of medical care, an assertion implying that Black Americans lacked the knowledge to care for their health needs by self-medicating with opiates, as whites often did" (Jones, 2021). In this case, anti-Black racism was used to shore up an ideal of whiteness defined by both innocence (i.e. vulnerable white women) and intelligence (white people possessing the know-how to use opiates to manage pain).

The narratives of white supremacy continually shapeshift. In this case, opium now became described as dangerous because it was perceived to transform the very whiteness of the white race. In 1887, the myth of a “racial transformation” prompted by eating opium began to appear in the media. Samuel Collins, promoter of the "Painless Cure" for addiction, described Mrs. Jones, an opium eater, who became “yellow” as a result of eating opium. He writes, "the opium was yellow, she lived in a yellow house, and she had yellow skin” (Hickman, 2000). This paradoxical notion of race as both essential and unchangeable and also transformable through behavior drove exclusion policies directed at controlling the “Yellow Peril,” which was understood as both an excess of Chinese immigrants and the threat of drugs and disease they were thought to bring to the country, weakening the white population. And the shapeshifting of white supremacist narratives continued: tabloids began to publish anti-drug advertising that focused primarily on the myth of white women being seduced by Chinese men to smoke opium, focusing on the protection of “innocent” white women.

State Control & Privatization of Opium

In 1890, in a supposed attempt to end the importation of opium, the U.S. Congress imposed a tax on opium and morphine. This was the first federal legislation regulating narcotics and it focused on increasing revenues for the state, not specifically on ending opiate use.

A sign from Bayer Pharmaceutical advertising aspirin & heroin, the sedative for coughs.

In 1895, Bayer company began the commercial production of heroin. While initially only available in hospitals as a pain reliever, by 1898 Bayer was marketing heroin as a cough suppressant. The name “heroin” came from the German word for hero. Heroin was marketed as the safer opium product, carrying the same pain-relief as other opiates but without the same addictive qualities and uncomfortable “side effects.” In 1900, the Saint James Society, a Catholic society focused on serving unhoused communities and people living in poverty, began providing free heroin to people living with morphine addiction.

As various new types of opiates began to be developed, each generated new opportunities for wealth generation in Western countries. Meanwhile, the “old” form of opium was labeled as dangerous and addictive, with blame for its use most often placed on Asian communities. In 1900, the Journal of the American Medical Association directly condemned Chinese community members for instigating opium use. The journal printed the story of a young white teacher who learned to smoke opium from her Chinese students and later died. The journal called for police raids on Chinese communities and named white “virtue” as being in danger of “pollution” by Chinese opium use. At the exact same time, heroin was promoted as a safer, cleaner drug.

In 1900, the first federal drug prohibition law was passed in the United States: the Smoking Opium Exclusion Act. The Act prohibited the importation and use of opium for smoking or other non-medical purposes. It led to an immediate increase in the cost of opium and pushed those experiencing addiction towards the cheaper “alternatives” of morphine and heroin. By 1914, the Smoking Opium Exclusion Act was expanded with the passage of the Harrison Narcotics Tax Act. The Harrison Act broadened police powers and established a federal list of prohibited drugs, including all opiates (morphine and heroin as well as opium) for non-medical use. Some, but not all, coca products were also prohibited. Chinese communities continued to be blamed for the misuse of opiates, while Black communities were blamed for the misuse of cocaine. Fear-based racist and xenophobic advertising and op-ed pieces proliferated across the United States, all designed to support the passage of the Harrison Act. All “opium dens” were ordered to be closed, with the last one closing in 1957 in New York City.

Once the Harrison Act was passed, opiate use was more heavily controlled. Opiate use began to decrease across the United States. Overall narcotics use had reached an all time low in the 1950s, until a shift in global economic strategy motivated the United States to once again open its doors to opiates. The shift was prompted by the United States bringing greater focus to Southeast Asia as part of its ongoing economic competition with China and campaign to limit the “spread” of communism in order to maintain US capitalist dominance.

After the Chinese Revolution in 1949, Chinese national influence had expanded to include an area in southeast Asia called the “Golden Triangle,” where Thailand, Laos and Myanmar meet. This area is one of the main global regions for the production of opium poppies. Chinese interest in this area was perceived as a threat to U.S. economic security. The United States, along with France, worked to build alliances with local leaders to maintain their support for Western capitalism in opposition to Chinese communism. The United States and France supplied local drug producers with ammunition to fight Chinese advancement, as well as provided financial support to enable the production and distribution of opium. Opiate sales increased to the United States, supposedly illegally. Heroin comprised the majority of these sales, branded as the newer, flashier opiate. Because the active ingredients in the opium poppy are distilled to create heroin, it brings about faster highs–and also faster addictions. Expanded U.S. military presence in southeast Asia brought more American soldiers into contact with cheap and accessible opiates, and use in the military again increased.

Narcotic dependence and the Vietnam War in the 1960s

New opium derivatives also continued to emerge. Fentanyl was first developed in 1959 as a synthetic opioid, initially marketed as a surgical anesthetic.

In 1961, the American government entered into a new international treaty focused on the production of opium. The United Nations Single Convention on Narcotic Drugs called for the prohibition of opioids outside of scientific and medical use. In particular, it called for the eradication of non-legalized opioid use within 15 years. In 1969, urinalysis was conducted on everyone entering a jail in Washington D.C. over the course of a month. Over that month, 44% of the people entering the jail tested positive for heroin use (PBS, n.d.).

In 1970, as part of its continued campaign to prevent the “spread” of communism and maintain U.S. dominance in southeast Asia, the Central Intelligence Agency (CIA) set up a charter airline specifically dedicated to transporting raw opium to the United States and Europe. The number of people addicted to heroin during the early 1970s exploded rapidly, reaching an estimated 750,000 people within a few years. Cheap and accessible heroin entered the street drug economy, thanks to the CIA’s drug pipeline.

Once again, treatment strategies also expanded along with the explosion in opiate use. In response to the increase in addiction across their communities, the Young Lords and Black Panther Party established acudetox programs, using acupuncture to support people in detoxing from heroin and other opiates. Lincoln Detox Center in New York, led by the Black Panthers and Dr. Mutulu Shakur, created an acupuncture protocol for opiate detox that is still in use today. In the same year, the Narcotics Treatment Institute was founded, focusing on methadone treatment as a harm reduction response to heroin. The program was controversial because some believed that trading methadone for heroin just meant trading one addiction for another. This led to increased education on the importance of harm reduction, or the reduction of the negative impacts of substance use.

Richard Nixon was elected in 1970 on a platform that included addressing heroin addiction. Nixon declared drugs “public enemy number one,” launching a “War on Drugs” and promising to fund programs to decrease drug use and addiction in the United States. Operation Golden Flow specifically focused on heroin addiction among servicemen. The U.S. military announced a urinalysis of all servicemen returning from Vietnam. One of Nixon’s top aides, John Erlichman, later admitted: “You want to know what this was really all about. The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and Black people...We knew we couldn’t make it illegal to be either against the war or to be Black, but by getting the public to associate the hippies with marijuana and Black (people) with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did” (EJI, 2016).

The campaign to control drug use was also used to build patriotic interest in the Vietnam War, without acknowledgement of the CIA’s role in expanding opiate access in the United States. Political language focused on controlling the production and exportation of opium from Southeast Asia by controlling the spread of communism.

Image of pills, a needle, a spoon, and white powder, representing various ways to ingest narcotics

After the war in Vietnam ended, the CIA stopped chartering the transport of opium into the United States. Heroin production then moved almost exclusively to Mexico and Guatemala. Poppy farming had first begun to scale up in Mexico after the United States’ demand increased as a result of the Civil War. Now, as addiction rates continued to climb in both the United States and Mexico, the two governments joined forces to spray agent orange, a chemical used in the Vietnam War, on poppy fields across Mexico. This attack significantly decreased opium (and then heroin) production, while also spreading environmental destruction.

America, Opium, and Afghanistan

Opium production also increased in Turkey and then, in the 1980s, in Afghanistan. Fariba Nawa (2012) writes: “It was in the 1980s with the help of the American government that Afghanistan became a major producer of opium. Ronald Reagan’s government looked the other way when Mujahideen guerrillas encouraged farmers to plant poppies and used those profits to buy weapons to fight the Soviets.”

U.S. American reliance on opium produced in Afghanistan has shifted directly in relationship to changing political leadership within Afghanistan. While Afghanistan was directly focused on fighting the Soviet Union, the United States stayed silent and even supported the Mujahideen. When the Taliban first took power, the United States initially supported their leadership, claiming that the Taliban would end opium production and decrease global heroin use. However, the Taliban did not stop the growth of the emerging illegal narcotics economy, as a way to build political goodwill with farmers in the poppy-growing regions and to support economic recovery after the devastation of the Russia-Afghanistan war. Support for the Taliban solidified amongst poppy farmers, who were able to grow and sell their product with limited government interference.

An outstretched hand holding an opium poppy seedpod with a whorled crown on top.

For the Taliban, the contradiction between heroin use (which goes against the cultural laws promoted by the Taliban) and the desire to support rural economic development led to a series of both increased and decreased regulations for poppy growers throughout the late 1990s and into the 2000s (Felbab-Brown, 2021).

The relationship between the United States and Afghanistan during this time was multilayered: the U.S. was attempting to secure access in the region for oil production at the same time as the Taliban fought against western cultural imperialism. All of this mixed with the complex dynamics of the opium trade to create the conditions for the United States’ War on Afghanistan from 1999-2021. Stopping opium production was one of the many justifications used for the continuation of this war, though the anti-narcotics narrative moved in and out of focus throughout the war’s 22 years. It wasn’t until 2005 and 2006 that the United States military actively worked to stop opium production by encouraging the Afghani government to spray poppy fields, promising alternative employment for the poppy farmers. When the alternative employment never materialized, the Taliban stepped in with support for rural farming and, in particular, poppy production.

The rise of prescription painkillers

Throughout the 1980s and 1990s, American recreational drug use shifted from heroin to the drugs of the coca plant: specifically cocaine and crack cocaine. While the Reagan Administration’s War on Drugs made it harder to buy and sell heroin in the United States, the market did not entirely disappear. Meanwhile, an entirely separate market was being developed; a “legal” market again tied to a prescription painkiller.

Visual graphic of oxycontin pills in 10, 20, 40, 80, and 160 milligram formations.

In 1996, Purdue Pharma began marketing Oxycontin, using data-targeted promotion tactics to promote the drug to physicians as well as offering a starter coupon program to patients. Derived largely from opium grown in Tasmania, Oxycontin was marketed as a newer and better, addiction-free opioid, just as morphine and then heroin were initially sold to the consumer. Drug prescriptions largely targeted poor white Southern and rural communities. Despite the unclear benefits of OxyContin in reducing pain for non-cancer patients and mixed research on the drug's potential to be abused, the drug became popular. Prescriptions rose from 670,000 in 1997 to 6.2 million in 2002.

In 2007, after multiple consumers and the family members of those who had died from OxyContin overdose sued Purdue Pharma, the corporation pleaded guilty to multiple criminal charges, including defrauding federal health agencies and striking illegal deals with drug manufacturers to increase OxyContin prescriptions. The company settled for over 5 billion dollars. While legal surveillance began to be extended to the medical use of opioids, the reality of thousands of Americans dealing with opioid addiction did not disappear.

The move to regulate opioid use in the American medical system led to an increasing number of Americans with opiate dependence losing their legal and medical supply. By 2017, poppy cultivation in Mexico, Guatemala, and Colombia had exploded, flooding the American market with heroin and other opiates. By this point, fentanyl had also exploded on the market.

In the 1980s, new drug delivery systems such as skin patches and nasal sprays had expanded opioids for medical use. These new drug delivery systems, combined with the ability to produce fentanyl synthetically, meant that by the 2010s, illegal laboratories for fentanyl production began to emerge. The quality and strength of the drug produced for the street economy varies largely from one batch to the next. Often marketed as heroin, fentanyl is generally stronger than heroin, resulting in an increasing number of deaths through overdose. Since 2014, overdose deaths due to fentanyl have risen from close to zero to over 80,000 (Hedegaard et al, 2021).

Vials of Fentanyl in a row, some in focus and some blurred in the background.

With many fentanyl labs located in Mexico, anti-immigrant fear and backlash to drug smuggling began to once again grow. Racist narratives call out Chinese producers of the chemical compounds needed in the creation of fentanyl as well Mexican drug cartels, ignoring the fact that this economy was initially created by the United States in response to opiate needs after the Civil War. In more recent years, U.S. Congresspeople have attempted to draw racist links between Wuhan, China as the origin of COVID-19 and as a center of fentanyl production.

While heroin, morphine, Oxycontin and more recently fentanyl are still highly used forms of opioids, research and development into a variety of new forms continues to move forward. Here is an incomplete list of the drugs that have so far been created from the use of the opium poppy: IV hydromorphone (aka Dilaudid), codeine, morphine, hydrocodone, hydromorphone, oxycodone, buprenorphine, propoxyphene, dextropropoxyphene, methadone, diphenoxylate, loperamide, fentanyl, alfentanil, sufentanil, remifentanil, pentazocine, tramadol, butorphanol, nalbuphine, levorphanol, tramadol, nalmefene, naloxone and naltrexone, hydrocodone-paracetamol (aka Percocet), and meperidine, just to name a few (Bionity, n.d.). On the streets what is used varies by location but in general, synthetic oxycontin and fentanyl are in highest use from coast to coast (Lail et al., 2014).

It’s only a matter of time before Big Pharma and/or drug producing empires will use pharmaceuticals as a way to further control communities and increase militarization to protect cash crops. This is the cycle on repeat. Most often, the same communities and bodies that are targeted and blamed are those struggling with addiction; which, at the end of the day, is merely another way of trying to survive. Liberatory harm reduction – a framework introduced to many of us by Shira Hassan in Saving Our Own Lives – reminds us that there is nothing new about this pattern: whether using heroin or oxycontin, crack cocaine or speed, our people self-medicate when they have no other way to tolerate otherwise intolerable conditions.

Sources Cited:

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