This paper examines the complicated origins of contemporary narcotics knowledge as well as the relationship between the markets (both illicit and intellectual) and technology that produce such knowledge. It traces the trajectory of narcotics research conducted in Egypt during the 1930s to the contemporary United States. Specifically, it shows how Egyptian doctors conducted studies on opiate consumption, withdrawal, rehabilitation, and the transmission of malaria via intravenous drug use that influenced approaches to public health in the United States. Drawing on this work, doctors in the United States produced research that continues to inform approaches to narcotics in the country, such as the understanding of withdrawal in studies concerning the current opioid crisis.
Three interconnected interventions emerge from this work that are relevant to policy makers and social scientists studying the opioid crisis in the contemporary United States. The first two are methodological: historical scholarship and popular media have often dismissed the sale and consumption of narcotics as criminal or immoral activity. This paper, however, acknowledges the political, economic, and, in particular, intellectual significance of illicit markets and those who engage in them. As a result, it shows how they produce intellectual markets that can span vast geographies and timeframes, such as those separating interwar Egypt and the contemporary United States. Additionally, this paper shows how medical technologies connect infectious and noninfectious epidemics both in terms of how patients experience them and how medical professionals understand them combining to constitute a public health crisis. Therefore, it promotes an understanding of substance use disorder as a combination of multiple public health concerns rendered visible, singular, and significant by the hypodermic needle. The third is historiographical: in framing Egypt as both a consumer of narcotics and an important producer of narcotics knowledge, this paper challenges the central position of the United States and Europe in the narrative of drug history and sheds light on the complicated webs of scientific knowledge production that underpin contemporary narcotics knowledge.