The rare earths so essential to our modern technology have become a new diplomatic weapon—used to leverage influence and wield power, reshape global alliances, and exert economic dominance. For centuries, says Boston University historian Benjamin R. Siegel , opium was used in much the same way.
In his new book, Markets of Pain: Opium, Capitalism, and the Global History of Painkillers (Oxford University Press, 2026), Siegel “shows how this potent crop reshaped global trade, medicine, and geopolitics,” according to his publisher. Like the rare earth elements used in phone screens and electric car batteries, legal opium—the raw ingredient in many opioid painkillers—was a tool that could be wielded for societal benefit, but that also gave nations an opportunity to control supply chains and bend the world to their advantage.
An expert on economic, political, and environmental history, Siegel charts how a legal trade was managed and manipulated as a weapon of state power, and explores a history that spiraled into the opioid epidemic that gripped the United States. Much of his past research has focused on South Asia—he’s the author of Hungry Nation: Food, Famine, and the Making of Modern India (Cambridge University Press, 2018)—and the new book also highlights how geopolitical machinations were often made with little thought to the farmers and growers in India who relied on the opium trade for their livelihoods.
The Brink spoke with Siegel, a BU College of Arts & Sciences associate professor of history, about how opium became an essential instrument for managing pain and for exerting geopolitical influence—and what lessons history has for managing today’s opioid crisis.
The Brink: When did you first start looking into the opium trade and why?
Siegel: I started the research in 2015, when the opioid crisis had entered a devastating new phase—what public health experts now call the third wave, driven by synthetic opioids like fentanyl—and it had entered into our politics in new ways because of the racial politics of who was seen to be using opioids.
As a South Asianist, I’d been finishing a book about India’s agricultural history when a colleague mentioned that the pharmaceutical supply chains in her research all seemed to lead back to India—and not just to its modern pharma industry, but further back, to opium. I started pulling at that thread, working in archives in India, Turkey, and the United States. What I found was that the story of opioids wasn’t merely connected to 19th-century opium empires, but was continuous with them. The opium that British merchants forced into China in the 1840s and the fentanyl precursors flowing out of Chinese chemical factories today aren’t the same thing, but they’re part of the same longer story that connects to our present in unexpected ways.
What makes India so conducive to producing opioids?
India isn’t the largest producer of global opioids—that distinction belongs to Tasmania, which is where most poppy-based opioids are now grown. What makes India unique is that it’s the only country in the world still producing opium gum—the raw, hand-harvested commodity that goes back centuries—as opposed to poppy straw, which is the industrialized extraction method that most other producers use.
Opium gum is a commodity that has very little commercial value left for most of the world, but India has maintained the practice, in part because of the deep historical and bureaucratic infrastructure built around it during the colonial era. What’s distinctive about India is the institutional continuity: the systems the British built to manage opium production were inherited by the Indian state after independence and, in modified form, persist today. That’s one of the central stories of the book.
What has changed around how people see opioids since you first started this project?
When I started this project, we were in the middle of what felt like a national emergency; the opioid crisis was on every front page. People were furious, and rightly so. But I think the fury, and the sheer awfulness of what overprescription and its aftermath did to communities, has left people with a kind of blindness. We’ve been so burned by the consequences that we’ve lost sight of what makes opioids so powerful in the first place: their extraordinary ability to manage pain in meaningful ways. These are not just dangerous drugs. They are, and have always been, among the most effective tools we have for alleviating human suffering.
The challenge—and this is what the history shows over and over—is that opioids are a tool like any other. They can be wielded well or badly, and the difference has less to do with the molecule itself than with the political and economic systems that control who gets access to it, on what terms, and at what price. That’s as true today as it was in the 19th century.
People might be aware of the role of opioids in shaping modern medicine, not in shaping state power. How did they do that?
We’re living in a moment when everyone is talking about supply chains as instruments of state power—chips, rare earths, tariffs. But the control of supply chains as a tool of geopolitics is not new. Opioids are one of the original cases.
The power to classify a substance—to decide what counts as medicine and what counts as contraband—is one of the most consequential forms of sovereignty there is. The same molecule can be a lifesaving painkiller or an illegal narcotic, depending on who is producing it, who is selling it, and which government gets to make the rules. For most of the 20th century, that government was the United States. The international drug control regime that the US helped build didn’t just regulate narcotics—it gave Washington enormous leverage over the agricultural and trade policies of sovereign nations. Countries like India and Turkey, whose economies had been shaped by centuries of opium production, found themselves subject to American decisions about what they could grow, how they could process it, and whom they could sell it to.
This is both pharmaceutical regulation and the exercise of imperial power through the management of a commodity—which is exactly what the British were doing in the 19th century, just with different tools. The mechanisms change, but the logic is remarkably consistent: control the supply chain, and you control much more than the product.
What was the most evocative moment in your research and how does that encapsulate your book’s overall message?
I was in a poppy field in central India, talking to farmers whose entire livelihoods were tied up in the crop. It gave them meaning and security, even as the markets for what they grew had largely disappeared. Standing there, I felt a kind of sadness that I think encapsulates what the book is really about: the human ends of a very long chain of politics, economics, and beliefs about how the world should be organized. We tend to tell the opioid story from the consumption side—the overdoses, the prescriptions, the courtroom battles. But at the other end of that chain are families whose lives are built around a crop the rest of the world can’t decide whether to value or condemn. That tension—between livelihood and danger, between local meaning and global markets—runs through the entire history of opioids, from the 19th century to today.
What can history teach us about how we might manage today’s opioid crisis?
The most important thing history teaches is that we’ve been here before—and that each time, we’ve made the same mistake. Every generation since the US Civil War has treated its opioid crisis as unprecedented, and every generation reaches for the same kinds of solutions: a new regulation, a new formulation, a new technology that promises to give us the painkilling power without the danger.
History shows that the problem is never really the molecule, it’s the system around it: who controls production, who profits from distribution, who gets access, and who bears the consequences when things go wrong. Until we address the political and economic systems that shape how opioids move through the world, we’ll keep repeating the cycle.
Your wife is a BU anthropologist. How did her perspective shape your work?
My wife, Caterina Scaramelli , teaches in the Earth and environment department, and we share a fundamental conviction: that rural places matter, and that the people who work the land are not peripheral to the global economy but deeply enmeshed in it. We both study agriculture as a site where people connect to global markets and global ideas—and where they can be simultaneously plugged into those currents and left behind by them.
Her perspective sharpened my attention to the growers themselves. It’s easy, when you’re writing about opioids, to focus on the consumers, the corporations, the regulators. Caterina pushed me to keep asking: What about the farmers?