CHAPTER 17

Extraction Is a Drug: A Brief Racial History of Pain, Policing, and Pandemics

Jih-Fei Cheng

George Floyd was born in Fayetteville, North Carolina, and grew up in the predominantly Black community of the Third Ward in Harris County, Houston, Texas. Despite the structural racism he experienced in the US South, Floyd showed promise as a basketball and football athlete, garnering the nickname “Big Floyd” for his 6′6″ stature. Underfunded and underresourced schools, however, meant that Floyd found himself more often facing intense policing, criminalization, and drug addiction throughout his life.1 Between 2015 and 2016, Harris County saw a sharp increase in drug overdose mortality, with methamphetamine overdose deaths rising sixfold since 2010.2 Floyd moved to Minneapolis in 2017 looking for a fresh start. His childhood friend, Christopher Harris, told him that Minneapolis “was a great place” and that “there wasn’t much racial stereotyping as there was down South.”3 When Floyd initially moved to Minneapolis, he roomed with friends he met in rehab. They slept together on mattresses in the living room to watch over one another and ensure the other didn’t go astray, with Floyd constantly reminding his friends how much he loved them.4 Like many others during the onset of the COVID-19 pandemic in 2020, Floyd lost his job as a bouncer and found himself once again looking for work and experiencing downward social and economic mobility.5

Since the COVID-19 pandemic, drug addiction and overdoses, especially from opioids, have dramatically risen in the United States and worldwide.6 In August 2023, the World Health Organization (WHO) updated its reporting: “The number of opioid overdoses has increased in recent years in several countries” because of “increased availability of opioids used in the management of chronic pain” and also because of “highly potent opioids appearing on the illicit drug market.” “Chronic pain” and “highly potent opioids” are factors of the epidemic drug overdoses and deaths; however, the report makes no connection between the two or to COVID-19. Instead, the report lays blame on the “illicit drug market,” presumably catering to the “viral underclass” of which Floyd belonged.7 The report fails to address the persistent convergence between increased opioid addictions and deaths and emergent viral pandemics that have become endemic. With our scrutiny turned away from biotechnology corporations, opioid market regulation has been left to the intensifying the so-called War on Drugs.

On May 25, 2020, law enforcement officers’ violent “subdual, restraint, and neck compression” of George Floyd resulted in his “cardiopulmonary arrest” and “homicide.” County coroner and independent postmortem reports are archived online, providing time-stamped public records of Floyd’s tortured asphyxiation, lasting into digital perpetuity. Each one reads like a pharmaceutical invoice as well as a colonial document for medical apartheid. “Other significant conditions” noted in the report include “arteriosclerotic heart disease,” “hypertensive heart disease,” and the presence of fentanyl, methamphetamine, and THC. A “postmortem nasal swab” tested “positive for 2019-nCoV RNA by PCR.” Evidence of “sickle cell trait” is recorded. Floyd’s blood, cells, tissue, mucus, and skin have become an accounting of the pharmacological management of pain in his body. His autopsy report reads as the legacy of historical subjects enslaved and dispossessed by the plantation economies of Euro-American settler colonialism. Floyd’s postmortem “asymptomatic” COVID-19 diagnosis points to an underinvestigated history of pain at the crossroads of the opioid epidemic, 2019-nCoV viral transmissions, and policing.8

US president Joe Biden’s critical national security priorities emphasized US “military readiness” in support of Israel’s genocide of Gaza and ethnic cleansing of Palestinians, bolstering Ukraine’s defense against Russia, and facing off China in the Indo-Pacific.9 The priorities calls for intensifying law enforcement and border patrols to “stop the flow of fentanyl into our country.” We cannot ignore the entanglements between opioid painkillers, viral pandemics, and US global securitization. Pain, policing, and pandemics structure systemic global health inequalities and disease crises now managed as chronic conditions underwriting biotechnologies and justifying campaigns of state violence and military imperialism.

Historically, epidemic heroin injection, addiction, and law enforcement have played equal roles in the global transmission of HIV/AIDS and the US launch of the War on Drugs. Floyd’s autopsy report prescribes biotechnologies and law enforcement as conditions spurring widespread modern health crises rather than their solutions. The opioid levels recorded in his postmortem report chemically surveil the pain in his brain and body. His police torture and murder attest to the differing values assigned to pain based on colonial histories of race and the disciplinary mechanisms deployed against enslaved subjects and indentured servants to scale plantation economies. Floyd’s postmortem, “asymptomatic” COVID-19–positive diagnosis in the War on Drug/Terror remarks on state armed and militarized forces wielding systematic torture, pain, and death to widen global, racial, and class divides by massively murdering and displacing peoples in wars waged over industrial extraction and causing environmental attrition.

Pain, Laboratory Medicine, and War

Floyd’s police murder archives what Robin D. G. Kelley calls the “casualty of a war” waged for the past five hundred years to colonize and disenfranchise African Americans.10 Laws criminalizing Black consumption and independent entrepreneurship of drugs such as tobacco and marijuana descend from chattel slavery. As plantation capitalists used armed soldiers to prevent enslaved people from organizing their own labor, sharing their harvest, and turning their own profit, today’s policing of opioids explicitly targets Black, Indigenous, Brown, and people of color communities. Viewing reports about Floyd as a corpus for the modern laboratory management of pain demands a political economic analysis of how a protracted war is waged using biotechnologies as a measure for pain calibrated by race. This archive reveals how racialized poverty, drug policing, and incarceration result in a global securitized medical apartheid historically rooted in the plantation economy and chattel slavery.

Like Eric Garner, who was assaulted and choked to death in 2014 by police for reportedly selling loose cigarettes, Floyd was arrested after being accused of using counterfeit bills to purchase tobacco. Like Michael Brown, whose toxicology report revealed “recent marijuana use,” Floyd’s execution was sensationalized over reports that he tested positive for opioids. In 1969, African American Robert Rayford died at age sixteen with Kaposi sarcoma, pneumonia, chlamydia, and traumatic injury. Like Floyd, Rayford’s postmortem tissue, blood, and cells posthumously revealed in 1988 that he passed with HIV/AIDS-related illnesses.11 Since the public health recognition of HIV/AIDS over a decade later, in the 1980s, Black/African American and Hispanic/Latino communities remain disproportionately affected by HIV compared to other racial/ethnic groups. Black women are disproportionately affected by HIV as compared to women of other races/ethnicities. Of the HIV diagnoses among transwomen, most are Black/African American.12

COVID-19 repeats this racial pattern. Black, Indigenous, Latinx, and other people of color are the most infected by COVID-19, while “nationwide, Black people have died at 1.4 times the rate of white people.”13 The COVID-19 era also marks a surge in police violence against Black and people of color communities, creating a synergy of epidemics, or “syndemic,” that can be traced more recently to the militarized medical apartheid entrenched by US president Richard Nixon at the time of Rayford’s mysterious passing.14

When Rayford was admitted for medical care in 1968, St. Louis’s City Hospital was still dismantling its de facto racial segregation to comply with US president Lyndon B. Johnson’s Medicare and Medicaid Act of 1965. In 1969, the same year that Rayford passed with undiagnosed HIV/AIDS, the newly elected President Nixon announced, “New York City alone has records of some 40,000 heroin addicts, and the number rises between 7,000 and 9,000 a year.” Two years later, he declared that “America’s public enemy No. 1 in the United States is drug abuse. . . . [T]o fight and defeat this enemy, it is necessary to wage a new all-out offensive.”15 Rayford’s postmortem report contained no reference to heroin. However, latter-day HIV/AIDS activists have contended that “vulnerability to AIDS was seen as inseparable from the disproportionate conditions of poverty, criminalization, and violence faced by black people in the United States.”16 There also remains the “long-standing charge of radical activists who argued the state had pushed heroin and crack into poor black and Latino communities during the very years that drug criminal penalties increased.” The “entrenched commitment to law enforcement” in the 1960s was considered a response to the “unprecedented rise in the nature and extent of illicit drug use.”17 Rather than recognize pain as a condition of chronic poverty, the US government made pain relief among the racialized poor morally prohibitive, chargeable offenses that funded police violence and prisons rather than housing and health care.

Under a securitized medical apartheid, policing maintains widespread impoverishment and unhealth. Rather than diminish crises, heroin criminalization and the global HIV/AIDS pandemic foment each other. US policing, prisons, and pharmaceuticals across the twentieth century are responsible for widespread drug addiction and the systemic infection of the underclass through the global spread of viral hepatitis and HIV/AIDS.18 The WHO reports that since 2024, injection drug use, including heroin, “accounts for approximately 10% of new HIV infections globally,” while needle sharing as the source for viral hepatitis and HIV transmission now amounts to about 1.3 million HIV-HCV coinfections worldwide.19 The War on Drugs operates as a public health threat to communities of color, working-class and poor communities, and Global South countries while protecting the monopoly that biotechnology corporations assert over drug patents to gain wealth. The labor exploitation and denial of housing and health care to the underclass funds US forever wars in Asia and forever diseases.

No direct route of COVID-19 transmission involving opioid usage has been identified, but there remains a racialized gap in wealth and health that facilitates both the opioid crisis and viral pandemics. Independent researchers contend that COVID-19 social distancing guidelines “likely led to large changes in drug use patterns,” “higher rates of drug use in isolation,” and increased risk of “fatal overdose.”20 Social distancing limited access to community, resources, familiar supply chains, treatment, and harm reduction interventions including syringe exchange and naloxone. The key determinants of opioid use include mounting stress, anxiety, mental health struggles, exacerbation of preexisting health disparities, and socioeconomic uncertainty. George Floyd had recently moved from Houston to Minneapolis before losing his job as a restaurant bouncer because of COVID-19 stay-at-home restrictions.21

Viral pandemics and opioid epidemics are structured together in mass violence. Pain infliction and drug criminalization maintain racialized poverty and the widespread underdevelopment of housing and health care. Opioids block nerve cells that send pain signals, thus controlling pain at the individually embodied and molecular level. However, Floyd’s pain was put on trial in the courtroom and lit by the media. An expert witness testified that police officer Derek Chauvin applied the “pain compliance” technique excessively on Floyd.22 Pulmonary expert Dr. Martin Tobin attested to how Floyd’s asphyxiation must have felt like surgical lung removal.23 Pointing to photos of Floyd’s hands gripping the pavement and the police car tire, Tobin said, “This is extraordinarily significant[;] . . . this tells you that he has used up his resources . . . now literally trying to breathe with his fingers and knuckles.”24

These excruciating conditions were corroborated by Floyd’s girlfriend, Courteney Ross, who testified that he struggled with opioid addiction and had recently overdosed. While being detained, Floyd’s symptoms signaled another overdose—stomach pain followed by foaming of the mouth—but the officers suffocated Floyd rather than initiate medical crisis protocol. Instead of relief, Floyd and Ross found cycles of addiction, including chemical withdrawal from opioids leading to “dysphoria (pain, agitation, malaise)” and other symptoms that become unmanageable without health care guaranteed by employment.25 Floyd’s sickness ended in his lynching. His postmortem report iterated protest against the biotechnologies underwriting his racist surveillance and deadly encounter.

Pain Managed by Pharma, Inc.

Today’s biotechnology industry is founded on opioid mass manufacture to manage chronic pain and vaccines to treat viral diseases. “Managerial capitalism” emerged in late nineteenth-century Germany and the United States and birthed new opportunities in biologics, chemical, and pharmaceutical production by the 1950s.26 The history of German-born US biotechnology giant Merck models how managerial capitalism transformed not only corporate pharmaceutical administration but also the science of pain and viral diseases. Postwar US “science-based” industries benefited from the “new government/university complex that pumped billions of public dollars into professional training and research” in the name of “national security.”27 Injured World War II veterans and viral threats became security priorities. Seizing on this, Merck expanded its family-owned business, amassed recently through its commercialization of morphine, into a transnational conglomerate led by “a fresh cadre of professional managers” focusing on the laboratory research, development, and patenting of drugs to treat chronic pain and viral epidemics as business.28

In 1804 German pharmacist Friedrich Wilhelm Adam Serturner isolated the world’s first organic alkaloid compound by separating it from the resinous gum secreted by Papaver somniferum, the opium poppy. The alkaloid, which Serturner later named after the Greek god of dreams, Morpheus, possessed ten times the power of processed opium.29 By the mid-1820s, Emmanuel Merck transformed the family’s pharmacy based in Darmstadt, Germany, by founding a commercial industry around the privatized distribution of standardized doses of morphine across Western Europe. Building on this success, in 1891 the US division of Merck & Co. opened and established itself as an innovator in research and development, specifically by engineering its brand of pharmaceutical managerial capitalism.

When US anesthesiologist and former professional wrestler John Joseph Bonica published his seminal textbook The Management of Pain in 1953, Merck’s longtime commercial supply of opioids paved the way to treatment solutions.30 As Bonica’s textbook asserts, “The development of pharmacology as a science parallels the treatment of painful conditions by medications. Alcohol and morphine were proven antidotes to pain.”31 As the “father” of pain, Bonica’s research and practice were motivated by his own injuries and concern for his wife, who nearly died from anesthesia during childbirth. He established in Seattle in 1947 the first multidisciplinary clinic to treat pain among wounded World War II veterans. Bonica initially proposed terms such as “abnormal” and “protracted” pain, but “chronic pain” became the medically standard nomenclature by the 1970s.32 Johns Hopkins Medicine now defines chronic pain as an experience that “lasts for more than 3 months.” “Chronic pain,” it adds, “is one of the most costly health problem[s] in [the] U.S. Increased medical expenses, lost income, lost productivity, compensation payments, and legal charges are some of the economic consequences.” This cost-benefit analysis of pain management reflects Merck’s management of worker health, the value of which lies in maintaining a surplus supply of replaceable laborers while producing injured workers as ready-made live research subjects and pharmacy consumers.

In 1953, Merck merged with West Point–based pharmaceutical and vaccine innovator Sharpe & Dhome to become a national leading producer of “fine chemicals and pharmaceuticals.”33 Merck inserted professional managers over laboratory researchers, “subdivid[ing] along functional lines its activities in science, science management, and science diplomacy” and was represented by “one forceful leader,” the chief executive officer. This infused corporate leadership presumably lacking among laboratory scientists. Merck became an industry force in 1957, producing vaccines against a new influenza A2 virus, labeled at the time as “Asian influenza.”34 In 1995 Merck made its mark in virology again by pioneering and patenting HIV antiretrovirals and extending the lives of infected people with medical and pharmaceutical access.

In modeling managerial capitalism, Merck’s laboratory research met the interests of the US national security marketization. By tying its future to US national security and to fear-mongering anti-Black viral outbreak and orientalist “antiterror” tropes, Merck’s research, development, and patenting of drugs presumably justifies its exceptional pricing, guaranteeing its profits over widespread distribution of lifesaving treatments.35 Our global biotechnological apartheid is controlled at the scale of the molecule and navigated by a political economy of transnational oligarchies operating across plantations. Commercialized biotechnological determinism is scaled as “global health” and backed by US military aggression.

From Opium Wars to the War on Drugs

The British-led Opium Wars (1839–1842 and 1856–1860) against Qing China provide a historical setting for today’s US-led War on Drugs. US managerial capitalism emerged from the struggle against “unfree wage labor” instituted by the exploitative contract work system predominating the postslavery Americas.36 Central to the debate over unfree labor were Asian indentured servants trafficked across the Indian and Pacific Oceans as contract workers meant to undercut Black wage work specifically while being targeted as existential threats to white supremacy. By 1881, US workers were significantly employed under a “gain-sharing system” that was presumably regulating against exploitation and guaranteeing social security and pensions. Managerialism expanded corporations by extending employment to workers and centralizing production using Frederick Taylor’s theory of scientific management. Asian workers were racialized as impediments to standardized wage work and liberal industrial progress. Accused of spreading opium to the Americas, East Asians became targeted by xenophobic narratives that painted their opium use as illicit, pathological, and ethically distinct from the state-authorized clinical experimentation and supply of opioids by scientists, doctors, and government agents.37

By launching war, the British forcibly opened Qing ports to the opium trade, leading to widespread opium addiction. In turn, Europe cleaned the Qing’s coffers of silver while undermining civil society and Qing sovereignty. Asians migrated en masse as indentured laborers, oftentimes drugged by opium, kidnapped, and sold into indentured servitude. Asian racialization rehearses xenophobic narratives of opium dens and contagious diseases. This has resulted in racist public health measures and immigration restrictions against “perverse” Asian bodies associated with sexually transmitted infections, including “queer” depictions of sexually depraved Asian men and sex-working Asian women threatening the moral corruption of white society.38 As contract workers, East Asians are associated with the unliberal bodies in the era of managerial capitalism. They are projected as the underdeveloped human linking opium to “mongoloid idiocy,” or Down syndrome, and Asian racialization to disability.39

Paradoxically, trafficking Asian indentured servants and opium advanced the Euro-American medical study and control of pain, disease, and disabilities. The phrase “pandemic disease” was coined at this time, emphasizing the heightened perceived threat of contagions and increasing interest in vaccines.40 Syringes became available by the 1850s, facilitating vaccine administration while making morphine injection standard for reducing surgical pain. Wary of morphine’s addictiveness, London-based chemist C. R. Alder Wright researched in 1874 a morphine alternative but produced an even more potent narcotic, diacetylmorphine, or heroin. Mass opioid addiction, vaccines, and the studies of disability descend from the Euro-American transnational trafficking of racialized labor and opium, which developed settler colonial plantation agriculture into managerial capitalism. Today, research on highly addictive opioid alkaloids, including synthetics such as fentanyl, and vaccines are rooted in industrial agriculture and hailed as logical and lucrative.

Like the colonial history of poppy plantations and the opioid treatment of pain, it is no coincidence that virology was founded in the late nineteenth-century studies of a microbe infecting tobacco.41 European settler colonization, having waged a genocidal conquest of Native peoples and expropriated vast lands, first exploited the Indigenous cultivation of tobacco across the Americas at scale, relying on enslaved Black labor. Since then, postslavery agricultural and pharmaceutical production relies on land privatization. Present-day policing descends from slave patrols. George Floyd’s postmortem reports document the collusion between virology, biotechnology, and policing to maintain agro-economic extraction, racialized poverty, and a global securitized medical apartheid.

To Remedy or Poison?

The inaugural United Nations 1988 drug abuse and illicit trafficking report forwarded the biotechnological-military terms that later appeared in the WHO’s COVID-19 opioid epidemic report in 2023. The 1988 report blamed “the increased availability of products, the expansion of communications, socio-economic factors, migration and rapid urbanization, changes in attitudes and in the sense of values and the ruthless exploitation of fellow human beings by criminals.”42 The report implicates a racialized criminal class but better describes the managerial class of modern military-biotechnology corporations such as Merck Industries. Merck is not alone in crossing corporate, pain, and chronic disease management. In 2021, Johnson & Johnson became the first to pioneer a single-shot COVID-19 mRNA vaccine.43 By 2022, Johnson & Johnson settled one in a series of lawsuits brought against it for the US opioid epidemic,44 in what would become a pattern across the health industry.45

Our present institutional public health approach to opioids and viral pandemics is to pursue more drugs. The WHO’s 2023 report solely examines individuals with addiction (“opioid use disorder”), which is the failed convention. This narrow focus ignores structural violence and concentrates in “pharmacological solutions,” namely more opioids such as methadone and buprenorphine for “maintenance treatment” and naltrexone to reduce opioid craving. This means further experimenting and flooding the opioid market. Exorbitant drug pricing ensures that biotechnological production remains invested and costly while criminalizable for the uninsured, poor, and global South.

Drug manufacturing and health securitization enforce our compulsory reliance on US biotechnology and defense. Viral threats prompt exceptional exercises of law and order and increased “military readiness.” Our US biotechnology–military industrial complex deters investigation for opioid epidemics and viral pandemics as overlapping, cyclical, and chronic health crises. Rather than prevent crises, our biotechnological-militarism facilitates their protractions as synchronic conditions and endemic diseases, resulting in intensified racial surveillance and molecular extraction systemizing the upward distribution of wealth.

Our definitions of “pain” must account for the security structures inflicting racialized torture beyond individual biotechnological measure while rationalizing law enforcement murders. COVID-19’s emergence amid escalating opioid addiction, deaths, and police murders echoes what George Floyd’s body conveyed to medical examiners: The opioid epidemic enables, if not directly causes, COVID-19 virus transmission. Floyd’s murder, his pain, and the accuracy of his autopsy became flashpoints in the court trial. These facts animated widespread organized responses to anti-Black dehumanization while confronting Trump authoritarianism, followed more recently by Biden’s campaigns of military destruction amid viral pandemic crises.46 In May 2020, the media activism and street protests of Black Lives Matter culminated in the wake of Breonna Taylor’s and Floyd’s police murders. Its activism inherits anticolonial, intersectional, and internationalist strategies for mobilizing bottom-up social movements calling for defunding the police and funding housing and health care.

This represents a populist public health movement communicated by globally diffuse direct-action networks and knowledge producers using social media to center Black lives and Black study while decentering information transmissions across local organizations with profuse political effects. Simultaneously, these movements attest to the global racialized inequality of health and wealth enforced by US militarized medical apartheid. Today’s cross-racial coalitions platform mechanisms of resistance to fascism, creating, for example, a commons for building knowledge about global abolitionist public health. These movements build Black and Indigenous, including Palestinian, solidarities against settler occupation, land dispossession, genocide, and ecocide.

Ending biotechnologically financed extractive solutions to managing chronic health crises requires naming extraction itself the tool inflicting pain and driving people to seek its relief. The platforming of abolitionist public health calls for ending policing and global militarism and responding to Indigenous sovereignty movements calling for the return of land. Indigenous sovereignty can restore custodial relations to land and cultivate local ecologies and biodiversity. With biodiversity in abundance and ecosystems restored, zoonotic disease emergence can be thwarted and viral pandemic crises can be averted.47

Notes

1. 1.  Robert Samuels and Toluse Olorunnipa, His Name Is George Floyd: One Man’s Life and the Struggle for Racial Justice (Penguin, 2024).
2. 2.  Eric V. Bakota, Deborah Bujnowski, Larissa Singletary, Sherry Onyiego, Nadia Hakim, and Dana Beckham, “Exploring Drug Overdose Mortality Data in Harris County, Texas,” Online Journal of Public Health Informatics 11, no. 1 (2019): e62454.
3. 3.  Wendy Grossman Kantor, “George Floyd Spoke About How Good It Is to Be a Black Man in Minneapolis on the Day He Died,” People, June 4, 2020, people.com/crime/george-floyd-spoke-good-being-black-minneapolis/.
4. 4.  Adrian Florido, Jonaki Mehta, and Patrick Jarenwattananon, “Many Know How George Floyd Died. A New Biography Reveals How He Lived,” NPR, May 18, 2022, https://www.npr.org/2022/05/18/1099585400/george-floyd-biography-book.
5. 5.  Todd Richmond, “Who Was George Floyd? Unemployed Due to Coronavirus, He’d Moved to Minneapolis for a Fresh Start,” Chicago Tribune, May 28, 2020, https://www.chicagotribune.com/nation-world/ct-nw-george-floyd-biography-20200528-y3l67rrmfnb3dh4x3i5iipneq4-story.html.
6. 6.  “Opioid Overdose,” World Health Organization, August 29, 2023, https://www.who.int/news-room/fact-sheets/detail/opioid-overdose.
7. 7.  Steven W. Thrasher, The Viral Underclass: The Human Toll When Inequality and Disease Collide (Celadon Books, 2022).
8. 8.  All quotes are from the Hennepin County Medical Examiner’s Office, “Cardiopulmonary Arrest Complicating Law Enforcement Subdual, Restraint, and Neck Compression: Deceased: George Floyd aka Floyd Perry,” May 26, 2020, https://int.nyt.com/data/documenthelper/6992-george-floyd-full-autopsy/4c5bdf52fbbd775ce156/optimized/full.pdf.
9. 9.  “FACT SHEET: White House Calls on Congress to Advance Critical National Security Priorities,” National Archives, October 20, 2023, https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2023/10/20/fact-sheet-white-house-calls-on-congress-to-advance-critical-national-security-priorities/.
10. 10.  Robin D. G. Kelley, “Mike Brown’s Body: A Meditation on War, Race, & Democracy with Robin D. G. Kelley,” YouTube, April 18, 2016, https://www.youtube.com/watch?v=RP8FP8qjKgc.
11. 11.  Robert F. Garry et al., “Documentation of an AIDS Virus Infection in the United States in 1968,” JAMA 260, no. 14 (1988): 2085–87, https://jamanetwork.com/journals/jama/article-abstract/374422.
12. 12.  “Impact on Racial and Ethnic Minorities,” HIV.gov, accessed December 18, 2023, https://www.hiv.gov/hiv-basics/overview/data-and-trends/impact-on-racial-and-ethnic-minorities/.
13. 13.  The COVID-19 Tracking Project, “The COVID Racial Data Tracker,” The Atlantic, last updated March 7, 2021, https://covidtracking.com/race.
14. 14.  Christopher Williams and Sten H. Vermund, “Syndemic Framework Evaluation of Severe COVID-19 Outcomes in the United States: Factors Associated with Race and Ethnicity,” Frontiers in Public Health 9 (2021): 720264.
15. 15.  Sean Gardner, “Heroin: From the Civil War to the 70s, and Beyond,” City Limits, July 5, 2009, https://citylimits.org/2009/07/05/heroin-from-the-civil-war-to-the-70s-and-beyond/.
16. 16.  Christina B. Hanhardt, “‘Dead Addicts Don’t Recover’: ACT UP’s Needle Exchange and the Subjects of Queer Activist History,” GLQ: A Journal of Lesbian and Gay Studies 24, no. 4 (2018): 429.
17. 17.  Institute of Medicine (US) Committee on Opportunities in Drug Abuse Research, “B Drug Abuse Research in Historical Perspective,” in Pathways of Addiction: Opportunities in Drug Abuse Research (National Academies Press, 1996), https://www.ncbi.nlm.nih.gov/books/NBK232965/.
18. 18.  Jih-Fei Cheng, “Cold Blood: HIV/AIDS and the Global Blood Biotechnology Industry,” Radical History Review 2021, no. 140 (2021): 143–50.
19. 19.  World Health Organization, “Global HIV, Hepatitis and STIs Programmes: People who inject drugs,” National Institute on Drug Abuse, https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/populations/people-who-inject-drugs.
20. 20.  R. Ghose, A. M. Forati, and J. R. Mantsch, “Impact of the COVID-19 Pandemic on Opioid Overdose Deaths: A Spatiotemporal Analysis,” Journal of Urban Health, 99, no. 2 (2022): 316–27, doi: 10.1007/s11524-022-00610-0.
21. 21.  Richmond, “Who Was George Floyd?”
22. 22.  Chris McGreal, “Chauvin Used Deliberate and Excessive Pain Technique on George Floyd, Police Expert Says,” The Guardian, April 21, 2021, https://www.theguardian.com/us-news/2021/apr/07/derek-chauvin-trial-george-floyd-death-police-expert.
23. 23.  Jemima McEvoy, “George Floyd Experienced Pain Comparable to Lung Surgery, Expert Testifies,” Forbes, April 8, 2021, https://www.forbes.com/sites/jemimamcevoy/2021/04/08/george-floyd-experienced-pain-comparable-to-lung-surgery-expert-testifies/?sh=1305d45d6e03.
24. 24.  Chris McGreal, “George Floyd’s Girlfriend Shared His Opioids Pain—Derek Chauvin Refused to See It,” The Guardian, April 4, 2021, https://www.theguardian.com/us-news/2021/apr/04/george-floyd-girlfriend-opioids-pain-officer-derek-chauvin.
25. 25.  T. R. Kosten and T. P. George, “The Neurobiology of Opioid Dependence: Implications for Treatment,” Science & Practice Perspectives 1, no. 1 (2002): 13–20, doi: 10.1151/spp021113.
26. 26.  Jürgen Kocka, Capitalism: A Short History (Princeton University Press, 2016), 108. See also Louis Galambos and Jane Elliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp and Dohme, and Mulford, 1895–1995 (Cambridge University Press, 1996), 53–56.
27. 27.  Galambos and Sewell, Networks of Innovation, 54.
28. 28.  Galambos and Sewell, Networks of Innovation, 58.
29. 29.  University of Chicago Medicine, “As Morphine Turns 200, Drug That Blocks Its Side Effects Reveals New Secrets,” Forefront, May 19, 2005, https://www.uchicagomedicine.org/forefront/news/as-morphine-turns-200-drug-that-blocks-its-side-effects-reveals-new-secrets.
30. 30.  William Raffaeli et al., “Chronic Pain: What Does It Mean? A Review on the Use of the Term Chronic Pain in Clinical Practice,” Journal of Pain Research 14 (2021): 828.
31. 31.  Jane C. Ballantyne et al., Bonica’s Management of Pain (Wolters Kluwer, 2018), 189.
32. 32.  Raffaeli et al, “Chronic Pain,” 829–30.
33. 33.  Galambos and Sewell, Networks of Innovation, 56.
34. 34.  Galambos and Sewell, Networks of Innovation, 75.
35. 35.  Joshua Cohen, “Pharmaceutical Industry Ought to Justify Drug Prices on Value, Not R&D Costs,” Forbes, June 1, 2023, https://www.forbes.com/sites/joshuacohen/2023/06/01/pharmaceutical-industry-ought-to-justify-drug-prices-on-value-not-rd-costs/?sh=3b27cb221c13.
36. 36.  Maja Breznik, “Unfree Wage Labor,” Critical Sociology 49, nos. 7–8 (2023), 1132–33.
37. 37.  Mel Y. Chen, Intoxicated: Race, Disability, and Chemical Intimacy Across Empire (Duke University Press, 2023), 37–39.
38. 38.  Nayan Shah, Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (University of California Press, 2001).
39. 39.  Chen, Intoxicated, 37–39.
40. 40.  “The noun, ‘a pandemic disease,’ is recorded by 1853, from the adjective,” https://www.etymonline.com/word/pandemic. “1877 As a pandemic disease, the dancing-mania died out in the fifteenth century.” Translation of H. W. von Ziemssen in translation of H. W. von Ziemssen et al. Cyclopædia of Practice of Medicine vol. XIV. 416,” Oxford English Dictionary, s.v. “dancing-mania, n.,” September 2023, https://doi.org/10.1093/OED/2219345684.
41. 41.  Jih-Fei Cheng, “‘El tabaco se ha mulato’: Globalizing Race, Viruses, and Scientific Observation in the Late Nineteenth Century,” Catalyst: Feminism, Theory, Technoscience 1, no. 1 (2015): 1–41.
42. 42.  United Nations, Declaration of the International Conference on Drug Abuse and Illicit Trafficking and Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control, US Department of Justice, 1988, https://www.ojp.gov/pdffiles1/Digitization/123362NCJRS.pdf.
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