Opium: Reality’s Dark Dream by Thomas Dormandy, and: History of the Opium Problem: The Assault on the East, ca. 1600–1950 in Sinica Leidensia by Hans Derks, and: Reforming the World: The Creation of America’s Moral Empire by Ian Tyrell (review)

Opium is one of the most useful and complex drugs in medical history. Made from the juice of the unripe seed capsule of the opium poppy, it contains several valuable alkaloids. Three of these, morphine, codeine, and thebaine—the last when processed into semisynthetic opioids like oxycodone—have potent analgesic effects. The rub is that opium-based drugs present as many risks as benefits. Overdose and addiction threaten individual lives. Widespread abuse and trafficking can threaten society itself.

Examples of personal and social ruin fill the pages of Thomas Dormandy’s and Hans Derks’s ambitious histories of opium. Dormandy begins his narrative in antiquity, when opium production and consumption centered on the Near East and Mediterranean. Derks takes up the story in the seventeenth century, when production and consumption began, under European pressure, to shift to South and East Asia. From there, nonmedical narcotics use and addiction became global phenomena, spreading in all settled regions during the last 150 years. The campaign against opium likewise became global. Its champions included Protestant moral activists who, as Ian Tyrell shows, worked effectively through transnational reform networks. All three authors, then, place the opium problem in the frame of world history.

An English physician and chemical pathologist, Dormandy, has written The White Death: A History of Tuberculosis (1998) and The Worst of Evils: The Fight Against Pain (2006). He is no stranger to opium, which was commonly prescribed in the later stages of tuberculosis and to alleviate pain. Even so, he aspires to go beyond medical history, showing how nonmedical events influenced opium’s usage and vice versa. He succeeds in this aim, though he is most surefooted when describing how prominent physicians and patients—often literary or artistic figures afflicted with tuberculosis—made use of the drug.

The therapeutic details varied by era and culture. Galen prescribed opium, but in polypharmaceutical concoctions that masked and diluted its effect—one reason, perhaps, for his unconcern with addiction. Avicenna, who worried more about dosage than addiction, prescribed the drug as a “cake,” infusion, poultice, suspension, suppository, and ointment. Maimonides, who regarded opium as a panacea, recommended giving it with honey for patients too sick to swallow. Early modern physicians in Europe and the Americas administered opium in pill or tincture form. By the first half of the nineteenth century, many patients spared them the bother by acquiring laudanum or an opium-based patent medicine on their own.

The isolation and commercial production of morphine, together with the advent of hypodermic medication in the mid-nineteenth century, made possible widespread morphine injection. This mode of administration proved dangerous as well as seductive. Because the window for a safe and effective dose was narrow—two or three times the customary amount of morphine could produce respiratory arrest—fatal overdose was an ever-present risk. So was addiction. A morphine habit was sometimes called a “Pravaz,” after the name of a hypodermic syringe.

While Europe and North America were experiencing a qualitative change in opiate addiction, East Asia was experiencing a quantitative one. In the late eighteenth and early nineteenth centuries, the British East India Company expanded opium cultivation and its (illegal) export to China, stimulating demand and spreading addiction. China’s humiliating defeat at the hands of the British in two wars further expanded the supply, as did increasing domestic poppy cultivation. The Chinese diaspora spread opium smoking, creating nuclei...