In the 19th century, opium circulated in America as a gift, a remedy, and a necessity-- a commodity whose social meaning was detached from the realities of addiction, colonial extraction, and racialized practice. Soldiers who received opium as a lifesaving cure of mercy were instead receiving a highly addictive narcotic, shaped by exploitation. In this context, it was seen as an act of compassion rather than the result of a commodification of bodies.

This fetishized image obscured these forces at play:

• Chinese laborers coerced into cultivation and transport

• British imperial policies that flooded markets and destabilized regions

• Racial hierarchies shape which bodies receive it

• Gender norms that criminalized addicted women as 'mad', emotional, or morally weak 

Opium appeared as a neutral, even benevolent medical good, while enabling social control and neglect. The Opium Wars themselves demonstrate this logic: Britain framed opium as a legitimate trade commodity, masking the violence, dependency, and geopolitical domination required to maintain that trade.

In the United States, opium was a medical gift for wounded soldiers. Veterans depended on it, but society viewed their addiction as personal failures rather than the result of medical practices and commercial supply chains. Marx would argue that the commoditization of opium obscured the relationship where suffering was created, then treated, then punished-- by the same system that produced the commodity itself.

Women's opium use was also fetishized in cultural imagination. Addiction among women was interpreted through stereotypes of emotional instability and hysteria. The commodity became a symbol for feminine fragility rather than a mirror of norms or medical malpractice. Similarly, the racist belief that Black soldiers felt less pain fetishized their bodies as biologically different, masking the violence of undertreatment and medical neglect under the guise of rational medical practice.

Marx's concept extends into the modern opioid crisis. Today's prescription opioids, such as OxyContin, Vicodin, and fentanyl, are similarly transformed into fetishized commodities, marketed as scientific miracles, detached from the corporate motivations and structural inequalities that enabled their spread. Pharmaceutical companies cultivated an image of opioids as safe and humane, masking the human labor, regulatory failures, and profit-driven strategies that led to their mass dependency.

Patients who are prescribed opioids are told they are harmless, just as Civil War soldiers were told that it was a gentle relief. Communities, especially those from poor, rural, Native, and Black communities, absorbed the fallout while the true relationships remained hidden.