Grappling with Morphine: A Local History of Painkiller Use in Kerala, India

Abstract

In this article I argue that the scarcity of painkillers in the Global South is driven by a central asymmetry in which the health of developed countries is valued over that of the much poorer countries that comprise the rest of the world. To elucidate this point, I argue that by examining the history of various legal institutions and specific events, like the opioid crisis, that have shaped the global production of opium and production in India, one will be able to see the genealogy of the imbalance and inequality that has always affected care. I turn to the state of Kerala to explore instances in which these legal inflections live within the contemporary guidelines for palliative care, and thus constantly affect the supply and delivery of care. This also ties in with the much longer history of opium control for the growth of the global pharmaceutical industry, within which India has been uniquely placed.