Throughout the late 1920s and early 1930s, large quantities of Turkish opiates flowed across the Eastern Mediterranean to Egypt, triggering an unprecedented heroin epidemic that swept through the society and claimed nearly four percent of the Egyptian population as addicts. While historians generally attribute interwar Egypt’s precipitous increase in heroin consumption to external sources, such as foreign narcotics traffickers, the British occupation, and the remnants of Ottoman capitulatory agreements in the Egyptian legal system, their analysis largely overlooks the influence that Egyptians themselves exerted over the country’s illicit opiate economy. During this period, Egyptian smugglers, merchants, dealers, and consumers played the dominant role in disseminating opiates throughout the country, which left local government officials, police officers, and the emerging professional class scrambling to address the ensuing epidemic. Drawing on Egyptian police records, memoirs, and periodicals, my research will examine the complex networks of opiate traffickers, distributors, consumers, bureaucrats, and law enforcement agents in order to highlight how they promoted and policed the interwar heroin epidemic. I contend that Egyptians, by participating in the opiate trade, formed profitable networks that helped relieve local economic pressures resulting from the Great Depression, which devastated the national cotton economy and, with it, the Egyptian middle class. While the interwar opiate trade generated considerable illicit economic activity, the government response to the subsequent heroin epidemic created opportunities for Egyptian bureaucrats and politicians to overcome the stringent fiscal austerity of the semi-colonial Egyptian state, build enforcement institutions like the Central Narcotics Intelligence Bureau, and provide public health services such as treatment for drug addiction. Although inherently at odds, these local criminal networks and newly established government institutions grew symbiotically and together shaped the trajectory of Egyptian state development in the early twentieth century.