From the 1890s to the 1920s across the American Midwest, newspapers reported arrests and altercations in ‘Cocaine Alleys’. Not all of these arrests involved people under the influence of drugs, but the term nevertheless became a non-geographic cultural construct highlighting readers’ fears about racialized drug use. By describing low-income Black women as ‘queens’ central to these spaces, newspapers mingled gender, race, criminality and drug use. The ‘Cocaine Alley Queen’ stereotype applied to Black women obscured the reality of White women’s greater propensity to recreational and medical narcotic addiction. As Black migrants moved from Southern states to Northern Midwestern industrialized cities, this reporting trend appeared in cities with higher Black populations than the state average. Newspapers created an intersectional, geographic identity that collected fears and stereotypes about drug use and Black communities when narcotics were accessible, and reformers sought to discipline Black, urban, female working-class bodies and impose middle-class behaviours on them.