HISTORY OF OPIUM USE & ADDICTION TREATMENT
Although Methadone was added as a treatment in the mid-1960s. In some ways, it is obsolete because it still requires daily visits to the clinics & the stigma of being seen at these types of clinics. It can also still cause problems if dosed too high & cause impairment & a "high". This is where Methadone is obsolete, unlike the newer Suboxone which is available by prescription and does not cause impairment in daily functioning. Even the very best inpatient, abstinence-based treatment models have unfortunately yielded very poor 10 -15% success rates over the years. The very real risk of relapse including death by overdose after discharge has changed the preferred treatment for opioid dependency to Medication-Assisted Treatment with Buprenorphine. Here is a brief history of events……
The history of Opium use, abuse and treatments in the U.S. is very interesting. Back at the turn of the century after the Spanish American War, the US won control of the Philippines from the Spanish. US Missionaries in the Philippines noticed there was a large proportion of the civilian population addicted to Opium, most of which was coming from China. President Theodore Roosevelt wanted to improve US relationships with China who had suffered their own Opium wars for many years. This was 1912 & The US then asked for International Conferences on Drug Control. Notably, Opium, Cocaine & other drugs were unregulated and easily obtainable, and a link was established by New York representative Franklin Burton Harrison between use of these drugs and crime. Supporters of his proposal inaccurately linked drug use specifically by Blacks, Mexicans, and Chinese immigrants, led to rapes, shootings & other violent crime. It was further hyped & sensationalized by newspapers that use of drugs encouraged users to rebel against white people of authority. This all led to passage of The Harrison Narcotic Act of 1914.
Initially, it was thought that the provisions of the Act merely looked to regulate the marketing of opiates and other narcotics. However, a clause concerning doctors prescribing drugs 'in the course of their professional practice only', caused confusion. This clause was interpreted by the law enforcement agencies to mean that doctors could not prescribe opiates to addicts, because addiction was not considered to be a disease. This caused a number of medical practitioners getting arrested and jailed. This sort of adverse action widely discouraged doctors from prescribing opiates to addicts, which was supported in a decision by the Supreme Court in 1919.
Since the prescription and usage of opiates and other drugs weren't illegal before the Act was passed, suddenly, addicts found themselves being labeled as criminals. However, this was not seen as an effective method to stop drug use. In fact, prominent law enforcement officials came out against this, and said that punitive action was not helping the situation, and that the drug problem should have been solved with the help of medical research, rather than enforcing strict laws. The Act also saw the beginning of smuggling and black markets for drugs. A special investigating committee reported that, by 1919, large amounts of drugs were being smuggled in through the Mexican and Canadian borders, and that the United States was consuming much higher amounts of opium than most European countries at the time. Like the prohibition on alcohol, the war on drugs was seen by many as oppressive, devastating, and very expensive; a sentiment that can be seen often even today.
The Harrison Narcotics Act was largely superseded by the Controlled Substances Act of 1970, which has brought in many sweeping changes. However, none will dispute that the Act of 1914 was an important first step in America's war on illegal drugs, which has had far-reaching consequences to the present day.
Milestones in Treatment for Addiction
1883 - Cocaine is recommended by Sigmund Freud and a number of American physicians in the treatment of alcoholism and morphine addiction.
1901 - The Charles B. Towns Hospital for Drug and Alcoholic Addictions in New York City marks the beginning of a new type of private "drying out" hospital for affluent alcoholics and addicts.
1907 - First of two waves of state laws are passed calling for the mandatory sterilization of "defectives": the mentally ill, the developmentally disabled, alcoholics and addicts.
1914 - The Harrison Tax Act brings opiates and cocaine under federal control and places physicians as the gatekeepers for access to these drugs.
1919- 1935 - A Supreme Court decision (Webb v. The United States) declares that for a physician to maintain an addict on his or her customary dose is not in "good faith" medical practice under the Harrison Act and thus an indictable offense. Some 25,000 physicians are indicted for violations of this act between 1919 and 1935.
1948 - The "Minnesota Model" of chemical dependency treatment emerges in the synergy between three institutions: Pioneer House, Hazelden, and Willmar State Hospital.
1964 -Dr. Vincent Dole, an endocrinologist, and Dr. Marie Nyswander, a psychiatrist specializing in addiction, introduce methadone blockade therapy in the treatment of narcotic addiction.
1970 - Congress passes the "Comprehensive Alcohol Abuse and Alcoholism Prevention Treatment and Rehabilitation Act.
1972 - The Food and Drug Administration approves use of methadone for treating heroin addiction.
1981- Nancy Reagan's "Just Say No" anti-drug campaign is launched within a broader "zero tolerance" campaign that will reduce federal support for treatment and mark the beginning of the dramatic rise in the number of drug users incarcerated.
1987 - President Reagan formally announces a renewed "War on Drugs"; the shift away from treatment toward punishment and incarceration intensifies. Authorizes $4 billion to fight drugs, mostly through law enforcement!
1995 - U.S. Food and Drug Administration approves prescription use of Naltrexone (Trexan) in treatment for opioid addiction. Naltrexone marks the emergence of a new generation of pharmacological adjuncts in the treatment of alcoholism and other addictions.
2000 - The Drug Addiction Treatment Act of 2000 (DATA 2000) authorizes certain specialized physicians to prescribe & dispense Buprenorphine for Opioid dependency.
2008 – Doctors Assisted Wellness Center opens in Johnson City, TN.