The History of Drug Abuse Treatment

Treatment for alcohol abuse paved the way for methods of treating all forms of drug abuse. It took the scourge of alcoholism and thousands of years for society as a whole to begin viewing addiction as a disease.

Early History

• A 1990 U.S. congressional study called "Broadening the Base of Treatment for Alcohol Problems" credits Dr. Benjamin Rush of Philadelphia, the surgeon general of the Continental Army and a signer of the Declaration of Independence, with originating the concept of treatment for alcoholism. Rush suggested alcoholism was a disorder that should be treated medically rather than a moral deficiency.

  By the 1870s, the first sanitariums for "inebriates" had begun to appear, but alcoholics and other addicts were still largely deposited in mental asylums. The disease continued to be classified as a disorder similar to schizophrenia and other mental problems.

Opiates

• Aside from alcohol, opium was the dominant addiction through the late 1800s and early 1900s, with even such experts as Sigmund Freud dabbling in treating those addicted to morphine and cocaine.

  The Harrison Act of 1914 was the first federal antidrug legislation, outlawing cocaine and opiates. Addiction to these substances immediately became a criminal rather than a medical matter. Although this change would seem to be to the detriment of addicts, it actually moved the government to begin treating them.

  In his book "Managing Multiculturalism in Substance Abuse Services," Dr. Jacob U. Gordon says, "The resulting growth in the number of opium addicts in federal prisons led to the opening of the Public Health Service Hospitals at Lexington, Kentucky, in 1935 and Ft. Worth, Texas, in 1938. These hospitals provided the first systematic data on treatment outcome of drug abusers."

Alcoholics Anonymous

• Alcoholics Anonymous (AA) formed on June 10, 1935. The founders framed "The Twelve Steps" of recovery from alcoholism. In 1939, the fledgling society published the book "Alcoholics Anonymous," and the movement's membership skyrocketed.

  Meanwhile, Sister Ignatia Gavin, head of admissions at St. Thomas Hospital in Akron and involved with AA, began surreptitiously admitting alcoholics for medical treatment in her facility. She, along with one of the founders of AA, Dr. Bob Smith, nearly single-handedly developed the model of hospital treatment for alcoholism and drug addiction that is largely adhered to today.

  Inspired by the success of AA, small groups of people addicted to drugs other than alcohol began meeting in the late 1940s. This culminated in the official founding of Narcotics Anonymous (NA) in 1953.

  In 1956, the American Medical Association classified alcoholism as a disease, and the medical community slowly began to treat it as such.

1960s Innovations

• The 1960s brought about the concept of treatment communities. These groups adopted some tenets of AA philosophy and expanded into a residential community where recovering addicts lived with each other and nonprofessional staff, usually former addicts, in a clean and sober environment.

  Methadone maintenance also became a viable treatment concept in the 1960s as a means of dealing with psychological cravings and physiological effects of opiates. Outpatient clinics opened across the country.

Modern Treatment

• Today, such programs as AA and NA continue to serve as crucial elements in the recovery of most drug abusers. Hospitals and treatment centers provide detoxification programs to wean patients off drugs, eventually sending recovering addicts to drug-free programs designed to address the psychological and behavioral aspects of drug addiction. These may be inpatient or outpatient programs with a variety of durations, depending on the severity of the individual's addiction.