The History of Drug Abuse and Addiction Treatment in America: part 9

In the last discussion we saw what happened in an evolving field that was beginning to address the treatment addiction in an institutional setting. The Drug Abuse Factsdevelopment of Synanon started from the ineffective results of 12-step support groups with people that were addicted to opiates, mainly heroin, and hallucinogens, which were usually marijuana and LSD. America had a growing population of seriously addicted individuals reaching for help, but finding that there was very little reaction to their call for help.

In the 1970s, the mental health industry didn’t take a formal position against the treatment of alcoholics and drug addicts, but due to their reputation being of little use in treating alcoholics, mental health therapist were reluctant to treat addiction.

By and large alcoholics and addicts were being untreated. In 1963, the first reports from the Rockefeller Institute were written to establish the efficacy of methadone hydrochloride as a maintenance drug for heroin addicts. Hitherto, the drug had been used in concert with tranquilizers to help opiate addicts in withdrawal, but the idea of its use as a replacement for opiate addiction hadn’t been introduced. The promoters of methadone maintenance changed the research paradigm around addiction and redefined treatment effective in terms of: (1) reduction in drug use, (2) reduction in criminal activity, and (3) increase in socially productive activities. These three criteria have persisted as a baseline in evaluating all treatment modalities, even though they uniquely germane for methadone maintenance. This has led to a universal acceptance of methadone maintenance as an effective treatment by the political and judicial public.

These measures represent an evaluation of the extent to which clients’ behaviors have become more socially appropriate, as opposed to concerns about their psychosocial functioning and the rehabilitation of the being by increasing ethical awareness and spiritual growth. Many have claimed that the outcomes of methadone treatment are robotic patients that relapse on other drugs to feel love, excitement and other human feelings that are suppressed by the drug.

With the expansion of methadone maintenance came an opportunity to market more pharmaceuticals to replace drugs of addiction. Naltrexone was one of the drugs introduced as an antagonist to opiates. It also proved to block the receptor sites for endorphins, which are the natural neurohormones that bring man feelings of happiness, love and joy, which leaves opiates addicts with the same dilemma they faced with methadone.

Conflict over the wisdom and ethics of methadone maintenance treatment has been a constant in the drug abuse field. In 1971, the US Congress took an unusual step of mandating research in the narrow area of efficacy of narcotic antagonist drugs for the treatment of heroin addiction and called for specific regulations governing methadone “treatment”. These regulations were an attempt to curb the entrepreneurs that were becoming wealthy owning and expanding methadone maintenance clinics. Critics claim the obvious that methadone is replacing one addiction for another, (e.g. whiskey for gin) and leaving the addict in a continual addiction that, over time, causes health and psychological problems. Methadone researchers and clinic owners have studies that demonstrate the efficacy of their “treatment” based on the lowering of heroin use and crime and increases in employment. Opponents point to the fact that very few methadone clients elect to stay in treatment and would chose to be drug-free. The resigning Vice President of the largest methadone maintenance clinic system in California, who had been employed to humanize methadone treatment, stated that “this form of addiction treatment is just emphatically and obviously wrong on every level but the profits continue to enslave the public and silence opposition”.

The controversy over methadone maintenance continues today, but apathy about heroin addicts has decreased the outcry that has been a large part of its history.

Article 7

Feel free to browse through this series of articles to learn the history of drugs and treatment in America.


Department of Drug Education, Prevention, and Information

Narconon International

  • Handbook of Drug Control In the United States by James A. Inciardi. Published by Greenwood Publishing Group, 1990.


Related article on Increasing Incidence and Prevalence of Prescription Drug Abuse and Addiction

More drug information

Comments are closed