Addiction is literally thousands of years old. Yet, addiction and drug treatment is still in its infancy in many ways. Only in the past hundred years has the medical community made serious advancements in addiction treatment.
A Brief History of Substance Use
Early human records dating back as far as 12,000 BCE show people used psychoactive substances. Humans of that time found crushing up certain plants created intoxicating effects. Archaeologists have found poppy seeds in some of the oldest human settlements ever unearthed. Stone age humans throughout Europe also grew opium poppies. While people likely used these for baking, evidence suggests they also used them as medicine and for consciousness-alteration.
In 4,000 BCE, Sumerians referred to the poppy as “Hul Gil,” which means “joy plant.” Clearly the plants were being used for fun.
Egyptians as far back as 1,500 BCE used poppies for medication. They also mass produced alcohol. Researchers have found breweries in Egyptian cities and villages. The Greeks mixed opium with wine to treat illnesses. They also used these concoctions for recreation. Opium eventually became popular through trade and wars with China and India as far back as the 5th century BCE.
In addition to medical and recreational uses, many religious practices included the use of mind-altering chemicals. Christians believed temperate drinking of alcohol to be a gift from God. They also claimed intemperate drinking was a sin. To them, it was a moral failing.
Thus began one of the major setbacks to addiction treatment.
Background of Addiction Treatment
Though there’s a clear record of substance use, drug treatment and addiction care are not as well documented. This is largely because intoxication wasn’t thought to be as disgraceful as it is today. Some, such as Dr. Benjamin Rush, saw that alcoholism was an issue. He even went so far as to describe it as a disease in the latter part of the 18th century. Physician Magnus Huss wrote “Alcolismus chronicus,” – a description of chronic alcohol abuse as a disease – in 1849. Despite this information, it wasn’t until the middle of the 19th century that society considered excessive substance use to be a problem.
The first drug treatments were indicative of the era. Mesmerism, bleeding, burning and homeopathic cures were common. Doctors of the time would frequently prescribe opium or laudanum to those who drank too much alcohol. This often led to cross-addiction, rather than curing the problem.
In the 1800’s and early 1900’s, those with substance use disorder (SUD) were frequently locked away in sanitariums and asylums. Inebriate homes, rescue missions, addict colonies and other private institutions were created to combat alcohol use disorder (AUD). Most of these were places where the “immoral” addict could either dry out, or die. Snake oil salesman as well as legitimate doctors proposed any number of cures and remedies. Most of these were more fantasy than reality.
It wasn’t until the 1930’s that society would come to recognize the disease model of alcoholism. Though proposed before, Dr. William Duncan Silkworth was the first to popularize the notion that addiction is a type of illness.
The Birth of Modern Treatment
Once alcoholism – now called AUD – became known as a disease, some of the moral stigma fell away. The idea that these people were sick, rather than immoral, changed the social outlook. Members of the medical community became more involved in treating AUD. They also began to treat other forms of addiction. In 1952, the American Medical Association defined alcoholism as a chronic, progressive and incurable illness.
With the shift in thinking came a change in methods of treatment. The scientific community began to seek medicinal cures for AUD and SUD. Support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) were formed. These groups allowed those who were battling with the illness to meet in an environment free from judgement. There they could help one another cope with their shared malady.
It was the success of Alcoholics Anonymous in treating AUD that first started the major changes in treatment. Drawing from the AA treatment program, an institution called the Hazelden Foundation invented the “Minnesota Model.” This was the first modern rehabilitation facility. It treated patients with dignity, helped them with cravings and introduced them to the 12-steps of recovery proposed by AA.
Though very basic, variations on the Minnesota Model have persisted into the 21st century. Some rehabilitation facilities still provide little more than group therapy, AA or NA meetings and a safe, sober environment in which to recover.
Current Addiction Treatment Theories
Though the disease model of addiction is still prevalent, it’s been altered somewhat. The rise of psychology and greater information regarding mental illness has changed Dr. Silkworth’s idea of an “allergy” to alcohol. Current theories state that AUD is a compulsive sickness. It also frequently manifests with other mental illnesses, such as depression and anxiety. Those who struggle with both AUD or SUD and other mental diseases have dual diagnoses. For these people, addressing the underlying mental health issues is as important as containing the addiction itself.
Mental health professionals are constantly developing better treatments to alleviate both substance disorders and underlying mental conditions. Scientists and academics alike are researching treatments backed by evidence. The most popular among these is Cognitive Behavioral Therapy (CBT). It is used in conjunction with support groups to assist those in recovery.
Gone are the days of snake oil. Instead, physicians prescribe Medically Assisted Treatments (MATs). These use medication along with therapy, in addition to support meetings to attack the disease from every angle.
Addiction Treatment Today
Today, anyone with AUD or SUD can live a normal, healthy, happy life. They can expect to need a combination of professional aid along with the support of peers. If necessary, there are drug treatment options to fit any lifestyle. Someone seeking sobriety can choose from residential treatment, Partial Hospitalization (PHP), Intensive Outpatient (IOP), and Outpatient (OP) options. They can opt to stay in a sober living house, where a safe and sober environment can assist their recovery. Thanks to the expanding options, a person can customize their treatment to include medication, therapy, hypnosis, meditation, group meetings and any other options they see fit.
More than anything, a continual change in thinking is needed. Words like “addict,” “drug abuser,” or “drunk” demonize someone who is sick. Using clinical terms such as “substance use disorder” removes the stigma. It is important to forever be evolving how we see these illnesses so that enhanced treatments can continue to develop.