Transcript History of Addiction

History of Addiction
Alixandra Kaiser
“A nation corrupted by alcohol can never be free”-Rush
Benjamin Rush
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Benjamin Rush (1746-1813)
Educated at Princeton, London and Paris
Often called the “father of American psychiatry”
First American authority on alcohol and alcoholism.
Father was an alcoholic, parents divorced=interest in alcohol
and alcohol related problems.
• Rush noticed s problem with drunkenness among soldiers in
the continental army.
• 1777-issued strong condemnation on use of distilled spirits
• 1784- An Enquiry into the Effects of Spirituous Liquors Upon
Human Body, and Their Influence Upon the Happiness of
Society.
Rush and Treatment
• Believed that health and disease were determined by the
balance of the four humors- blood, phlegm, black bile, yellow
bile
• Rush would attempt to re-establish balance by inducing
perspiration and vomiting, inducing fright, and bleeding the
patient
• Poisoned his patients with mercury-laden calomel
• Dehydrated patients by excessive purging
• Risked lives by bleeding
• Inflicted painful blisters
• Decrease of his use of medical treatment due to refusal of
benign medical treatment
Pathway to Alcoholism Recovery
• Rush laid out several
remedies
• Christian conversion
• Acute guilt or shame
• Linking of drink with painful
impression
• Vegetarianism
• Cold baths
• Acute disease
• Blistering at ankles
• Witnessing the death of a
drunkard
• Swearing on oath of
abstinence
• Use of Pavlovian Psychology
• Saw the failures of
hospitals and jails
• Called for the creation of a
“Sober House”
• Only thing he didn’t
anticipate was the increase
consumption (highest use
in history) of alcohol for
the next 40 years
Before Asylums: Mid 19th Century
• Addicts and alcoholics were placed it the almshouse, the
charitable lodging home, the jail, the workhouse, and lunatic
asylum
• None of these were equipped to treat addictions
• Fail of temperance-prevent the creation of new drunkards and
let the old drunkards die off
• Failure rose the need for specialized institutions to reach
alcoholics on a medical and moral basis
Second half of 19th Century
• Rapid growth in number of
institutions
• 1878 only 32 institutions
• 1902 more than 100 facilities in the
U.S. specializing in treatment of
alcoholism and other addictions
• This included New York State
Inebriate Asylum, Pennsylvania
Sanitarium for Inebriates, Washington
Homes in Boston and Chicago, Kings
County inebriates’ Home, and Walnut
Lodge.
• Most institutions fell under two
categories: inebriate homes and
inebriate asylums.
• Inebriety: captured the cravings of
addicts and the social
consequences the coincide with
it.
Treatment Methods
• Inebriety Specialist believed in continuum of care
• Most important technologies within these homes and asylums
was enhancing treatment retention: this became difficult
when patients didn’t want to stay around
• Isolation: patients were isolated to rid them of stress and
temptations of normal life. First step.
• Detoxification: methods used were “cold turkey”, soap-suds,
enemas and other purgatives.
• Physical restoration: Turkish baths, massages, phototherapy
(exposure to sunlight), electrotherapy, nourishing meals,
vitamin supplements, and lots of fresh air.
Treatment Methods Cont.
• Religious/ Spiritual Influences: use of chaplains, daily religious
services, bible readings and prayers.
• Social Support: encouragement from other people in a similar
circumstance. Also clubs were created to increase support.
• Work and Recreation: manual labor and recreational activities
such as croquet and games. Goal to create an environment
both socially and intellectually stimulating.
• Music: therapeutic value, pianos, violins and harps. They
would also partake in self-reflection- self inventory
• Moral Suasion: exposure to motivational talks, inspirational
literature and information on addiction.
• Counseling was rarely provided
Treatment Methods Cont.
• Induced Inversion: Benjamin? Aversion to alcohol by classical
conditioning or post hypnotic suggestion. Whiskey with
everything example.
• Hydrotherapy
• Electrotherapy
Fall of Inebriate Asylums
• 1922 decline in institutions due to the decreased demand in
treatment.
• Most institutions closed down out of 184 only 27 remained
• Decrease number of patients
• By mid-1920s, most inebriate homes, asylums, and private
sanitaria specializing in addiction were gone.
Eugenics!
• Darwin and Galton (cousins) 1883: improve race through
manipulation of heredity.
• Goal was to create a gifted race through marital partners
across successive generations.
• “negative eugenics”: decrease or eliminate breeding of those
people deemed unfit (alcoholism, insanity, laziness, crime and
poverty)
• Purification of the race would result in less need for state
institutions and services.
• What was the most radical idea of eugenics?
“Surgical Solution”
• Involuntary Sterilization of
particular groups of people.
• Sterilization laws: 1922,
fifteen states passed
sterilization laws and then
two thirds of all states went
on to pass some sort of
sterilization law.
• Result? 60,000 Americans
were subjected to involuntary
sterilization
• Sterilization of alcoholics was
“voluntary”
• Case were alcoholic women in a
psychiatric facility in the 1940s
and 50s could not be release
until they submitted to
“voluntary” sterilization.
Hydrotherapy
• Hydrotherapy: Well ..hydro
=water, application of water
as healing agent
• Brought to US from Europe by
Dr. Simon Baruch.
• baths would reduce
excitement, to reduce pain, to
improve circulation, and
induce sleep.
• Water was taken into and
drawn out of the body
through every possible orifice.
• During same period Benjamin
Rush was cold showers in
treatment.
Drug Therapies: “Equisine”
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Certain antibodies were produced in response to alcohol
These antibodies could prove useful in treatment
Poor horses….
Gave horses high doses of alcohol until they became
dependent
• Draw the blood from them and injected into non alcoholic
dependent horses, they would respond with revulsion for
alcohol
• Method proved inconclusive in humans
No to Alcohol, Yes to Morphine!
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Idea brought by Dr. J.R. Black
Replace alcohol with opium
Morphine is cheaper
Less socially and economically devastating to alcoholics family
and themselves
Morphine is less damaging to the body
Less hereditary degeneration compared to alcohol
The problem?
Dr. W.H. Bently advocated the use of cocaine for morphine
addiction in 1878
Convulsion Therapies
• 1934 by Dr. J.L. Meduna
• Seizures induced through
administration of drugs
• Depression and agitation would
decrease following treatment
• Ended due to the horrors
patients were experiencing
before going into the seizure
• Electroconvulsive therapy
“shock therapy”- electric current
would pass through the brain
• Widely used in 1940s
• Stories of institutional staff
using ECT if the alcoholics
embarrassed or challenged
them
Psychosurgery
• 1902 Dr. H.A. Rodebaugh
• Treat addictions through treatment of physical medical
conditions such as hemorrhoids and rectal fissures
• When fixed, use of anesthetizing drugs would cease
• 1935-Egas Moniz introduces lobotomy
• 15th patient of Freeman and Watts
• 1944-1960: 100,000 psychosurgery procedures were
performed on alcoholics and addicts.
• Conclusion?
• Psychosurgery in treatment of addiction provides evidence on
how great harm can be done in the name of good
Narcotic Farm: Lexington,
Kentucky, 1935
“Drug Addicts Have a Future”
• First united States Narcotic
Farm, also known as “Narco”
by locals
• Dr. Lawrence Kolb, the
institutes first director
proclaimed “ new era”.
• Goals: discover a permanent
goal for drug addiction. Social
rehabilitation for addicts.
• Functioned not only as a
humane hospital for drug
addicts, but it is also a place
where drug addicts can be
incarcerated… Prison
• People sent to Narco often
resisted treatment.
“Using” Addicts
• They would experiment on addicts using morphine and even
LSD in hopes to discover a cure for addiction.
• Even cocaine, alcohol, marijuana, tranquilizers, and heroin was
used.
• Luckily nobody died during this process.
• Inmates would get time off their sentence for volunteering.
• Would have to go through 6 month rehabilitation and drug
independent before being released.
• Later using patients for practice was banned.
Lexington Cure
• Inmates would be immediately
detoxed upon entering the
facility.
• Include giving doses of morphine,
or methadone, and slowly take
them off to avoid harsh
withdrawal.
• “flow baths” were used to calm
and soothe nerves of inmates
going through withdrawal.
• Hygiene was important part of
“the cure” keeping up with
personal health.
• “Talking cure”: Psychotherapy
was administered to either
individual or groups at a time.
• Also yielded an insight to
addiction
The Farm
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Inmates would learn hard work
Rose before dawn to milk cows and harvest crops
Award-winning dairy
Farm also had pigs and horses
Work was used as therapy
Prison bars were cut down
Inmates vs. residents
Population vs. Therapeutic communities
Less Success
• 93% who completed “the cure” went back to using drugs
immediately after being released.
• Despite efforts they could just not make change to addicts.
• One thing that came from Narco?
• The changed view society had on drug dependency.
• Just not be treated just like criminals, but get the help they
need.
• Narco shut down in the 1970s
Bibliography
• Campbell, Nancy D., JP Olsen, and Luke Walden. The Narcotic
Farm: The Rise and Fall of America's First Prison for Drug
Addicts. New York: Abrams, 2008. Print.
• White, William L. Slaying the Dragon: The History of Addiction
Treatment and Recovery in America. Bloomington, IL: Chestnut
Health Systems/Lighthouse Institute, 1998. Print.