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Recent Responses to Drug Use

Research into the mechanisms of drug addiction and dependence has greatly increased in the past quarter-century. In the nineteenth century, research centered on modes of delivery, the development of the hypodermic syringe, and the nature of opiate addiction.

The pattern of withdrawal was described and treatment for opiate addiction sought. Cocaine was offered, for example, as a cure for morphinism and alcoholism. Other cures were drawn from popu­lar medical theories of the time, autointoxication, and other aspects of immunological response.

Confidence in treatment was equaled only by en­thusiasm for research, until after World War I when, especially in the United States, a powerful reaction against drug use caused both professionals and the public to reject current treatments — which, in fact, were of little value - and to lose interest in research. The battle against drug abuse came to rely primarily on law enforcement. Research again found support in the late 1960s and the 1970s when consumption rose and there was a certain toleration of “recreational” or “experimental” drug use among youth. However, as fear of drugs and drug users increased, the public grew impatient with treat­ment and toleration of any drug use and, again, funding for research fell. In recent decades, signifi­cant advances have included the discovery of opiate receptor sites in the brain, of the existence of natu­rally produced opiates, endorphins, and of the exis­tence of chemicals that block opiate receptor sites. Specific treatment for cocaine dependence has eluded investigators.

On an international level, attempts have been made to interdict drugs coming from producing ar­eas; persuade local growers of poppies, coca bushes, and marijuana to grow other crops; arrest local deal­ers; and spray illicit crops with herbicides. Crop sub­stitution as an international policy dates to the 1920s, when the League of Nations sought to per­suade opium growers in Persia to grow other crops, and continues today in major opium-producing ar­eas, such as the “Golden Triangle” in northern Burma.

This scheme has not yet cut into the world supply of opium and coca and, of course, is irrelevant to the control of manufactured drugs such as syn­thetic opiates and stimulants like amphetamine. Spraying the crops of producing nations and other policies advocated by consuming nations raise sensi­tive questions of sovereignty. Furthermore, produc­ing nations claim, as they did during the first U.S. campaign to control production before World War I, that the problem is not production but the consum­ing nations’ demand for drugs.

In its worldwide campaign against addiction, the United States early in this century asserted that the use of narcotics for anything other than strictly medi­cal treatment was dangerous and morally wrong. This attitude represented the thinking of most North Americans at the time, but it was not a univer­sal view and is not a view always held by the United States. The vicissitudes of moral attitude toward addiction over the past two centuries illustrate that the response to addiction is intimately bound to the social history and mores of a nation or region at any given time. The history of addiction has a medical element, but it is also a reflection of nations’ charac­teristic approaches to individual and social prob­lems. Integration of the history of addictive sub­stances with the social history of nations and regions remains a fertile area for research.

David F. Musto

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Source: Kiple Kenneth F. (Editor). The Cambridge World History of Human Disease. Cambridge University Press,1993. — 1200 p.. 1993

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