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Kill or Cure: The Evolution of Addiction Treatment Through the Ages

As far back as history has been recorded, mankind has been using hallucinogens, opioids and stimulants for many varied purposes. Medical treatments, nutritional supplements, religious rituals, and even social events included the use of what we now call ‘illicit substances.” However, even in the early days of human civilization, and throughout history, society has condemned the abuse and overuse of such substances.

Alcoholism: Mankind’s Earliest Enemy

Thousands of years ago, before the were an option, alcohol was a commonly used drink in almost every part of the world. Some archaeological records date back to 10 thousand years ago in ancient China where people mixed honey, rice, and fruit in order to create alcohol. Even though a term for alcoholism hadn’t yet been invented, their society frowned upon excessive drinking.

It was in the early 19th century when a German doctor called Christoph Wilhelm Hufeland coined a term that would define the state of uncontrollable craving for alcohol. Hufeland named the addiction “Dipsomania”, which comes from the Greek dipso (‘thirst’) and mania.  The idea of dipsomania played an important historical role in promoting a disease theory of chronic drunkenness.

A century later, the puritan organizations like “Anti-Saloon League” popularized the new term ‘alcoholism’, which we still use today.

An 1820 engraving warning of the dangers of alcohol (public domain)

An 1820 engraving warning of the dangers of alcohol ( public domain )

Alcoholism became a problem of the industrial age, mostly because technological progress allowed faster and cheaper production of alcohol, which made the product more available to the public. Society supported the cause propagated by the pietistic Protestant organizations and soon the 18th Amendment to the US Constitution was in play, prohibiting the "manufacture, sale, or transportation of intoxicating liquors...".

The two decades of prohibition were not enough to extinguish people’s taste for alcohol. Alcoholism had taken its roots, and society was in dire need of rehab facilities and support groups, which finally emerged in the 1940s.

Since then, science has been working on finding new ways to treat alcoholism and illnesses like cirrhosis, clogged arteries, cancer, and many others that are direct or indirect consequences of the excessive use of alcohol.

Old wine barrels (Roman Sigaev / Adobe Stock)

Old wine barrels ( Roman Sigaev / Adobe Stock)

Heroin – The Modern Derivative of an Ancient Drug

Heroin’s origins lie in opium, an ancient drug from the sap of opium poppies that has been used as far back as the civilization of Mesopotamia around 3,400 BC. Opium was used by the ancient Egyptians and Persians, before spreading to Europe, India and China.

In 1805, morphine (named after the Greek god of dreams, Morpheus) was isolated from opium and Merck began marketing it commercially in 1827. However, when the American Civil War began to show victims of morphine addiction appearing among the wounded soldiers that took the drug for pain relief, a substitute had to be found.

Heroin was synthesized from morphine in 1874 by an English chemist, and attempts were made to use heroin instead of morphine due to problems of morphine abuse. It wasn’t realized at the time that Heroin was also highly addictive. The new substance proved to become an even greater threat, leading to the Harrison Act and the ban on importing, producing, and using any opium products. This ban, however, failed to keep people safe from heroin and it still remains one of the most dangerous opioids widely available on the street.

Opium Smokers in Central-Asia - 19th century (Erica Guilane-Nachez / Adobe Stock)

Opium Smokers in Central-Asia - 19th century ( Erica Guilane-Nachez / Adobe Stock)

Cocaine: From Coca to Crack

Coca is one of the oldest and most potent stimulants of natural origin. For at least 5,000 years, people of the high mountain ranges in the Andes, in South America, would chew on coca leaves to counter the effects of living in this mountain air – the stimulating effect of the coca would increase breathing and therefore oxygen intake.

In 1859, cocaine was extracted from coca leaves by German chemist Albert Niemann and by the 1880s, it has become popularized in the medical community. The drug got a massive popularity boost when it was included as an ingredient in Coca Cola in 1886 and was praised for its euphoric and energizing effects.

Cocaine became a celebrated drug, praised by politicians, scientists, and actors alike. The substance was widely used until a figure of around 200,000 cocaine addicts raised the alarm and the cocaine fell under the ban placed by Harrison Act in 1903. The new legislature kept the use of this drug under lockdown for a few decades, however in the early 70s, popular culture and lifestyle revamped cocaine. Crack cocaine – a crystallized form of the drug – became popular in the 1980s but was even more deadly. Between 1985 and 1989, the number of regular cocaine users jumped from 4.2 million to 5.8 million people.

Coca leaves for sale at a market in Peru (zeljka / Adobe Stock)

Coca leaves for sale at a market in Peru ( zeljka / Adobe Stock)

Addiction Treatments

The Oracle of Delphi was a popular place of gathering for the worshipers of Dionysus, the Greek God of wine. People would come and worship the god through excessive drinking and orgies. The walls of Delphi temple hold ancient writings that say “water is best,” “know thyself,” and “nothing in excess”. These writings indicate that people have been aware of the problems caused by alcohol for thousands of years.

Pythia, the Oracle of Delphi (public domain)

Pythia, the Oracle of Delphi (public domain)

In Ancient Egypt and Babylon, where alcohol was commonly used for recreational purposes, some taxations and monopolies limited the use of alcohol, its production, and sales. Simply put, there were no other methods to combat the overuse of alcohol.

In the 14th century, Turkish Sultan Murad IV punished the use of hashish by beheading the people, and the Russian tsar, Mikhail Fyodorovich Romanov would order the cutting of lips of anyone caught smoking cigarettes.  All these practices were a means of restricting the use of substances that lead to addiction. However, there is very little in historical accounts that indicate strategies for fighting addiction once it takes over.

Even though the use of alcohol and drugs is old as the human civilization, addiction treatments were all but non-existent until the 17th century. Calvinistic theologians were the first to offer theological explanations for uncontrolled intake of alcohol. However, the Calvinists blamed the sinful nature of mankind for this type of behavior and offered only prayer as a way to heal the soul from sin. Later on, Dutch scientists adapted the Calvinistic theory and gave the matter a scientific component describing alcoholism as a willful progressive loss of control over alcohol intake.

17th century engraving of Calvinist theologians (public domain)

17th century engraving of Calvinist theologians ( public domain )

Early addiction treatments were ineffective and based on completely invalid assumptions. Leslie Keely ran an institute in the early 19th century where he had patients injected with gold chloride four times a day to treat alcohol addiction. By the end of the 19 th century, over 200 Keeley Institutes were administering this supposed ‘cure’. The injections are likely to have been useless, but the institutes formed the foundations for group therapy and community support.

In the early 1900s, Bromide-sleep therapy was introduced as another miracle cure. Addicts were induced into a coma with bromide with the hope they would wake up cured from addiction. Unfortunately, the treatment had a very high death rate.

Other dangerous treatments included the consumption of the deadly nightshade plant belladonna, attempting to introduce antibodies to alcohol via cuts in the skins, administration of large doses of insulin to induce coma, electroshock therapy, and surgical removal of the frontal love of the brain.

Fortunately, modern treatments include a much safer and more holistic approach which address issues with mind, body and spirit. The addiction is carefully diagnosed, patients are supported, and counselling and other behavioral therapies are usually given, sometimes in tandem with medications. Drug rehab facilities of today don’t use invasive approaches, and while there’s still no universal cure, progress is undisputed.

Top image: Amazonian Shaman Smoking ( Ammit / Adobe Stock)

By Thanush Poulsen

References

Cellular basis of memory for addiction. Dialogues Clin Neurosci . 2013; 15(4): 431-43.

Eugenical Sterilization in the United States. Harry H. Laughlin. 1922.

Fermented beverages of pre- and proto-historic China. Proceedings of the National Academy of Sciences. Dec 2004; 101 (51): 17593-17598.

Historical and cultural aspects of man's relationship with addictive drugs. Dialogues Clin Neurosci . 2007; 9(4):355-61.

Public Acts of the Sixty-Third Congress of the United States. Sixty-Third Congress . Sess. III. Ch. 1. 1914.

The evolutionary origins and significance of drug addiction. Harm Reduction Journal . 2005; 2(8).

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