TREATMENT OR CONTROL? DILEMMAS FOR STAFF IN DRUG DEPENDENCY CLINICS (FROM PROBLEMS OF DRUG ABUSE IN BRITAIN, 1978, BY D J WEST - SEE NCJ-48378)

• NCJ Number: 48380
• Author(s): G V STIMSON
• Date Published: 1978
• Length: 22 pages
• Corporate Author: University of Cambridge
• Publication Format: Document
• Publication Type: Historical Overview
• Language: English
• Country: United States of America

Annotation

CONTROL OF THE DRUG PROBLEM AND ADDICT BEHAVIOR IS VIEWED IN ITS OVERSHADOWING EFFECTS ON TREATMENT IN DRUG DEPENDENCY CLINICS BY EXAMINING THE HISTORY OF BRITISH DRUG POLICY AND DAILY CLINIC OPERATIONS.

Abstract

BRITISH POLICY TOWARD DRUG ADDICTION BEGAN IN THE 1920'S WHEN THE FIRST LEGAL CONTROLS ON THE USE OF OPIATES WERE INTRODUCED. THESE LEGAL CONTROLS PROVIDED THAT OPIATES COULD BE DISTRIBUTED AND POSSESSED ONLY THROUGH MEDICAL DOCTORS ON A PRESCRIPTION BASIS FOR THE PURPOSE OF DISEASE TREATMENT. ADDICTION WAS INTERPRETED AS A DISEASE, THUS ALLOWING DOCTORS TO PRESCRIBE A DRUG OF ADDICTION, EITHER AS A PRELUDE TO WITHDRAWAL OR A FORM OF CONTROL OF AN INCURABLE CONDITION. THIS WAS THE GENERAL APPROACH TO DRUG CONTROL UNTIL 1967 WHEN THE DANGEROUS DRUGS ACT PROVIDED FOR THE ESTABLISHMENT OF DRUG DEPENDENCY CLINICS (DDC) WHOSE STAFFS ALONE ARE LICENSED TO PRESCRIBE ADDICTIVE DRUGS. IN ADDITION TO CONTROLLING THE ISSUING OF DRUGS THROUGHOUT THE COUNTRY, DDC WAS ALSO CHARGED WITH THE RESPONSIBILITY OF TREATING ADDICTS. BASED ON OBSERVATIONS OF THE DAILY OPERATIONS OF THE CLINICS AND CONVERSATIONS AND ACTIVITIES OF THE CLINIC STAFF IN INTERACTION WITH CLIENTS IS ORIENTED TOWARD CONTROLLING THE AMOUNT OF DRUG PRESCRIBED AND THE BEHAVIOR OF THE CLIENT WHILE IN THE CLINIC AND ON THE OUTSIDE. THE POWER OF THE STAFF TO ISSUE OR WITHHOLD DRUGS IS OFTEN USED BY THE STAFF TO CONTROL CLIENT BEHAVIOR. REALIZING THAT THE ADDICTS COULD SEEK DRUGS ELSEWHERE SHOULD THEIR DOSAGE BECOME TOO LOW OR BE WITHHELD, THE STAFF, TOO, IS MANIPULATED BY THE CLIENT WITH THE THREAT OF GOING TO ILLICIT SOURCES FOR DRUGS. THESE MANIPULATIVE GAMES ARE SEEN AS BEING PRIMARY IN THE INTERACTION BETWEEN STAFF AND CLIENT. IT IS REPORTED THAT STAFF MEMBERS ARE BEGINNING TO QUESTION WHETHER AN EFFECTIVE TREATMENT LEADING TO ADDICTION CURES CAN EFFECTIVELY OCCUR IN THIS CONTEXT. A SYSTEMATIC ANALYSIS OF THE IMPACT OF CLINICS IN THEIR DUAL ROLE OF CONTROL AND TREATMENT IS RECOMMENDED. (RCB)