The 'British system' of heroin addiction treatment and the opening of drug dependence units, 1965-1970

Social History of Medicine

Volumn 17, Issue 3, 2004, Pages 501-517

  Mold, Alex ^a  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

Author keywords

'British System'; Addict; Addiction; Brain Committee; Drug Dependence Unit; Heroin; Hospital; Psychiatry; Social disease; Treatment

Indexed keywords

EID: 10344257287     PISSN: 0951631X     EISSN: None     Source Type: Journal    
DOI: 10.1093/shm/17.3.501     Document Type: Article

References (131)

1. J. Warner, '"Resolv'd to Drink no More": Addiction as a Preindustrial Construct', Journal of Studies on Alcohol, 55 (1994), 685-91, p. 688.
2. V. Berridge, Opium and the People: Opiate Use and Drug Control Policy in Nineteenth- and Early Twentieth-century England (London, 1999), pp. 277-8.
3. Ministry of Health, Drug Addiction: Second Report of the Interdepartmental Committee on Drug Addiction (London, 1965).
4. Berridge, Opium and the People. Other historians who have examined the use and control of opiates in Britain include R. Davenport-Hines, The Pursuit of Oblivion: A Global History of Narcotics 1500-2000 (London, 2001); G. Harding, Opiate Addiction, Morality and Medicine: From Moral Illness to Pathological Disease (Basingstoke, 1988); T. Parssinen, Secret Passions, Secret Remedies: Narcotic Drugs in British Society 1820-1930 (Manchester, 1983).
5. Berridge, Opium and the People. Other historians who have examined the use and control of opiates in Britain include R. Davenport-Hines, The Pursuit of Oblivion: A Global History of Narcotics 1500-2000 (London, 2001); G. Harding, Opiate Addiction, Morality and Medicine: From Moral Illness to Pathological Disease (Basingstoke, 1988); T. Parssinen, Secret Passions, Secret Remedies: Narcotic Drugs in British Society 1820-1930 (Manchester, 1983).
6. Berridge, Opium and the People. Other historians who have examined the use and control of opiates in Britain include R. Davenport-Hines, The Pursuit of Oblivion: A Global History of Narcotics 1500-2000 (London, 2001); G. Harding, Opiate Addiction, Morality and Medicine: From Moral Illness to Pathological Disease (Basingstoke, 1988); T. Parssinen, Secret Passions, Secret Remedies: Narcotic Drugs in British Society 1820-1930 (Manchester, 1983).
7. Berridge, Opium and the People. Other historians who have examined the use and control of opiates in Britain include R. Davenport-Hines, The Pursuit of Oblivion: A Global History of Narcotics 1500-2000 (London, 2001); G. Harding, Opiate Addiction, Morality and Medicine: From Moral Illness to Pathological Disease (Basingstoke, 1988); T. Parssinen, Secret Passions, Secret Remedies: Narcotic Drugs in British Society 1820-1930 (Manchester, 1983).
8. Berridge, Opium and the People.
9. M. Kohn, Dope Girls: The Birth of the British Drug Underground (London, 1992).
10. Berridge, Opium and the People, pp. 258-60, 262-4.
11. Ibid., pp. 264-7.
12. Ministry of Health, Report of the Departmental Committee on Morphine and Heroin Addiction (London, 1926), p. 2.
13. Ibid., pp. 9-13; V. Berridge, '"Stamping Out Addiction": The Work of the Rolleston Committee, 1924-6', in H. Freeman and G. E. Berrios (eds), 150 Years of British Psychiatry, Volume II: The Aftermath (London, 1996), 44-60.
14. Ibid., pp. 9-13; V. Berridge, '"Stamping Out Addiction": The Work of the Rolleston Committee, 1924-6', in H. Freeman and G. E. Berrios (eds), 150 Years of British Psychiatry, Volume II: The Aftermath (London, 1996), 44-60.
15. Departmental Committee on Morphine and Heroin Addiction, p. 11.
16. Berridge, Opium and the People, pp. 277-8; M. Kohn, Narcomania: On Heroin (London, 1987), pp. 99-100.
17. Berridge, Opium and the People, pp. 277-8; M. Kohn, Narcomania: On Heroin (London, 1987), pp. 99-100.
18. Berridge, Opium and the People, p. 278.
19. Ibid., pp. 277-8.
20. J. Strang and M. Gossop, 'The "British System": Visionary Anticipation or Masterly Inactivity?', in J. Strang and M. Gossop (eds), Heroin Addiction and British Drug Policy: The British System (Oxford, 1994), 343-51.
21. G. Edwards, 'Some Years On: Evolutions in the "British System'", in D. J. West (ed.), Problems of Drug Abuse in Britain: Papers Presented to the Cropwood Round-Table Conference (Cambridge, 1978), 1-51; H. B. Spear, 'The Early Years of the "British System" in Practice', in Strang and Gossop (eds), Heroin Addiction and British Drug Policy, 6-27.
22. G. Edwards, 'Some Years On: Evolutions in the "British System'", in D. J. West (ed.), Problems of Drug Abuse in Britain: Papers Presented to the Cropwood Round-Table Conference (Cambridge, 1978), 1-51; H. B. Spear, 'The Early Years of the "British System" in Practice', in Strang and Gossop (eds), Heroin Addiction and British Drug Policy, 6-27.
23. J. Witton, F. Keaney, and J. Strang, 'Opiate Addiction and the "British System": Looking Back on the Twentieth Century and Trying to see its Shape in the Future', in J. Sheridan and J. Strang, Drug Misuse and Community Pharmacy (London, 2003), 5-16, p. 7.
24. See, for example, E. Schur, Narcotic Addiction in Britain and America: The Impact of Public Policy (Bloomington and London, 1962); G. Stimson and E. Oppenheimer, Heroin Addiction: Treatment and Control in Britain (London and New York, 1982); A. Trebach, The Heroin Solution (New Haven and London, 1982).
25. See, for example, E. Schur, Narcotic Addiction in Britain and America: The Impact of Public Policy (Bloomington and London, 1962); G. Stimson and E. Oppenheimer, Heroin Addiction: Treatment and Control in Britain (London and New York, 1982); A. Trebach, The Heroin Solution (New Haven and London, 1982).
26. See, for example, E. Schur, Narcotic Addiction in Britain and America: The Impact of Public Policy (Bloomington and London, 1962); G. Stimson and E. Oppenheimer, Heroin Addiction: Treatment and Control in Britain (London and New York, 1982); A. Trebach, The Heroin Solution (New Haven and London, 1982).
27. H. B. Spear, Heroin Addiction Care and Control: The British System 1916-1984 (London, 2002).
28. Ministry of Health, Drug Addiction: Report of the Interdepartmental Committee (London, 1961), p. 3.
29. Ibid., pp. 16-17.
30. Ministry of Health, Drug Addiction: Report of the Second Interdepartmental Committee, p. 5.
31. Davenport-Hines, The Pursuit of Oblivion, p. 312.
32. Quoted in The National Archives, Public Record Office, Kew (hereafter PRO), MH 149/166, Home Office Memorandum presented to the Interdepartmental Committee on Drug Addiction, 1964.
33. Drug Addiction: Report of the Second Interdepartmental Committee, p. 8.
34. Ibid., p. 8.
35. M. Hilton, Smoking in British Popular Culture 1800-2000 (Manchester, 2000), pp. 179-80, 189-90.
36. Drug Addiction: Report of the Second Interdepartmental Committee, p. 9; PRO, MH 149/166, third Meeting of the Second Interdepartmental Committee, 4 December 1964; Ibid., Home Office Memorandum presented to the Interdepartmental Committee on Drug Addiction, 1964.
37. Drug Addiction: Report of the Second Interdepartmental Committee, p. 9; PRO, MH 149/166, third Meeting of the Second Interdepartmental Committee, 4 December 1964; Ibid., Home Office Memorandum presented to the Interdepartmental Committee on Drug Addiction, 1964.
38. Drug Addiction: Report of the Second Interdepartmental Committee, p. 9; PRO, MH 149/166, third Meeting of the Second Interdepartmental Committee, 4 December 1964; Ibid., Home Office Memorandum presented to the Interdepartmental Committee on Drug Addiction, 1964.
39. Stimson and Oppenheimer, Heroin Addiction, p. 54.
40. Trebach, The Heroin Solution, p. 174.
41. D. Armstrong, The Political Anatomy of the Body (Cambridge, 1983).
42. M. Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (London, 1973).
43. R. Lart, 'Changing Images of the Addict and Addiction', http://www.drugtext.org/92333.html, 1-8. Also, in International Journal on Drug Policy, 1 (1992), 118-25. Lart elaborates on these themes in idem, 'HIV and English Drugs Policy' (unpublished Ph.D. thesis, London, 1996), pp. 40, 51-5.
44. R. Lart, 'Changing Images of the Addict and Addiction', http://www.drugtext.org/92333.html, 1-8. Also, in International Journal on Drug Policy, 1 (1992), 118-25. Lart elaborates on these themes in idem, 'HIV and English Drugs Policy' (unpublished Ph.D. thesis, London, 1996), pp. 40, 51-5.
45. R. Lart, 'Changing Images of the Addict and Addiction', http://www.drugtext.org/92333.html, 1-8. Also, in International Journal on Drug Policy, 1 (1992), 118-25. Lart elaborates on these themes in idem, 'HIV and English Drugs Policy' (unpublished Ph.D. thesis, London, 1996), pp. 40, 51-5.
46. Ibid. Here, Lart is clearly drawing on notions of surveillance and discipline in M. Foucault, Discipline and Punish: The Birth of the Prison (New York, 1979).
47. V. Berridge, Health and Society in Britain Since 1939 (Cambridge, 1999), pp. 48-54. See also D. Porter, Health, Civilisation and the State: A History of Public Health from Ancient to Modern Times (London, 1999).
48. V. Berridge, Health and Society in Britain Since 1939 (Cambridge, 1999), pp. 48-54. See also D. Porter, Health, Civilisation and the State: A History of Public Health from Ancient to Modern Times (London, 1999).
49. Drug Addiction: Report of the Second Interdepartmental Committee, p. 8.
50. C. Smart, 'Social Policy and Drug Addiction: A Critical Study of Policy Development', British Journal of Addiction, 79 (1984), 31-9, pp. 35-6.
51. Stimson and Oppenheimer, Heroin Addiction, pp. 94, 205-19; G. Stimson, 'Treatment or Control?', in West (ed.), Problems of Drug Abuse in Britain, 52-73.
52. Stimson and Oppenheimer, Heroin Addiction, pp. 94, 205-19; G. Stimson, 'Treatment or Control?', in West (ed.), Problems of Drug Abuse in Britain, 52-73.
53. BMJ, 27 November 1965, pp. 1259-60.
54. I b i d.
55. I b i d.
56. The Times, 21 December 1965, p. 5; Stimson and Oppenheimer, Heroin Addiction, p. 54.
57. The Times, 21 December 1965, p. 5; Stimson and Oppenheimer, Heroin Addiction, p. 54.
58. Lancet, 27 November 1965, pp. 1113-4.
59. PRO, MH 149/170, Letter from the Scottish BMA to Sharp, 6 December 1966.
60. Dangerous Drugs Act, 1967; Dangerous Drugs (Notification of Addicts) Regulations, 1968.
61. Dangerous Drugs Act, 1967; Dangerous Drugs (Notification of Addicts) Regulations, 1968.
62. Trebach, The Heroin Solution, p. 183.
63. Sunday Times, 20 August 1967, pp. 1-3.
64. PRO, MH 149/170, Meeting between representatives of the Ministry of Health (MoH) and Dr Goulding, 10 May 1966.
65. 'Conversation with Thomas Bewley', Addiction, 90 (1995), 883-92, p. 885.
66. PRO, MH 149/170, Meeting between representatives of the MoH and Dr R. Goulding, 10 May 1966.
67. H. D. Beckett, 'Society at Work: Maintaining Heroin Addicts', New Society, 14 September 1967, 360-1; idem, 'The Salter Unit - An Experimental In-patient Treatment Centre for Narcotic Addiction in Men', British Journal of Addiction, 63 (1968), 51-3.
68. H. D. Beckett, 'Society at Work: Maintaining Heroin Addicts', New Society, 14 September 1967, 360-1; idem, 'The Salter Unit - An Experimental In-patient Treatment Centre for Narcotic Addiction in Men', British Journal of Addiction, 63 (1968), 51-3.
69. See 'Conversation with Thomas Bewley', p. 887; T. Bewley, 'Advantages of Special Centres', BMJ, 20 May 1967, 498-9; T. Bewley, 'Heroin and Cocaine Addiction', Lancet, 10 April 1965, 808-10; PRO, MH 149/172, Meeting between representatives of the MoH and Dr T. Bewley and Dr A. B. Monro, 1966.
70. See 'Conversation with Thomas Bewley', p. 887; T. Bewley, 'Advantages of Special Centres', BMJ, 20 May 1967, 498-9; T. Bewley, 'Heroin and Cocaine Addiction', Lancet, 10 April 1965, 808-10; PRO, MH 149/172, Meeting between representatives of the MoH and Dr T. Bewley and Dr A. B. Monro, 1966.
71. See 'Conversation with Thomas Bewley', p. 887; T. Bewley, 'Advantages of Special Centres', BMJ, 20 May 1967, 498-9; T. Bewley, 'Heroin and Cocaine Addiction', Lancet, 10 April 1965, 808-10; PRO, MH 149/172, Meeting between representatives of the MoH and Dr T. Bewley and Dr A. B. Monro, 1966.
72. PRO, MH 149/172, Meeting between representatives of the MoH and Dr T. Bewley and Dr A. B. Monro, 1966.
73. PRO, MH 150/369, HM 67 (16), 'Treatment and Supervision of Heroin Addiction', March 1967.
74. Drug Addiction: Report of the Second Interdepartmental Committee, p. 8.
75. PRO, MH 149/172, Outline scheme for implementing the recommendations of the Brain Committee, 31 October 1966.
76. B. Thom, Dealing With Drink: Alcohol and Social Policy From Treatment to Management (London, 1999), pp. 45-66.
77. PRO, MH 160/709.
78. PRO, MH 160/709, Memorandum from K. J. Moyes to Slater, 9 February 1967.
79. PRO, MH 160/709, Note of meeting between A. Winner and Dr S. Clark of Guy's Hospital, 15 December 1966.
80. PRO, MH 160/709, Note of meeting between K. J. Moyes, G. Tooth, and Powditch of St Mary's Hospital, 7 February 1967.
81. PRO, MH 160/709, Note of meeting between A. Winner and Dr S. Clark, 15 December 1966.
82. PRO, MH 149/170, Letter to C. H. W. Hodges from F. A. Adams, 18 November 1965.
83. PRO, MH 160/709, Memorandum from K. J. Moyes to Slater, 9 February 1967.
84. PRO, MH 160/710, Letter from Driscoll at St Thomas' Hospital to K. J. Moyes, 26 September 1967; Estimate of Costs of Unit for the Treatment of Addiction, no date.
85. PRO, MH 160/709, Letter to J. Hauff from the House Governor of the Westminster Hospital, 7 June 1967.
86. London Metropolitan Archive (LMA), H1/ST/A128/13, Letter to the MoH from the Chairman of the Medical Committee, St Thomas' Hospital, 3 April 1967.
87. PRO, MH 160/710, Slater to G. Tooth and Shore, 28 July 1967.
88. Beckett, 'Society at Work: Maintaining Heroin Addicts', pp. 360-1.
89. I b i d.
90. Hansard [HC], 732, col. 856, 21 July 1966; question by W. Deedes, HC, 729, cols 283-4, 24 May 1966; question by R. Short, HC, 732, cols 865-6, 21 July 1966.
91. Hansard [HC], 732, col. 856, 21 July 1966; question by W. Deedes, HC, 729, cols 283-4, 24 May 1966; question by R. Short, HC, 732, cols 865-6, 21 July 1966.
92. Hansard [HC], 732, col. 856, 21 July 1966; question by W. Deedes, HC, 729, cols 283-4, 24 May 1966; question by R. Short, HC, 732, cols 865-6, 21 July 1966.
93. See, for example, W. Deedes, The Drugs Epidemic (London, 1970); Hansard [HC], 740, cols 121-74, 30 January 1967.
94. See, for example, W. Deedes, The Drugs Epidemic (London, 1970); Hansard [HC], 740, cols 121-74, 30 January 1967.
95. I b i d.
96. Sunday Times, 20 August 1967, p. 3.
97. Guardian, 16 November 1967, p. 4.
98. The Times, 8 July 1967, p. 1.
99. PRO, MH 160/709, Letter from Dr A. Hawes to K. Robinson, 31 May 1967.
100. PRO, MH 160/709, K. J. Moyes to Slater on the options of how to deal with Hawes, 15 June 1967.
101. PRO, MH 160/709, Reply to A. Hawes, 22 June 1967.
102. The Times, 8 July 1967, p. 1
103. I b i d.
104. I b i d.
105. See, for example, The Times, 14 July 1967, p. 7, The Times, 18 July 1967, p. 8, and Sunday Times, 20 August 1967.
106. See, for example, The Times, 14 July 1967, p. 7, The Times, 18 July 1967, p. 8, and Sunday Times, 20 August 1967.
107. See, for example, The Times, 14 July 1967, p. 7, The Times, 18 July 1967, p. 8, and Sunday Times, 20 August 1967.
108. A. Hawes, Lancet, 22 July 1967, p. 208.
109. BMJ, 11 February 1967, pp. 319-20; BMJ, 2 March 1968, p. 719.
110. BMJ, 11 February 1967, pp. 319-20; BMJ, 2 March 1968, p. 719.
111. PRO, MH 160/709, Organisation of the Treatment and Supervision of Heroin Addiction, no date.
112. PRO, MH 150/369, HM 67 (16), Treatment and Supervision of Heroin Addiction', March 1967.
113. Figures quoted in Stimson and Oppenheimer, Heroin Addiction, p. 81.
114. Ibid., pp. 81-2.
115. PRO, MH 150/369, Letter from County Medical Officer of Health, Cambridgeshire to the MoH, 4 March 1968.
116. PRO, MH 160/709, Report of visit to Charing Cross Hospital.
117. M. Tripp, quoted in H. F. Judson, Heroin Addiction in Britain (New York, 1973), p. 93, and D. Beckett, quoted in Davenport-Hines, The Pursuit of Oblivion, pp. 321-2.
118. M. Tripp, quoted in H. F. Judson, Heroin Addiction in Britain (New York, 1973), p. 93, and D. Beckett, quoted in Davenport-Hines, The Pursuit of Oblivion, pp. 321-2.
119. Quoted in Judson, Heroin Addiction in Britain, p. 87.
120. Spear, 'The Early Years of the "British System'", p. 24.
121. 'Conversation with Thomas Bewley', p. 886; 'Conversation with Philip Connell', British Journal of Addiction, 85 (1990), 13-23, pp. 16-17.
122. 'Conversation with Thomas Bewley', p. 886; 'Conversation with Philip Connell', British Journal of Addiction, 85 (1990), 13-23, pp. 16-17.
123. Spear, Heroin Addiction: Care and Control, pp. 193, 209-10; A. Glanz, 'The Fall and Rise of the General Practitioner', in Strang and Gossop, Heroin Addiction and Drug Policy, pp. 151-66.
124. Spear, Heroin Addiction: Care and Control, pp. 193, 209-10; A. Glanz, 'The Fall and Rise of the General Practitioner', in Strang and Gossop, Heroin Addiction and Drug Policy, pp. 151-66.
125. For an account of clinic treatment policies, see Stimson and Oppenheimer, Heroin Addiction, pp. 81-113, 205-25; Spear, Heroin Addiction Care and Control, pp. 235-54.
126. For an account of clinic treatment policies, see Stimson and Oppenheimer, Heroin Addiction, pp. 81-113, 205-25; Spear, Heroin Addiction Care and Control, pp. 235-54.
127. For an account of clinic treatment policies, see Stimson and Oppenheimer, Heroin Addiction, pp. 81-113, 205-25; Spear, Heroin Addiction Care and Control, pp. 235-54.
128. For an account of clinic treatment policies, see Stimson and Oppenheimer, Heroin Addiction, pp. 81-113, 205-25; Spear, Heroin Addiction Care and Control, pp. 235-54.
129. Trebach, The Heroin Solution, p. 110; Stimson and Oppenheimer, Heroin Addiction, p. 61.
130. Trebach, The Heroin Solution, p. 110; Stimson and Oppenheimer, Heroin Addiction, p. 61.
131. Quoted in Judson, Heroin Addiction in Britain, p. 145.