Over the last century, US and UK drug treatment policy has moved from abstinence to harm-reduction, and is currently being re-directed towards long-term recovery from drug use. The application of NeuroElectric Therapy (NET™) to combat acute and chronic withdrawal contributes to achieving this goal.

Prior to the First World War, drug consumption was considered a vice and legal sanctions were generally rare. There was open availability of opiate and stimulant compounds from physicians, pharmacies, general stores and by mail order.

While various Acts restricted access to drugs within the UK, drug-taking was largely seen as a medical affliction rather than as criminal behavior. Medical response retained primacy over legal stricture; a policy confirmed by the Rolleston Committee Report of 1924 that confirmed physicians remained free to treat addiction by maintenance-prescribing.

In the United States, however, the 1914 Harrison Act stipulated prescribing ‘in the course of his professional practice only’ and maintenance-prescribing was banned. Despite calls for specialised narcotics treatment facilities, only in 1935 did the first Public Health Service hospital open; a thousand-bed unit in Lexington, Kentucky. Others followed. Although abstinence remained official policy, neither medicine nor the law could demonstrate successful long-term abstinence using ‘cold turkey’ approaches or pharmacology-assisted withdrawal. Addiction slowly became accepted as a ‘chronic relapsing condition’.

In 1960’s Britain, as drug use increased substantially and official concern grew over notably profligate over-prescribing, the Brain Committee re-examined British policy and recommended the creation of specialist clinics. At the same time in the USA, Dole and Nyswander continued with their investigation of methadone as a maintenance-based treatment programme. By 1970, they could report that 88% of program participants had achieved an arrest-free record and equally successful employment record. Nationally, the prevalence of heroin use amongst American forces returning from Vietnam led to a significant policy-shift towards ‘rehabilitation’ of addicts. Methadone substitution and maintenance came to form the cornerstone of that policy.

The explosion of HIV/AIDS in the 1980’s and 1990’s and the subsequent growth of Hepatitis infection gave further impetus towards harm-reduction policies and practice on both sides of the Atlantic, based primarily around methadone-maintenance and needle-exchange/risk reduction programmes.

As drug policy has recently begun to shift towards recovery as a measurable outcome, substitute prescribing has received criticism for the difficulty in producing long term drug free behavior with clients who express a desire for abstinence. NeuroElectric Therapy offers an exit path option from substitute prescriptions and is currently under evaluation for use with stabilised, high-dose methadone-dependants.

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