L1 – History of Drug Addiction
Early history Scythians (9th-1st Century BC)
- Scythian funeral rites
- Vapour of Scythian goldware
- Contained opium and cannabis following an analysis of black residue
inside the goldware vessels (Belinski, 2016)
Theriac (161-180 AD)
- Theriac developed to offset effects of poisoning attempts
- Used daily by Emperor Marcus Aurelius
- Found to contain opium and anti-anxiety results
- Used to ease stomach and chest problems but not to offset poison
Roman style prohibition (200 BC)
- Bacchanalia in Rome – Parties with drugs
- Banned in 5 AD – Specifically for young people, common peoples
(plebeians), and women
Hogarth’s Gin Lane (18th C)
- Promotions encouraging Gin usage Greatly increased consumption
- Inability to stop working class individuals from stopping
- 1689 – Grain prices very low, so English government began to encourage
grain distilling. Imports of French wine and spirits banned.
- 1703 – Charles Davenant on subsequent gin consumption - "Tis a growing
fad among the common people and may in time prevail as much as
opium with the Turks.” (Dillon, 2004)
- 1727 – Defoe ”…the Distillers have found out a way to hit the palate of
the Poor, …so that the common People seem not to value the French-
brandy as usual, and even not to desire it". [
- 1736 – Gin Act passed, high taxes on gin sales, and licence to sell gin.
Rioting ensued, had little effect beyond increasing smuggling and driving
the distilling trade underground (Dillon 2002).
- 1750’s (time of ‘Gin Lane’) – at least 11 million gallons consumed London
alone, with a population of less than 1 million.
- Subsequent decline in gin production due to poor grain harvests and
higher population leading to higher grain prices, lower wages, increased
food prices and less motivation to supply gin trade with grain (Dillon
2002).
Middle Class Addiction
- 2-part book discussion of opium addiction (Thomas de Quincey, 1821)
- Using laudanum for recreation (Lord Byron, 1788-1824)
- Addicted to laudanum after using for asthma treatment (Ada Lovelace,
1815-1852)
Class division and implications on drug addiction
- Higher classes often use drugs and is tolerated of doing so
- Lower classes often criminalised for using drugs
,Contemporar World War 1
y • Legal selling of drugs such as cocaine and opium
History • 1914 – Defence of the Realm Act (DORA; Regulation 40B). Ban on sale
and posSeminar of cocaine, opium, cannabis, and related psychoactive
substances to troops without a prescription.
• 1916 – supplies to troops continued, so Reg.40B extended to ban any
none-medical/veterinary professionals from prescribing.
Billie Carleton (Popular musical comedy actress)
• Frequent opium and cocaine use
• Died from drug overdose at 22 years old (1918)
The Rolleston Report
• 1924 – Government instituted the ‘Rolleston Committee’ to investigate
the extent to which doctors should supply drugs such as heroin and
morphine.
• Sir Humphry Rolleston, Chair of the Committed and President of the
Royal College of Physicians concluded:
• “Evidence we have received from most of the witnesses forbids any
sanguine estimate as to the proportion of permanent cures which may
be looked for from any method of treatment, however thorough.
Relapse, sooner or later, appears to be the rule, and permanent cure
the exception.” Rolleston Report (1926)
• Doctors were then able to continue to prescribe these drugs.
World War 2
• Fordham (1986): social upheavals of WWII gave rise to new underground
club scene in London, including GI’s and sailors. Jazz blossomed, together
with wide availability of drugs e.g. cannabis (cf. Windrush).
• These clubs became the “crucible of the ‘be-bop rebellion”.
• Kohn (2012): the authorities noted the wartime return of opium, and a
new, post-war rise in cannabis seizures.
• Sunday Graphic (John Ralph, September 1951):
• “…there is the gravest danger of the reefer craze becoming the
greatest social menace this country has known…the other day I
sat in a tawdry West End Club…
Development of drugs in British system
• 1961 – Single Convention on Narcotic Drugs UN International Treaty
signed, banned countries from treating addicts by prescribing illegal
substances, allowing only scientific and medical uses of drugs. Not
binding.
• 1964 – Dangerous Drugs Act: the UK enacted the UN 1961 Single
Convention, and also criminalised posSeminar of small amounts of
narcotic drugs.
• 1964 - Drugs (Prevention of Misuse Act): criminalised posSeminar of
amphetamines.
• 1971 – Misuse of Drugs Act: Introduced classes A, B, and C of drugs.
Created offence of "intent to supply". Increased penalties for trafficking
and supply (14 years imprisonment for trafficking Class A drugs).
Established the Advisory Council on the Misuse of Drugs (ACMD).
, Dr. John Marks – The widnes Experiment
• Hari (2015): “[Beginning in 1982,]…every Thursday, a slew of addicts
came into the clinic, and it was John’s job to write them prescriptions for
heroin. They sat down. They answered a few questions. Then they were
given enough heroin to last them until the following Thursday. And that
was it. At first, John was bemused, thinking this a bizarre idea. Free
heroin for addicts?”
• Marks commissioned Dr Russell Newcombe who found (surprisingly) that
none of the addicts had HIV, and none of them had typical issues e.g.
overdoses, abscesses, etc. They mostly had regular jobs and led normal
lives.
• For example, Marks (1994): “Sydney was ‘an old Liverpool docker,
happily married, lovely couple of kids. ‘He’d been chugging along on his
heroin for a couple of decades [with no issues]…”
• Marks (1994): “…[the] rate of recovery was not different from those not
prescribed drugs but…sixteen deaths would have been expected after
seven years. There have been no deaths among the maintained Widnes
addicts. If the remission rate is …impervious to external agency, medical
intervention should try and ensure healthy survival…”
• Hari (2015): “When Dr Marks was prescribing, from 1982 to 1995, he
never had a drug-related death. After closure, of 450 patients he
prescribed to, 20 were dead in six months. Forty-one were dead in two
years. More lost limbs and caught potentially lethal diseases. Sydney the
docker died.”
• Dr Marks was blacklisted, and needed to move to Gisborne, New Zealand
to find work.
Major aspects Nutt (2009)
of legislation
Mean Harm Scores vs. Classification (Nutt et al., 2007)
, Media attention (Nutt et al., 2007)
• 2007: Advisory Panel asked by the Home Secretary Jacqui Smith to
review the Class C status of cannabis as:
• "Though statistics show that cannabis use has fallen significantly,
there is real public concern about the potential mental health
effects of cannabis use, in particular the use of stronger forms of
the drug, commonly known as skunk. “
• 2008: Advisory Panel (Rawlings et al. 2008) reported that “The
harms caused by cannabis are not considered to be as serious
as drugs in class B and therefore it should remain a class C
drug.”
• 2008: Government moved cannabis up to Class B anyway.
L2 – Neural Bases of Reward
Focus The mesolimbic dopamine system (MDS)
- Or the mesoaccumbens dopamine projection
- Dopamine = Pleasure, but also aversive stimuli
Details of MDS
- The system passes through the medial forebrain bundle (MFB) between
the VTA and nucleus accumbens
Early history Scythians (9th-1st Century BC)
- Scythian funeral rites
- Vapour of Scythian goldware
- Contained opium and cannabis following an analysis of black residue
inside the goldware vessels (Belinski, 2016)
Theriac (161-180 AD)
- Theriac developed to offset effects of poisoning attempts
- Used daily by Emperor Marcus Aurelius
- Found to contain opium and anti-anxiety results
- Used to ease stomach and chest problems but not to offset poison
Roman style prohibition (200 BC)
- Bacchanalia in Rome – Parties with drugs
- Banned in 5 AD – Specifically for young people, common peoples
(plebeians), and women
Hogarth’s Gin Lane (18th C)
- Promotions encouraging Gin usage Greatly increased consumption
- Inability to stop working class individuals from stopping
- 1689 – Grain prices very low, so English government began to encourage
grain distilling. Imports of French wine and spirits banned.
- 1703 – Charles Davenant on subsequent gin consumption - "Tis a growing
fad among the common people and may in time prevail as much as
opium with the Turks.” (Dillon, 2004)
- 1727 – Defoe ”…the Distillers have found out a way to hit the palate of
the Poor, …so that the common People seem not to value the French-
brandy as usual, and even not to desire it". [
- 1736 – Gin Act passed, high taxes on gin sales, and licence to sell gin.
Rioting ensued, had little effect beyond increasing smuggling and driving
the distilling trade underground (Dillon 2002).
- 1750’s (time of ‘Gin Lane’) – at least 11 million gallons consumed London
alone, with a population of less than 1 million.
- Subsequent decline in gin production due to poor grain harvests and
higher population leading to higher grain prices, lower wages, increased
food prices and less motivation to supply gin trade with grain (Dillon
2002).
Middle Class Addiction
- 2-part book discussion of opium addiction (Thomas de Quincey, 1821)
- Using laudanum for recreation (Lord Byron, 1788-1824)
- Addicted to laudanum after using for asthma treatment (Ada Lovelace,
1815-1852)
Class division and implications on drug addiction
- Higher classes often use drugs and is tolerated of doing so
- Lower classes often criminalised for using drugs
,Contemporar World War 1
y • Legal selling of drugs such as cocaine and opium
History • 1914 – Defence of the Realm Act (DORA; Regulation 40B). Ban on sale
and posSeminar of cocaine, opium, cannabis, and related psychoactive
substances to troops without a prescription.
• 1916 – supplies to troops continued, so Reg.40B extended to ban any
none-medical/veterinary professionals from prescribing.
Billie Carleton (Popular musical comedy actress)
• Frequent opium and cocaine use
• Died from drug overdose at 22 years old (1918)
The Rolleston Report
• 1924 – Government instituted the ‘Rolleston Committee’ to investigate
the extent to which doctors should supply drugs such as heroin and
morphine.
• Sir Humphry Rolleston, Chair of the Committed and President of the
Royal College of Physicians concluded:
• “Evidence we have received from most of the witnesses forbids any
sanguine estimate as to the proportion of permanent cures which may
be looked for from any method of treatment, however thorough.
Relapse, sooner or later, appears to be the rule, and permanent cure
the exception.” Rolleston Report (1926)
• Doctors were then able to continue to prescribe these drugs.
World War 2
• Fordham (1986): social upheavals of WWII gave rise to new underground
club scene in London, including GI’s and sailors. Jazz blossomed, together
with wide availability of drugs e.g. cannabis (cf. Windrush).
• These clubs became the “crucible of the ‘be-bop rebellion”.
• Kohn (2012): the authorities noted the wartime return of opium, and a
new, post-war rise in cannabis seizures.
• Sunday Graphic (John Ralph, September 1951):
• “…there is the gravest danger of the reefer craze becoming the
greatest social menace this country has known…the other day I
sat in a tawdry West End Club…
Development of drugs in British system
• 1961 – Single Convention on Narcotic Drugs UN International Treaty
signed, banned countries from treating addicts by prescribing illegal
substances, allowing only scientific and medical uses of drugs. Not
binding.
• 1964 – Dangerous Drugs Act: the UK enacted the UN 1961 Single
Convention, and also criminalised posSeminar of small amounts of
narcotic drugs.
• 1964 - Drugs (Prevention of Misuse Act): criminalised posSeminar of
amphetamines.
• 1971 – Misuse of Drugs Act: Introduced classes A, B, and C of drugs.
Created offence of "intent to supply". Increased penalties for trafficking
and supply (14 years imprisonment for trafficking Class A drugs).
Established the Advisory Council on the Misuse of Drugs (ACMD).
, Dr. John Marks – The widnes Experiment
• Hari (2015): “[Beginning in 1982,]…every Thursday, a slew of addicts
came into the clinic, and it was John’s job to write them prescriptions for
heroin. They sat down. They answered a few questions. Then they were
given enough heroin to last them until the following Thursday. And that
was it. At first, John was bemused, thinking this a bizarre idea. Free
heroin for addicts?”
• Marks commissioned Dr Russell Newcombe who found (surprisingly) that
none of the addicts had HIV, and none of them had typical issues e.g.
overdoses, abscesses, etc. They mostly had regular jobs and led normal
lives.
• For example, Marks (1994): “Sydney was ‘an old Liverpool docker,
happily married, lovely couple of kids. ‘He’d been chugging along on his
heroin for a couple of decades [with no issues]…”
• Marks (1994): “…[the] rate of recovery was not different from those not
prescribed drugs but…sixteen deaths would have been expected after
seven years. There have been no deaths among the maintained Widnes
addicts. If the remission rate is …impervious to external agency, medical
intervention should try and ensure healthy survival…”
• Hari (2015): “When Dr Marks was prescribing, from 1982 to 1995, he
never had a drug-related death. After closure, of 450 patients he
prescribed to, 20 were dead in six months. Forty-one were dead in two
years. More lost limbs and caught potentially lethal diseases. Sydney the
docker died.”
• Dr Marks was blacklisted, and needed to move to Gisborne, New Zealand
to find work.
Major aspects Nutt (2009)
of legislation
Mean Harm Scores vs. Classification (Nutt et al., 2007)
, Media attention (Nutt et al., 2007)
• 2007: Advisory Panel asked by the Home Secretary Jacqui Smith to
review the Class C status of cannabis as:
• "Though statistics show that cannabis use has fallen significantly,
there is real public concern about the potential mental health
effects of cannabis use, in particular the use of stronger forms of
the drug, commonly known as skunk. “
• 2008: Advisory Panel (Rawlings et al. 2008) reported that “The
harms caused by cannabis are not considered to be as serious
as drugs in class B and therefore it should remain a class C
drug.”
• 2008: Government moved cannabis up to Class B anyway.
L2 – Neural Bases of Reward
Focus The mesolimbic dopamine system (MDS)
- Or the mesoaccumbens dopamine projection
- Dopamine = Pleasure, but also aversive stimuli
Details of MDS
- The system passes through the medial forebrain bundle (MFB) between
the VTA and nucleus accumbens
