First Period 19351949

From the start, the hospitals were designed to treat not only the physical dependence but also the mental and emotional problems thought to be re lated to addiction. This was an advanced conception, for treatment of narcotic addiction until then had been focused almost exclusively on the Physical dependence. The initial treatment programs at both hospitals emphasized residence in a drug-free environment for at least six months, during which time the patient could not only recover from the physical dependence but perhaps also overcome the mental difficulties or learn to adapt to them without using drugs. While all patients received psychological help in the form of encouragement and persuasion, only small numbers received formal psychotherapy. That was because few of the staff were trained in psychotherapy. All patients considered physically able had work assignments, and all had access to educational and vocational services, recreation, and religious activities. Treatment of voluntary patients was hindered because most left during or shortly after Withdrawal treatment (often to return to lower doses of their drug—before readmission). In 1948, the research division of the Lexington hospital reported that a new synthesized narcotic drug called Methadone was effective in the treatment of opiate withdrawal. Methadone substitution followed by a gradual decrease of its dose subsequently became the standard treatment for morphine and heroin withdrawal in the United States. Also in 1948 the research division of the Lexington hospital was administratively separated from the hospital, renamed the Addiction Research Center (ARC) and made a part of the National Institute of Mental Health (NIMH).

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