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E History of Drug Addiction Research: Key Discoveries/Events, National Policies, and Funding
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APPENDIX E History of Drug Addiction Research: Key Discoveries/Events, National Policies, and Funding Event Funding Historical Time Line Theme Dr. Benjamin Rush, a signer of the Declaration of Independence and surgeon general of the Continental Army, was one of the pioneers of drug addiction research in the new America. 1784 Pioneer researcher in substance abuse, Dr. Benjamin Rush, published a pamphlet entitled, "An Inquiry into the Effects of Ardent Spirits on the Mind and Body" 1806 F.W.A. Sertürner, a German pharmacist, extracted the first addictive ingredient, morphine, from crude opium, revolutionizing pain control Morphine and Pain Control Availability of morphine and the new hypodermic syringe during the Civil War created the "army disease." 1868 Congress enacted the Pharmacy Act, requiring registration of individuals dispensing drugs 1875 Key elements of human addiction to morphine identified (e.g., fixation, withdrawal) 1897 Gioffredi's study on possible immune system antibodies to morphine or other toxins The Bayer Company sold cocaine in pure form, as well as morphine and heroin, through pharmacies beginning in 1898.
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The soft drink Coca-Cola contained cocaine until 1903, when it was replaced with caffeine. 1906 U.S. Pure Food and Drug Act required that fraudulent claims be removed from patent medicines and that habit-forming ingredients be disclosed Narcotic Control 1908 Nobel Prize winner Elie Metchnikoff's work helped to develop the theory of "autointoxication" related to narcotic dependence 1909 International Opium Commission convened in Shanghai to begin international discussions concerning the problems of narcotics and the narcotics trade Congress banned opium imports 1913 Rockefeller Institute created the Bureau of Social Hygiene to study drug addiction and its role in society and impact on criminality Substance Abuse and Criminality 1914 Valenti's study of the hypothesis that toxins produce abstinence effects
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Event Funding Historical Time Line Theme Around World War I, a growing fear of drug addiction prompted more and more restrictive legislation to prevent easy access to drugs. The Harrison Anti-Narcotics Act of 1914 set forth a 6-year federal effort to control distribution of opiates and cocaine. In 1915, doctors who prescribed narcotics to addicts to help them avoid withdrawal were prosecuted. Congress passed the Harrison Anti-Narcotic Act, which began to regulate the production and sale of opiates and cocaine 1919 Supreme Court ratified the Harrison Anti-Narcotic Act in Webb et al., v. United States, holding that doctors may not prescribe maintenance supplies of narcotics to addicts 18th Amendment to prohibit alcohol is ratified 1920 The Rockefeller Institute's Bureau of Social Hygiene established a Committee on Drug Addiction to study and publish reports on addiction Alcohol Prohibition E.J. Pellini, assistant city chemist of New York, rebutted Gioffredi's and Valenti's claims and stated that addiction and withdrawal had no organic basis and that those phenomena were "functional" or "psychological" Addiction Perceived as Psychological
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1921 Narcotics Division established within the Prohibition Unit of the Treasury Department The Bureau of Social Hygiene gave $186,500 to the National Research Council (NRC) Committee on Drug Addiction 1929 Bureau of Social Hygiene transferred its support of research to the NRC's standing Committee on Drug Addiction; the committee included medical school researchers and key governmental scientists and administrators, including the future head of the Federal Bureau of Narcotics, H.J. Anslinger 1930 President Hoover created the Federal Bureau of Narcotics, led by Harry Anslinger, precursor to the modern day drug czar, under the Treasury Department 1933 The 21st Amendment repealed Prohibition Prohibition Repealed $65,000 working budget for Lexington Narcotic Farm 1935 First narcotic farm opened in Lexington, Kentucky, under the Porter Act for addicts in Federal prisons Alcoholics Anonymous established Alcoholics Anonymous Established
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Event Funding Historical Time Line Theme $663,330 overall budget for U.S. Division of Mental Hygiene, overseeing drug treatment 1937 The U.S. Marihuana Tax Act (the federal government spelled marijuana with an "h" at this time) made the use and sale of marijuana without a tax stamp a federal offense $103, 883 working fund for Lexington Narcotic Farm 1938 Second narcotic farm opened in Fort Worth, Texas 1938 Development of a quantitative symptom scale for the severity of the opioid withdrawal syndrome in individuals by Himmelsbach and colleagues at the Addiction Research Center in Lexington, Kentucky (one of their first quantitative studies was of CNS drug effects in human studies) 1939 Meperidine (Demerol®) synthesized as first nonopioid narcotic analgesic (initially thought to be free of morphine's narcotic-like activity) 1943 Methadone treatments for pain were administered to soldiers in Germany during World War II when opium supplies were interrupted 1947 NRC established the Committee on Drug Addiction and Narcotics as the successor to the Committee on Drug Addiction
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1948 The drug disulfiram (Antabuse®) was introduced into therapeutics for treating alcoholism 1949 National Institute of Mental Health was established as the successor to the Public Health Service's Division of Mental Hygiene $12 million overall budget for mental health activities, including drug treatment, in Public Health Service 1954 American Medical Association declares alcoholism a disease Alcoholism Defined as a Disease 1956 Congress enacted the Narcotic Control Act to increase penalties for the sale and possession of marijuana and heroin 1958 Synanon, begun in California, was the first therapeutic community 1958–1959 LSD was found to affect the brain's serotonin systems; stimulants were found to produce paranoid psychotic states 1961 Methadone maintenance developed from studies on a hospital ward in New York (Rockefeller University) by Drs. Vincent Dole and Marie Nyswander
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Event Funding Historical Time Line Theme 1963 The U.S. Community Mental Health Centers Act provided the first federal assistance to local treatment of addiction under the rubric of mental illness Psychedelics (LSD) appeared in the United States. 1964 U.S. Surgeon General declared that smoking cigarettes and other forms of tobacco was hazardous to health 1965 The term ''drug dependence," meaning the psychological or physical dependence on a drug, arising in a person following administration of that drug on a periodic or continuous basis, is adopted by the World Health Organization (WHO) WHO Defined Drug Dependence NRC Committee on Drug Addiction and Narcotics became the Committee on Problems of Drug Dependence; that name was changed later to College on Problems of Drug Dependence (CPDD) 1965–1975 Modern modalities of treatment for drug addiction began to emerge and develop $504,000 for the Narcotic Addict Rehabilitation Act 1966 Congress passed the Narcotic Addict Rehabilitation Act for the treatment and reorientation of drug addicts
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$4 million for narcotic research for the Public Health Service's Mental Health Projects 1970 U.S. Comprehensive Drug Abuse and Control Act consolidated drug laws and set penalties for trafficking according to each illegal drug's perceived harm U.S. Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act (Hughes Act) created the National Institute of Alcohol Abuse and Alcoholism (NIAAA) NIAAA Established Congress passed the Drug Abuse Education Act Ford Foundation Drug Abuse Survey was initiated to estimate the prevalence of drug use in the United States. Ford Foundation initiated the "Drug Abuse Survey Project" to pinpoint more precisely what should be done to combat drug abuse $6 million for narcotic addiction and drug abuse research allocated to the National Institute of Mental Health (NIMH) 1971 President Richard M. Nixon declared "war on drugs" Establishment of the National Commission on Marijuana and Drug Abuse "War on Drugs" Declared
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Event Funding Historical Time Line Theme $6 million for alcoholism research at NIMH 1971–1978 Ford Foundation established the Drug Abuse Council to fund policy studies related to substance abuse 1972 President's National Commission on Marijuana and Drug Abuse recommended that laws against use of marijuana be relaxed Congress passed the Drug Abuse Office and Treatment Act, which established the Special Action Office for Drug Abuse Prevention (SAODAP) in the Executive Office of the President. SAODAP lasted until 1975, when it was incorporated into the new Department of Health, Education, and Welfare War on Drugs began with the establishment of the Drug Enforcement Administration (DEA) in 1973 and the National Institute on Drug Abuse (NIDA) in 1974. 1973 DEA was established to control supply and enforce regulation of controlled substances DEA Established Increased knowledge of the difficulty of maintaining smoking abstinence led to new views of relapse behavior First demonstration (using tritium-labeled opiates) of the presence of receptors for morphine-like drugs in brain tissue by three groups working independently; this discovery initiated the extensive use of radioligand binding to study receptors for many types of drugs and endogenous transmitters in the brain and spinal cord
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$22 million for drug abuse research to NIDA 1974 NIDA was established to give a national focus to the federal effort to increase knowledge of substance abuse; NIDA was supervised by the Alcohol, Drug Abuse and Mental Health Administration (ADAMHA) NIDA Established Congress enacted the Narcotic Addict Treatment Act, imposing federal control on the dispensing of methadone $34 million for drug abuse research to NIMH 1975 Enkephalins discovered by Hughes and Kosterlitz 1976 Demonstration of the opioid drug-like actions of beta-endorphin, a peptide found in brain, pituitary gland, and peripheral blood 1977 CPDD becomes an independent organization Schacter advocated a nicotine-addiction hypothesis based on studies demonstrating that when nicotine content was varied, heavy smokers adjusted their smoking rates to keep nicotine blood levels at a consistent level. He concluded that some internal control mechanism controlled smoking Nicotine Addiction
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Event Funding Historical Time Line Theme Rise in cocaine use occurred during the 1980s 1978–1979 Development of the intracranial microdialysis technique led to direct studies on the dynamics of neurotransmitter release. This resulted in an increased understanding of the synaptic pharmacology of neurotransmitter systems and the neuropharmacological basis of normal and abnormal behavioral reactions 1978 Congress authorized law enforcement agencies to seize the assets of drug dealers, including money, real estate, and vehicles Demonstration by Aghajanian of the important role of the locus coeruleus in the expression of withdrawal symptoms in opioid dependence 1979 Cloning by Japanese scientists of the genes for the three families of endogenous opioid peptides: proopiomelanocortin, proenkephalin, and prodynorphin A plane crash on the aircraft carrier USS Nimitz in 1981 led to drug testing of military personnel. 1981 Demonstration that behavioral reinforcement (reward) induced by heroin is dependent on dopamine release in the brain Congress passed a block grant program to give states more control over drug abuse treatment and prevention services
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$28 million for research to NIDA 1982 Sequencing of gene for the nicotinic cholinergic receptor at the neuromuscular junction provided molecular basis for first cloned receptor Smoking literature described self-titration, or self-limiting action, as a process involving a threshold or satiation point of dose intake that functioned to maintain nicotine at consistent levels that regulate consumption rates 1983 Measures taken to defer intravenous drug users from donating blood Virus for AIDS identified in 1984. 1984 Crime Control Act increased federal mandatory minimum sentencing provisions for drug-related crime Naltrexone (Trexan™) approved for treatment of heroin and narcotic addiction Test for detecting HIV developed and licensed in 1985. Crack Cocaine Appeared in the United States Athletes Len Bias and Don Rodgers died from overdoses in 1986, awakening the country to the lethal implications of crack cocaine. $1 million for NIDA training grants 1986 WHO established a three-step analgesic ladder to promote compassionate and rational use of opioid and other analgesics in treatment of cancer pain
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Event Funding Historical Time Line Theme $130 million for NIDA research 1988 U.S. Anti-Drug Abuse Act mandated the creation of the Office of National Drug Control Policy (ONDCP) and stiffened penalties for drug possession U.S. Surgeon General's report stated that cigarettes and other forms of tobacco are addicting U.S. forces invaded Panama and capture Gen. Manuel Antonio Noriega in 1989. He is sentenced and imprisoned for cocaine trafficking. 1989 Worldwide heroin production reached an all-time high Heroin Use Increased President George Bush appointed William J. Bennett as the first "drug czar" of the new Office of National Drug Control Policy First Drug Court was established in Miami; also known as "Treatment Court," this was a criminal-justice-run program to treat addicted nonviolent offenders prior to trial $194 million for NIDA research 1990 NIDA's Medications Development Division was established to develop new medications for the treatment of drug addiction $4 million for NIAAA training grants and $118 million for research 1991 Supreme Court upheld a Michigan law imposing a mandatory life sentence without possibility of parole to anyone convicted of possessing more than 650 grams of cocaine
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$7 million for NIDA training grants and $230 million for research 1992 NIDA and NIAAA became part of the National Institutes of Health, U.S. Department of Health and Human Services (DHHS) 1992–1993 Mu, kappa, and delta receptors in the brain were cloned and sequenced, leading to a greater understanding of the pathogenesis of opioid addiction 1993 Supreme Court ruled that officials may not seize property acquired with the proceeds of illegal drug sales if the owner is unaware of the source of those funds Society of Americans in Recovery (SOAR), the first modern consumer advocacy group, was established; it disbanded 2 years later due to management problems and difficulty enlisting support from "recently" recovered individuals LAAM (Orlaam®) approved for treatment of narcotic addiction 1994 DHHS adopted and published AHCPR/WHO guidelines for use of analgesics in cancer pain, including chronic high-dose use of opioids Naltrexone (ReVia™) approved for treatment of alcoholism
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Event Funding Historical Time Line Theme $9 million for NIDA training grants and $331 million for research grants 1995 FDA Commissioner David Kessler launched campaign to regulate nicotine use among adolescents Regulation of Nicotine $5 million for NIAAA training grants and $142 million for research grants $11 million for NIDA training grants 1996 Nicotine chewing gum approved for over-the-counter sale; expanded public advertising of methods to reduce nicotine craving and dependence SOURCES: Bureau of Justice. 1992. A National Report: Drugs, Crime, and the Justice System. Washington, DC: U.S. Government Printing Office. Lowinson JH, Ruiz P, Millman RB, eds. 1992. Substance Abuse: A Comprehensive Textbook. Baltimore: Williams & Wilkins. U.S. Department of Health and Human Services. 1994. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Washington, DC: U.S. Government Printing Office.
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