Dynamic dualities: the ‘British system’ of heroin addiction treatment, 1965-1987

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http://eprints.org/relation/isVersionOf http://etheses.bham.ac.uk/id/document/181 http://eprints.org/relation/isVolatileVersionOf http://etheses.bham.ac.uk/id/document/181 http://eprints.org/relation/isIndexCodesVersionOf http://etheses.bham.ac.uk/id/document/181 archive 4031 disk0/00/00/00/75 2008-03-19 18:41:54 2019-01-23 09:51:29 2011-07-19 16:12:30 thesis show 0 Mold Alex Nicola Alex.Mold@lshtm.ac.uk Hilton Matthew University of Birmingham Dynamic dualities: the ‘British system’ of heroin addiction treatment, 1965-1987 unpub HV DA 30sch_hist A revised version is published in book form by Northern Illinois University Press, 2008, ISBN 9780875803869. Mold, A. Heroin : the treatment of addiction in twentieth-century Britain. Part of Chapter 1 is drawn from the article Mold, A. "The ‘British System’ of Heroin Addiction Treatment and the Opening of Drug Dependence Units, 1965–1970" Social History of Medicine, Dec 2004; 17: 501 - 517, DOI 10.1093/shm/17.3.501 This thesis is concerned with the treatment of heroin addiction between 1965 and 1987. It examines a series of conflicts between seemingly opposed forces: between the medical and the social, the specialist and the generalist, the public and the private provision of healthcare, and the short-term and the long-term prescription of drugs to addicts. The establishment of specialised Drug Dependence Units (DDUs) in 1968 demonstrated that addiction was seen as both a disease to be treated and a social problem to be controlled. It is argued that the effects of this dynamic duality can be observed in the subsequent response to heroin addiction. Tension existed between specialist consultant psychiatrists who treated addicts at hospital based DDUs and community based private and general practitioners involved in the treatment of addiction. This was the result of contrasting approaches to addiction and its treatment. Conflict between these groups was particularly evident in the General Medical Council’s (GMC) cases for serious professional misconduct in 1983 and again in 1986-1987 against Dr Ann Dally, a leading private practitioner involved in the treatment of addiction. These cases highlighted the continuing differences between medical and social approaches to addiction but also demonstrated how these elements were inseparable and equally crucial to the formulation of drug treatment policy in this period. 2004-12-08 graduation 2393489 eng author checked This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. public 338 University of Birmingham School of History and Cultures, Department of History d_ph na 2004-12-08 graduation