The Treatment of Opium Addiction

Oct 27, 2012 by

The Treatment of Opium Addiction by Dr. J. B. Mattison was originally published in 1885 and provides a fascinating window into opium drug addiction during the 19th century.  It might be thought that the 19th century was devoid of drug addiction, but nothing could be farther from the truth.  With the influx of opium from China and its use as a medication given to everyone like it was aspirin, opium addiction became a societal problem in the late 1800’s.

Instead of reading current books on what things were like in the past, I prefer to read the actual books from that time if at all possible. Of course old and out of print books are hard for most of us to come by, so I am happy to read scanned reproductions of the actual old books.  This is such one, and it does not disappoint.

Here are a few paragraphs to give you a feel for the book:

“We now desire to call attention to another point, which our experience has convinced us is of value. We refer to the treatment just after the habitual hypodermic or other opiate is abandoned. Supposing a case where, at the end of five to seven days, as individual peculiarity may determine, the desired sedation is secured and the usual opiate reduced to a minimum — say  to  gr. each dose — instead of an entire discontinuance, we change the order of affairs and make a break in upon the routine-taking — the “habit,” so to speak — by giving one full dose, by mouth, in the evening. This ensures a sound, all-night sleep, from which the patient awakes greatly refreshed, and often quite surprised at his good condition, which usually persists during the day.

The next evening at about the same hour, the maximum bromide dose and two thirds of the previous opiate are given ; the third evening, the same amount of bromide and one third the first evening’s opiate. This ends both opiate and bromide. Exceptionally, the full single dose of opium and sodium is given only one or two evenings. During the following day, if the patient be quiet, nothing is given. Should there be minor discomfort, one half ounce doses of fid. ext. coca, every second hour, have a good effect.

Cases occasion usually require nothing else. If, however, as usually occurs, despite the coca, the characteristic restlessness sets in, we give full doses of fid. ext. cannabis indica, and repeat it every hour, second hour, or less often, as may be required. When the disquiet is not marked, this will control. If more decided measures be called for, we use hot baths, temp. 105° to 1 12°, of ten to twenty minutes’ duration, and repeated as required. A short shower or douche of cold water often adds to their value. Nothing equals them for this purpose. Warm baths are worthless. The water must be hot — as much so as one can bear. We have repeatedly known a patient to fall asleep while in the bath. And, just here as to ” full doses ” of the hemp. The dose of the books is useless. As before stated, addiction to opium begets a peculiar tolerance of other nervines, and they must be more robustly given. We give sixty minims Squibbs fid. ext., repeated as mentioned, and have never noticed unpleasant results. Small doses are stimulant and exciting, large ones sedative and quieting ; hence the latter are seldom followed by the peculiar hashish intoxication.

And, lest some timid reader should regard this as reckless dosing, we hope to calm his fears by saying that the toxic power of hemp is feeble, and that these doses are the result of an experience of the drug in many cases in which smaller ones have failed of the desired effect. At this writing, two lady convalescents, still insomniac, are nightly taking these full doses with good effect in securing sleep. One recent lady patient, who did not lose a single night’s slumber during treatment, and whose need for a soporific ended in eight days, took no other hypnotic whatever. We have used it of late more largely than ever, and with growing confidence in its sleep-giving power ; taking, in this regard, almost exclusively, the place of chloral. Regarding this insomnia, Levinstein and other German writers assert that it will “resist every treatment during the first three or four days.” This may be true with them, considering their method, and is, of itself, added proof that they are lamentably lacking in the therapeutics of this disease. Under the plan we pursue no such sleepless state is noted, and in ordinary, uncomplicated cases, patients can usually be promised recovery without the loss of a single entire night’s slumber.”

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