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Published online by Cambridge University Press: 07 May 2025
A system of controlled prescribing of opiates for addicts was instituted in Tennessee in 1913 with a rigidly guarded permit system and a specified druggist for each addict. (“The Tennessee System”?). Although this system was abused in a few cases its good results appeared to far outweigh its defects and it led to the collection of a considerable mass of data about drug addiction which could not otherwise have been easily obtained (Brown L.P. 1915). Uncontrolled prescribing of heroin (“The British System”?) led to a marked increase in the number of known opiate addicts in the United Kingdom and an Interdepartmental Committee (1965) recommended changes to deal with this. These were implemented in 1968 following changes in the Dangerous Drugs Act (1967). Notification of addiction to controlled drugs became compulsory and the prescribing of heroin or cocaine to an addict could only be carried out by a specially licensed doctor. At this time the Department of Health set up a number of special clinics [the majority in London) to treat opiate addicts. In evaluating the effectiveness of such clinics, since abstinence as a goal is unlikely to be achieved in any but a small minority of cases, it is necessary to try and evaluate how patients function. Better overall control of drugs available should be reflected in a reduced incidence rate.