History of Addiction Treatment (2025-2026 Recording)-History of Addiction Treatment Recording

Video Transcription

Video Summary

This lecture traced the history of stigma, treatment, and policy around alcohol and opioid use disorders in the United States, with some global context. Dr. Sugden began by outlining five forms of stigma: public, courtesy, structural, self, and multiple stigma, and showed how stigma remains common among the public and healthcare professionals.<br /><br />He then reviewed early alcohol history, from ancient fermentation to colonial America, and highlighted Benjamin Rush as an early, influential thinker who framed alcoholism as a chronic medical condition but still used harsh, moralistic, and faith-based approaches to treatment. The talk followed the shift from temperance and abstinence pledges, to institutional treatment and mutual aid groups, to later public health efforts such as AA, the Minnesota model, and medications like naltrexone. He also noted how alcohol advertising and social norms have complicated prevention efforts.<br /><br />The opioid section traced poppy use from ancient Mesopotamia and Egypt through European trade, the British opium trade with China, and the Opium Wars. In the U.S., the Civil War, syringe development, and morphine use contributed to the first major opioid epidemic among veterans. The Harrison Act and later “war on drugs” policies criminalized users and prescribers, deepening racial inequities and stigma. Later reforms included methadone treatment, naloxone, buprenorphine, SBIRT, and expanded access under the Affordable Care Act.<br /><br />The lecture closed by warning that history repeats itself when fear, hate, and punishment guide policy. Dr. Sugden argued for humane, evidence-based care, reduced stigma, and broader approaches including lifestyle medicine.

Keywords

stigma

alcohol use disorder

opioid use disorder

public health

Benjamin Rush

temperance movement

Alcoholics Anonymous

naltrexone

Opium Wars

Harrison Act

methadone treatment

harm reduction