The most logical step would be to take as many into treatment as possible thus starving the black market of customers but with respect to this, treatment, even when demanded by courts of law, is not making much of an impact. Cure rates are disappointing.

For those who have worked in the drugs field, they know only too well that the preferred treatment of methadone reduction to abstinence is associated with many problems, the most important being relapse and fatalities. One is simply substituting heroin for a synthetic opiate which itself is associated with unpleasant side effects and prolonged and agonizing withdrawals. Many deaths happen when the patient relapses often within days of leaving treatment. Curiously there are no figures that actually record this phenomenon because deaths after treatment are no one’s responsibility. Suicide and overdose rank high. Others end up in jail or eventually return for another course of treatment and a further if diminishing supply of free drugs. These become the chronic addicts of the future and over the years become intractable to treatment or counseling.

The most realistic estimate for cure rate for Western treatment methods of 6% was issued by the World Health Organization in the early nineties. Statistical surveys since claim success in up to 30% of cases but are heavily flawed.

An interesting perspective on treatment is found in the American National Survey on Drug Use and Health. Each year thousands of Americans are interviewed about their drug and alcohol habits. In 2002, the latest year for which data are available, 22 percent of Americans between ages 18 and 25 were abusing or were dependent on a substance including alcohol, versus only 3 percent of those aged 55 to 59. Further surveys concluded that only 27% [of total] had sought any help whatsoever during their lifetime. This might point towards the fact that with maturity and changing personal circumstances such as the responsibility of work or to family many can change simply by their own motivation. Two key factors may be that firstly, once a person becomes labeled, the stigma is there for life. How often is the expression ‘once an addict, always an addict’ heard? This could affect future work prospects and matters such as insurance and obtaining a mortgage. The second factor is that many cannot tolerate the oppressive and degrading regimes encouraged in psychiatric clinics, the only carrot being free drugs.

So, given an ideal world anyone who uses drugs should be regarded as deserving of some kind of help and support whether it can be bought anonymously over the counter or provided, in the case of the worst affected in specialized medical clinics where injectable but clean therapeutic substitute drugs are available. No one method should predominate or, to quote the Medical Act of 1843 ‘let no convention be established’. What applied in those days to the way surgeons tied knots could well apply today for the complex issues surrounding drug treatment. Traditional Chinese Medicine may well play an important role in the future of drug addiction treatment.