Drug Treatments of the Past, Present and Future

As the 1970s heroin epidemic hit New York City, the mayor's office began an experiment that would define addiction treatment in the next decades: offering methadone, an opioid, to keep addicts away from heroin.

The new approach had been developed years before at Rockefeller University and proved to be successful. It was the first step toward the creation of new drugs that avoid cravings and help addicts go back to normal life. But science never figured out a cure for opioid addiction.

"Unless you give medication, many (addicts) will relapse and overdose," said Adam Bisaga, professor of psychiatry at the Columbia University Medical Center, and a research scientist at the New York State Psychiatric Institute.

Although it has been proved that addiction is a medical condition, the most popular approach in the U.S. still is to detoxify patients with no medication. There are about 1.5 million people currently on traditional rehabilitation programs, which are based solely on abstinence and group therapy, and don't assess the physical addiction.

On the other hand, choices of drug-based treatment have grown. Methadone is still largely used, especially due to its low cost. Modern medication like suboxon and vivitrol have made addiction treatment easier, since they don't require daily medical assistance. New approaches focus on long-term maintenance using virtual reality and under the skin pallets.

"Ideally, the best treatment should be personalized," said Bisaga. "Like contraceptives, some women prefer to take a pill every day, others prefer an implant every few years. Our hope is that we'll have the same kind of approach to drug addiction in the future."