History and the future of addiction

The future of treatment—including addiction treatment—is biotechnological. Depot injections, agonist/antagonist implants, deep brain stimulation, and hapten conjugate vaccines are hailed by researchers pharmaceutical manufacturers as medicine's best hope to minimize illicit use, decrease risk overdose painful withdrawal, prevent diversion medicines markets. Marketing use new technologies reveal old tensions framing concepts its treatment: between medical condition disorder the will, criminal justice health, patient choice system control. Using examples depot naltrexone implantable injectable buprenorphine in U.S., this essay considers arc long-acting opioid treatment implications for future. These include rise Vivitrol courts “carceral prescription”—where systems mandate medicine lock up receptors much they might people themselves—as well formulations positioned increasing both benefit provider We also consider lessons from debates on contraceptive such Norplant Depo-Provera. While multiple under development, success will be determined less characteristics particular more whether or not accompanied a ethics that emphasizes therapeutic alliance, concordance over compliance, genuine commitment allowing patients ability narrate believed their descriptions experiences.