Historical overview of policy developments and evolution of treatment services

We will begin by summarising key policy developments in England and the resulting addiction treatment services, with specific focus on the socalled ‘British system’ (Spear, 2005). Although this summary provides a chronological account of the evolution of Britain's drug policies (Box 2.1), it is recommended that it be read in conjunction with two key references: Strang & Gossop (2005a,b) and Spear (2002). Space precludes detailed descriptions of the socio-political context within which the various British drug policies have developed, although it is worth noting that dramatic and unplanned shifts in policy have often been the result of a combination of changing political ideals, social structures and medical ideologies, rather than the consequence of any better understanding of addiction.

The 18th and 19th centuries

Although the origins of the British system are often traced to the Rolleston Report of 1926 (Ministry of Health, 1926), Berridge (2005) describes three systems that existed in Britain in the 18th and 19th centuries: the lay or commercial control system, the pharmaceutical control system and the medico-penal system. During the 18th and initial part of the 19th centuries, opium was freely available in pharmacies, grocers and other general stores. There was no regulation on its sale or purchase and, like alcohol, it was marketed just as any other product, i.e. subject to a lay or commercial control system.