User:Johnchapple/C.U.R.E.

C.U.R.E
Cure was one of the first independent drug treatment centres established in London in the 1967. It was originally known as the National Addiction and Research Institute Cure stood for care, understanding research and education. Its medical director was Doctor Peter Arbuthnot Lane Chapple MB, CHB, DPM, MRCPsych. His general philosphy was to cure addicts, rather than just to maintain them (7)

Location
Its first location was in Beauford Street, Chelsea, where two doctors: Dr G Grey, and Dr Chapple had their practice. Then with the assistance of the Salvation Army and Major Betty Care of the Salvation Army moved to World's End in Chelsea. In June 174 a fire spread from an adjoining building and destroyed the premises, however it was re-established at the Ecumenical Centre, in Notting Hill.(5)

Progress
Following a six month study visit to the US, Dr Chapple introduced the methadone-maintenance approach to the uk (1) This was used in the United States at the time. Addicts had to take Methadone rather than hard drugs, ("Methadone Maintenance" by Vincent Dole and Marie Nyswander (3)). Methadone was regarded at the time as very much less harmful than hard drugs. and a way to withdraw (stop) taking drugs.

Later Dr Chapple came to believe Methadone was not useful as a subststute. Dr Chapple realised that asking an addict about the drugs he/she took and their quantities was likely to be unreliable, so he introduced urine analysis to reliably monitor an addicts consumption (2)

The basis of the treatment was that addicts were kept within the community, not totally taken out of it, which the establishment drug dependency units, the DDUs, did. Patients were treated if they agreed to targets for reduction of heroin intake. This was supported by group sessions and daytime activities delivered by occupational therapists and nurses.

Drug addicts, he said, did not respond well to figures of authority, so the staff did not wear white coats and were all addressed by their first names, although they were all qualified professionals

He eventually decided that drug treatment was best carried out in a drug free environment

His approach was frowned on by many in authority.

The "Assessment"
Funding had always been difficult, however, in order to receive funds from the Health Authority, they had to be assessed by two doctors: Dr H B Milne (a colleague and director of a DDU, Drug Dependency Unit) and Dr J W McCullock. This assessment was highly critical of the centre, and was full in misinformation, and inferences however, as a result of this report, CURE did not get funded and was forced to close. In paticular, CURE had been told not to move into more suitable premises until after the revue, yet the assessment revued the tenporary place as permanent. The assesment looked at the previous years work, not the current years work (which had just been published) so it looked like the information CURE presented on the patients was incorrect. A rebuttal was written but never publishhed (6)

Various papers were published including:

"Follow-up of Cases of Opiate Addiction from the Time of Notification to the Home Office", PETER A. L. CHAPPLE, DAVID E. SOMEKH, MARILYN E. TAYLOR published in the BMJ June 1972.A total of 108 cases of opiate* addiction were followed up for six to seven years until April 1971.

"The five-year follow-up from first contact with us" (Chapple, P.A.L et al 1972). British Journal of Addiction, 67, 33.

"ONE YEAR"S WORK AT A CENTRE FOR THE TREATMENT OF ADDICTED PATIENTS" The Lancet, Volume 291, Issue 7548, Pages 908-911 P.Chapple.

(1) Narcotics Addiction and Control in Great Britain by Edgar May http://www.druglibrary.org/schaffer/library/studies/dwda/staff7.htm

(2) Application of Urine Analysis to Diagnosis and Treatment of Heroin Addiction by Vincent Marks, Denys Fry, P. A. L. Chapple, and Geoffrey Gray Br Med J. 1969 April 19; 2(5650): 153–155 http://ukpmc.ac.uk/articles/PMC1982942/

(3) Obituary Peter Artbuthnot Lane Chapple - A Personal Appreciation. British Journal of Addiction March 1976 by Dr. H Dale Beckett. M.R.C Psych., D.P.M.

(4) The criminal histories of male non-medical opiate users in the United Kingdom by Joy MOTT Senior Research Officer, Home Office Research Unit, London, 1975/01/01 http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1975-01-01_4_page004.html

(5) Obituary of Dr Peter Chapple, The Times Tuesday 2nd December 1975, by Professor Michael Ginsburg and Dr Dale Becket

(6) Unpublished document: Assessment of Cure, A Rebuttal August 1975 (7) American and British Addicts in the British System by Paul Lowinger, West J. Med, AU: Peter A. L. Chapple AU: David E. Somekh AU: Marilyn E. Taylor TI: A Five-Year Follow-up of 108 Cases of Opiate Addiction SO: Addiction VL: 67 NO: 1 PG: 33-38 YR: 1972 ON: 1360-0443 PN: 0965-2140 AD: National Addiction & Research Institute, 533A Kings Road, London, S.W.10 DOI: 10.1111/j.1360-0443.1972.tb01165.x US: http://dx.doi.org/10.1111/j.1360-0443.1972.tb01165.x File:Example.jpg|The Duke of Edinburgh visits the centre. Dr Chapple in the foreground.