This section is from the book "The Home Hand-Book of Domestic Hygiene and Rational Medicine. Volume 2.", by J. H. Kellogg, M.D.. Also available from Amazon: The Home Hand-Book of Domestic Hygiene and Rational Medicine, Volume 2.
The amount of opium which the system will tolerate after the habit has been continued for many years, is sometimes astonishing. We have had under treatment patients taking daily amounts varying from one or two grains of opium to forty-eight grains of sulphate of morphia, equivalent to more than half an ounce of the drug. In treating these patients, especially those by whom the quantity consumed was very large, the physician's skill and patience are often taxed to the utmost. In beginning the cure, it is of the first importance to convince the patient that much will depend upon his own efforts. His will-power and fortitude, which invariably become sadly demoralized by the long subjection to the habit, must be stimulated as much as possible. He must be taught the necessity of patiently bearing some pain, and enduring a considerable degree of suffering. This is often hard to do, as the fortitude to bear pain is, in most cases, almost wholly lost. In the further carrying out of treatment, we have adopted several plans with success. In some cases, especially those in which the quantity of opium or morphia taken daily is not very large, we have obtained very excellent results by withholding the drug altogether for two or three days, or until the patient was entirely out from under its narcotic influence.
By this time, the sufferings of the patient will become considerable, and a small dose is then administered. It is found that a very small dose indeed, after the patient has abstained for two or three days, will generally produce as much effect as was produced by the full dose at the beginning of the treatment. After a day or two, the same process is repeated, each time the quantity of opium administered being diminished until finally it is left off altogether. When the patient has a great deal of will-power, and is willing to make the attempt, especially when the amount of opium taken is moderate, the drug may be wholly discontinued from the first In general, however, it is better to diminish the amount of the drug by degrees, quite rapidly at first, and more slowly afterward. This should not be left to the patient, however, as very few have the moral courage to conduct the treatment successfully. The patient should be deprived of every particle of the drug, and of all means of access to it, and the daily amount should be administered at a regular hour each day in a gradually diminishing quantity. We have, in some cases, slowly diminished the quantity of the drug until it was finally left off entirely without the patient being aware of the change. In one case, the hypodermic injection of pure water was continued for several weeks, producing precisely the same effects which had before been produced by the usual dose of the drug, illustrating the powerful effect of the imagination upon the body. We have found the employment of electricity in the form of galvanization of the spine, general faradization, electro-thermal baths, together with massage, warm baths, and other hygienic measures, of very great use in mitigating the sufferings of patients undergoing cure of the opium habit.