Treatment, History of

Early America

Alcohol use was fairly common throughout colonial America with many people, including children, drinking a little every day without many reported ill effects. After the Revolutionary War, distillation and production of spirits went up and drinking increased, especially of stronger drinks like whiskey. The harmful and addictive effects of alcohol were being observed more often. In 1784, Benjamin Rush published a pamphlet called "Inquiry Into the Effects of Ardent Spirits on the Human Mind and Body." This publication was the first to propose the idea that alcoholism was a medical disease and should be treated as such. Rush noted the characteristics of alcohol dependency that could qualify it as a disease. These included its progressive nature, chronicity, and adverse effects on the body. He called for the establishment of special hospitals for the afflicted, which he called Sober Houses.

During this time period, people also used opium, morphine, chloroform, ether, and cocaine without much ill effect and mostly for medicinal purposes. Marijuana was often planted as a cash crop and was used in making rope and other consumer products. By the 1820s, however, the Temperance Movement against the use of alcohol was gaining strength in the country. This movement did what was called "rescue work" in trying to save alcoholics from their affliction. They set up "inebriate houses" to help sober up heavy drinkers and instill in them some moral changes. The stays in these houses were voluntary and of short duration. Residents were then released back into the community and referred to local support groups to help them stay sober. Some of these temperance groups evolved into, and survived as, the Salvation Army.

Some local support groups included the Washington Movement, the Fraternal Temperance Society, the Ribbon Reform Club, and the Drunkards' Club. These groups collapsed later in the century as many of the inpatient asylums did. The first publicly funded hospital opened in New York in 1864 as an Inebriate Asylum. Patients sent there were often legally coerced and required to stay for years.

A Swedish doctor, Magnus Huss, first coined the term alcoholism in 1849. He used it to describe a group of drinking behaviors that he called a disease and called for medical treatment of those afflicted. These qualities included a hereditary predisposition, loss of control, craving, tolerance, and progression.

Early Government Actions

During the 1870s, for-profit asylums like the Keeley Institutes and the Gatlin Institute opened to aid those suffering from the disease of alcohol dependency. These organizations also sold patent medicines they called "cures" for addiction. An exposé in 1905 revealed that most of these potions contained cocaine, alcohol, or morphine and that the "cure" was indeed worse than the disease.

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