Noah Vinter
Alcoholism has been a pervasive issue throughout history, with the term 'alcoholism' first being coined in 1852. The conventional treatment for alcoholism in the 1920s and 1930s varied greatly and was influenced by the social and political climate of the time. The 18th and 19th Amendments to the US Constitution, ratified in 1919 and 1920, respectively, ushered in the Prohibition era, which aimed to eradicate alcohol and mind-altering substances from society. This approach was largely ineffective and contributed to the rise of criminal organizations and the proliferation of speakeasies. During this time, the medical understanding of alcoholism was evolving, with some considering it a disease, while others viewed it as a moral failing. Treatment options included confinement in asylums, detox, withdrawal management, and the controversial use of drugs like insulin and belladonna elixir to induce comas or extreme reactions, with the hope that patients would awaken cured of their addiction. The mutual-aid group Alcoholics Anonymous (AA) was also established in 1935, promoting the 'disease theory' and offering a self-help model for recovery.
| Characteristics | Values |
|---|---|
| Treatment focus | Detox, withdrawal, and physical stabilization |
| Treatment methods | Insulin comas, blisters on abdomen, re-injecting drained fluids, codeine or subcutaneous morphine injections, aversion therapy |
| Treatment centers | Mendocino State Hospital, Worcester State Hospital, Norwich State Hospital, Philadelphia General Hospital, Leavenworth, narcotic hospitals in Lexington and Fort Worth |
| Legislative changes | Prohibition in the 1920s, alcohol prohibition revoked during the Great Depression |
| Support groups | Alcoholics Anonymous (AA) |
| Treatment impact | Ideological and institutional |
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What You'll Learn
- Alcoholics Anonymous (AA) was formed in 1935
- Prohibition in the 1920s tried to remove alcohol from society
- Alcoholics were confined to asylums to help them 'dry out'
- Community clinics for addiction treatment were shut down in the 1920s
- The mental hygiene movement of the 1920s and 1930s influenced AA's ideology
Alcoholics Anonymous (AA) was formed in 1935
In the 1920s and 1930s, the conventional treatment for alcoholism was influenced by the prohibitionist movement of the time, which sought to remove alcohol from society. This led to the closure of community clinics that had previously offered support for those struggling with addiction.
People with alcohol use disorder might have been confined to an inebriate asylum or sent to drunk tanks, wards, or hospitals. Treatment often focused on detox, withdrawal, and physical stabilization, with varying degrees of success. The New York State Inebriate Asylum, which opened in 1864, was one of the first institutions to treat alcoholism as a disease. However, by the 1920s and 1930s, alcoholism was commonly perceived as a moral failing, and medical professionals often viewed it as an incurable and lethal condition.
During this time, there were also various mutual aid societies and sobriety circles that provided early recovery support. These groups offered a community-based approach to battling alcoholism, with an emphasis on abstinence and spiritual practices.
It was within this context that Alcoholics Anonymous (AA) was formed in 1935. AA was founded by Bill Wilson (known as Bill W.) and Robert Smith (known as Dr. Bob), two individuals who shared a struggle with alcoholism. The organization grew out of their mutual support and collaboration, influenced by the Christian revivalist Oxford Group.
The famous "Big Book," Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism," was published in 1939, introducing the twelve-step program and providing the basis for the organization's name. The twelve steps outline a suggested program of ongoing rehabilitation and self-improvement, emphasizing rigorous honesty and a personal relationship with a higher power.
Since its beginnings in 1935, AA has sparked interest and grown into a global movement, with an estimated presence in 180 countries and nearly two million members as of 2021. The success of AA has had a profound impact on the treatment of alcoholism, both ideologically and institutionally. It has promoted the disease theory and influenced how recent generations view excessive alcohol consumption and treatment methods.
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Prohibition in the 1920s tried to remove alcohol from society
Prohibition in the 1920s aimed to remove alcohol from society, but it was ultimately ineffective and the laws were repealed by the early 1930s. During this period, community clinics that had been helping individuals with opioid or narcotic addiction were shut down. The movement was driven by a belief in the harmful effects of alcohol, with some even advocating for alcohol taxation and education about its dangers. However, the ''wetter' nature of the age saw alcohol becoming associated with progressive, urban, middle-class lifestyles, leading to more lenient attitudes and treatments.
The early 20th century saw the rise of the temperance movement, which aimed to abolish alcoholism through public sanctions. This movement was influenced by Benjamin Rush, a physician who characterised disease as excessively stimulated nervous tissue, requiring aggressive bloodletting and purging as treatment. The New York State Inebriate Asylum, opened in 1864, was the first medically monitored addiction treatment centre in the US and is considered the first alcohol rehab centre. It catered to the upper-crust society of New York in the late 19th century, treating alcoholism as a disease. However, this belief was later shunned.
In the early 20th century, there was also a great temperance upsurge, with more than twenty states passing tobacco prohibition laws, although most were quickly repealed. The 1920s and 1930s saw the growth of the mental hygiene movement, which influenced the formation of Alcoholics Anonymous (AA) in 1935. AA promoted the "disease theory" of alcoholism and changed how people thought about excessive alcohol consumption and treatment methods. The four founding members of AA were influenced by the Emmanuel Movement and the Christian organisation, the Oxford Group.
The treatment of alcoholism in the 1920s and 1930s varied, with some dangerous methods being employed. For example, individuals addicted to drugs may have been intentionally given large doses of insulin, raising their blood sugar to dangerous levels with the hope that they would wake up "cured" of addiction. Other treatments included aversion therapy and the use of codeine or subcutaneous morphine injections to manage medical withdrawal. While these methods were used, there was also a growing recognition of alcoholism as a disease, with self-organised groups like AA advocating for the rights of alcoholics as patients.
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Alcoholics were confined to asylums to help them 'dry out'
Alcoholism has been a prevalent issue for centuries, with problematic alcohol use mentioned in some of the earliest historical records. The term "alcoholism" was first coined in 1852, and while it is considered stigmatizing today, it was a groundbreaking term at the time.
In the 1920s and 1930s, the treatment of alcoholism was quite different from what it is today. One approach that was used during this time was the confinement of alcoholics to asylums to help them "dry out." This approach built upon the idea of inebriate homes and asylums that first emerged in the 1850s and gained prominence in the late 19th century. These institutions, such as the New York State Inebriate Asylum, were designed to provide short, voluntary stays that focused on non-medical detoxification, isolation from drinking culture, and moral reframing. However, by the 1890s, these inebriate homes and asylums fell out of favor due to various issues, including poorly evaluated clinical therapies, ethical abuse, and the criminalization of alcohol-related problems.
As a result of the closure of many inebriate homes and asylums, alcoholics were often sent to city drunk tanks, wards, and hospitals in the late 19th century. This marked a shift towards a more punitive approach to dealing with alcoholism, rather than a treatment-focused one. By the 1920s and 1930s, the asylum tradition remained important, especially for drug addicts. The persistence of this approach is evident in the establishment of state-sponsored institutions in California in 1928 and Washington in 1935, which were variations of jail farms under the purview of state hospital systems.
The confinement of alcoholics to asylums in the 1920s and 1930s was part of a broader societal context. Prohibition, which began in the 1920s, aimed to eradicate alcohol and mind-altering substances from society. However, it proved ineffective and was largely repealed by the early 1930s. During this time, there was also a growing influence of the mental hygiene movement, which shaped how people viewed excessive alcohol consumption and treatment methods.
While the approach of confining alcoholics to asylums to help them "dry out" may have been well-intentioned, it is important to recognize the limitations and potential drawbacks of this method. Firstly, the effectiveness of such confinement in treating alcoholism is questionable, as it primarily focused on detox and withdrawal without addressing the underlying causes of addiction. Secondly, the conditions within these institutions could vary, and ethical abuses were not uncommon. Lastly, this approach contributed to the stigmatization of alcoholism, portraying it as a moral failing rather than a complex condition requiring medical attention and support.
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Community clinics for addiction treatment were shut down in the 1920s
The 1920s saw the rise of Prohibition, an attempt to remove alcohol and mind-altering substances from society. This movement led to the closure of community clinics that had been providing treatment for those struggling with opioid or narcotic addiction. The clinics had been established after the Supreme Court's antimaintenance ruling in 1919, with the aim of supplying addicts with their regular dosages of drugs like morphine and heroin to prevent withdrawal. However, many of these clinics ended up functioning as maintenance programmes, contrary to the Court's interpretation of the Harrison Act.
The closure of these community clinics left those suffering from alcoholism or drug addiction with limited treatment options. They were often confined to inebriate asylums or "inebriate homes", which were short-stay lodging homes that provided non-medical detoxification, isolation from drinking culture, and moral reframing. These institutions, such as the New York State Inebriate Asylum, were among the first to attempt treating alcoholism as a disease. However, the belief in treating alcoholism as a disease was shunned, and the inebriate asylums and homes eventually closed due to poorly evaluated clinical therapies, ethical abuse, economic depressions, stigma, de-medicalization, and the criminalization of alcohol and drug problems.
With the community clinics and inebriate asylums no longer available, individuals battling alcoholism or drug addiction were sent to drunk tanks, wards, and foul wards of hospitals. They also had the option of seeking treatment at private hospitals, such as the Charles B. Towns Hospital in New York City, which catered to affluent alcoholics. However, the cost of treatment at these private institutions was often high, equivalent to thousands of dollars per day in today's money.
The 1920s and 1930s also saw the rise of Alcoholics Anonymous (AA), a mutual-aid society that promoted the "disease theory" of alcoholism. AA's influence was both ideological and institutional, changing how people viewed excessive alcohol consumption and shaping the funding and practices of treatment institutions. The formation of AA and its focus on the disease concept of alcoholism contributed to a shift in societal attitudes towards alcohol and its harmful effects.
During this time, there were also experimental and controversial treatment methods for drug addiction. One such method involved intentionally inducing a coma by raising an individual's blood sugar to dangerous levels with a large dose of insulin, with the hope that they would wake up "cured" of addiction. These unconventional methods reflected the limited understanding of addiction and the harmful effects of substances during that era.
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The mental hygiene movement of the 1920s and 1930s influenced AA's ideology
Alcoholics Anonymous (AA) was formed in 1935 by Bill Wilson, Ebby Thatcher, Rowland Hazard, and Dr. Bob Smith, who were all influenced by the pioneers of the Emmanuel Movement. AA's impact on the treatment of alcoholism has been both ideological and institutional. It promoted the "'disease theory" within the mutual-aid tradition, changing how people thought about excessive alcohol consumption and treatment methods. AA's impact was facilitated by the growing influence of the mental hygiene movement during the 1920s and 1930s.
The mental hygiene movement of the 1920s and 1930s aimed to reform the mental health care system in the United States and improve care for vulnerable citizens. The movement emerged from a growing understanding of psychiatry and psychology, which led to structural changes in the mental health care system. The National Committee for Mental Hygiene, later known as the National Mental Health Association and now as Mental Health America, was founded in 1909 by Clifford Beers, a person with lived experience of mental illness. Beers's autobiography, published in 1908, exposed the mistreatment of people with mental illnesses and sparked a reform movement. During the 1920s and 1930s, data collected by organizations like the Bureau of the Census and the New York State Department of Mental Hygiene served as the basis for psychiatric epidemiology.
The mental hygiene movement influenced AA's ideology by providing a therapeutic bridge between institutions and the wider community. This was recognized by figures such as Clinton Duffy, who encouraged the establishment of AA groups in his prison in 1942. AA's promotion of the "disease theory" aligns with the mental hygiene movement's interest in understanding the social and environmental factors contributing to mental disorders.
The 1920s and 1930s also saw a focus on social betterment and the prevention of social problems such as crime, prostitution, and dependency. Thomas W. Salmon, medical director of the National Committee for Mental Hygiene, argued in 1917 that psychiatrists needed to play a crucial role in these areas. The movement's emphasis on social betterment and prevention may have influenced AA's focus on mutual aid and community support as key components of recovery.
During the 1920s and 1930s, conventional treatment for alcoholism included detox, withdrawal, and physical stabilization in inebriate asylums. Prohibition in the 1920s attempted to remove alcohol from society, but it was ineffective and the laws were repealed by the early 1930s. The closure of inebriate homes and asylums in the 1890s led to alcoholics being sent to drunk tanks, wards, and hospitals. The Charles B. Towns Hospital, which opened in 1901, treated affluent alcoholics, including Bill Wilson, the founder of Alcoholics Anonymous.
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Frequently asked questions
Prohibition in the 1920s sought to remove alcohol from society, but this was found to be ineffective and the laws were repealed by the early 1930s. During this time, community clinics that had been helping individuals battling addiction were shut down.
Alcoholics Anonymous (AA) was formed in 1935 by Bill Wilson, Ebby Thatcher, Rowland Hazard, and Dr. Bob Smith. AA's impact was facilitated by the growing influence of the mental hygiene movement during the 1920s and 1930s.
In the 1930s, there was a revived focus on alcoholics as patients with a right to medical treatment. Aversion therapy for alcoholism was introduced at the Shadel San in 1935. Additionally, alcoholics may have been confined to an inebriate asylum for a period of time to help them detox and withdraw. There was also a shift in the perception of alcohol's harmful effects, with a greater emphasis on alcoholism as a disease.
