History of Addiction Treatment and Recovery

1. History of Addiction Treatment and Recovery CSD 5970

2. Sources • White, W. (1998). Slaying the Dragon: The History of Addiction Treatment and Recovery in America • The National Council on Alcoholism and Drug Addiction http://www.ncadd.org

3. Perspectives • Addiction is a social problem. • Addiction should be treated as a crime. • Addiction should be treated as a disease • Addiction should be treated as a moral problem. • Others?

4. 1750 -1800 • 1750 The first sobriety circles are formed within Native American tribes. • 1752 Benjamin Franklin flies his kite. • 1774 Anthony Benezet publishes the first American essay on alcoholism, Mighty Destroyer Displayed. • 1784 Dr. Benjamin Rush argues that alcoholism is a disease. Rush’s writings mark beginnings of temperance movement.

5. 1800-1830 • 1804 Lewis and Clark begin their expedition to explore the Northwest Territory • 1810 Dr. Benjamin Rush calls for the creation of a “sober house” for the care of the confirmed drunkard. • 1825 Six Sermons of Intemperance by Rev. Lyman Beecher describes an “insatiable desire to drink” in those “addicted to sin”. • 1830 Dr. Samuel Woodward advocates inebriate asylums.

6. 1831-1845 • 1831 Nat Turner leads a revolt of enslaved African Americans in Virginia. • 1840 The Washingtonian Society is organized by and for “hard cases”. • 1844 The opening of Lodging Homes marks the beginnings of the inebriate homes. • 1845 Frederick Douglass calls for abstinence as a foundation of the drive to abolish slavery.

7. 1846-1869 • 1849 Swedish physician Magnus Huss describes the disease Alcoholismus chronicus – introduce the term alcoholic. • 1857 Baudelaire publishes a collection of poems called Flowers of Evil • 1861 Civil War Begins • 1864 New York opens the first inebriate asylum.

8. 1870-1879 • 1870 The American Association for the Cure of Inebriety is founded, publishes journal advocating disease model. • 1872 Water Street Mission opens, the first Salvation Army type of mission. • 1879 Dr. Leslie Keeley – “alcoholism is a disease and I can cure it”. The beginning of for profit clinics.

9. 1880-1900 • 1880 Freud recommends cocaine for the treatment of alcoholism and morphine addiction. • The patent medicine business booms. • 1893 The Duryeas invent the first gasoline powered automobile. • Keeley League advocates medical not penal treatment for the drunkard.

10. 1901-1913 • 1901 The Towns Hospital is the first private hospital for affluent addicts and alcoholics. • 1907-1913 States begin passing laws calling for mandatory sterilization of “defectives” such as the mentally ill, developmentally disabled, and alcoholics and addicts.

11. 1914-1919 • 1914 The Harrison Act brings opiates and cocaine under federal control. The beginning of physician involvement in prescribing narcotics. • 1919 The supreme Court rules that a physician maintaining an addict on his/her customary dose is not acting in “good faith”. • 1919 – 1924 Morphine maintenance open and then close under threat of federal indictment.

12. 1920-1933 • Prohibition

13. 1920-1939 • 1920s Most inebriate homes, asylums, and private cure hospitals collapse. • 1929 Depression Begins • 1935 Shadel Sanatorium begins using aversive conditioning to treat addictions. • 1935 Dr. Bob and Bill W. meet • 1939 The book Alcoholics Anonymous is published.

14. 1940-1950 • 1942 Research Council on Problems of Alcohol advocates public education about alcoholism. • 1944 Marty Mann founds the National Council on Alcoholism • 1948-1950 The Minnesota Model emerges – Antabuse is introduced.

15. 1950s • AA membership surpasses 90,000 • A halfway house movement begins – advocated by the Association of Halfway House Alcoholism Programs of North America. • 1957 The Veterins Administration begins developing alcoholism treatment units. • 1958 Synanon is founded – the first self-directed therapeutic community.

16. 1960s • Jellineck publishes The Disease Concept of Alcoholism • 1961 American Bar Association/American Medical Association call for community-based treatment programs. • 1963 The American Public health Association “alcoholism is a treatable disease”.

17. 1960s continued • 1964 Methadone therapy is introduced • 1964-197 Insurance payments lead to dramatic increase in addiction treatment. • 1967 American Medical Association adopts position that alcoholism is a “complex disease”.

18. 1970s • Hughes Act “comprehensive alcohol abuse and alcoholism prevention act” National Institute on Alcohol Abuse and Alcoholism founded. • 1971 Criteria for Diagnosis of Alcoholism published • 1973 Fetal Alcohol Syndrome first described

19. 1970s • 1974 The first of a series of programs to credential alcoholism counselors. • The field struggles with whether to clinically and administratively merge alcoholism and drug treatment. • 1975 Women for Sobriety is founded • 1978 Betty Ford discloses her addiction and treatment.

20. 1980s • The “just say no” campaign is launched. Federal support for treatment declines and the numbers of drug users incarcerated begins to rise. The “war on drugs” shifts focus to punishment and incarceration • Block grants transfer funding and responsibility for treatment to states. • 1985 crack cocaine appears – Rational Recovery is founded

21. 1989 -1994 • 1989 The first Drug Court in Miami – Stanton Peele publishes Diseasing of America: Addcition Treatment Out of Control • Insurance reimbursements for treatment begin to decline – the “28 day” private programs close sparking a renewed recovery home movement.

22. 1989-1994 • The American Society for Addiction Medicine publishes Patient Placement criteria for the Treatment of Psychoactive Substance Use Disorders. • 1995 USDA approves Naltrexone • 1998 Center for Substance Abuse Treatment begins funding “recovery community support projects”

23. Perspectives • Addiction is a social problem. • Addiction should be treated as a crime. • Addiction should be treated as a disease • Addiction should be treated as a moral problem. • Others?

24. Approaches • Education • Counseling • Prayer • Incarceration • Punishment • Medication

25. Exercise From each perspective – answer these questions. What should the individual addict do? What should the addicts family do? What should society do? What approaches make sense? What historical events were fueled by this perspective?