Note: This article was originally published in the Spring 2006 edition of Cutting Edge, the online newsletter of The Meadows.
History & Addiction
by Claudia Black, PhD, MSW
Like every aspect of mankind, addiction has its own history. Long before anyone understood the core problems of addiction, people became hooked on substances. The following is adapted from Claudia's videos The History of Addiction and The Legacy of Addiction.
Chemical dependency has plagued humankind since man first crushed grapes. Each millennium has treated the problems that addiction brings with a methodology unique to the times. Historically, society, as a way of treating those addicted, has imprisoned them, banished them, put them in mental institutions, religiously converted them and, in today's world, treated them.
What has not changed is the impact of chemical dependency, particularly on those addicted and their families. Herein lies the story.
The roots of addiction are deep and ancient, and the methods used to deal with addicted persons are historically bizarre. The Egyptians used to flog drunkards; the Romans created Bacchus, a God of wine and revelry; and the Turks "cured" drunkenness by pouring molten lead down the throat of the inebriate, perhaps the first example of aversion conditioning - crude, but effective. The Greeks believed that the use of amethysts, beautiful deep purple stones, would ward off drunkenness. They festooned their cups with amethysts, wore them when drinking, and even ground them up and put them in the wine they drank.
An example of an early addict we might recognize is Alexander the Great, king of Macedonia in 350 B.C. By the age of 31, he had conquered the world and, during all his mighty triumphs, had abstained from intoxicating beverages. However, after his great triumphs, in a short span of two years, Alexander became an alcoholic and ended his career in a series of insane escapades.
He burned cities at the request of a courtesan and killed his best friend, and his demise came in a contest of wine drinking. Alexander the Great was 33 years old when he drank himself to death.
Wine making and its export became the economic basis of the Roman Empire. With the collapse of the empire, religious institutions, particularly the monasteries, became the source of brewing and wine making techniques. It was not until the 19th century that the production of beer, wine and distilled beverages became efficient and cheap enough to supply inexpensive alcohol to the masses.
Throughout the 19th century and into the early 1900s, alcohol and various drugs - notably morphine, cocaine and chloral hydrate - were used in various combinations as medicines. These "patent" medicines were highly addictive; alcohol content was as high as 95 percent. By the mid-1800s, the problem of addiction was major and growing. A physician from Battle Creek, Michigan, traveled extensively and used charts to show the effects of alcohol, drugs and nicotine on the body. Today, you would most likely recognize him as the founder of Corn Flakes. His name was Dr. John Harvey Kellogg.
In the 1840s, the first large temperance group, The Washingtonians, was born. The origin of this movement was a drinking club that met nightly at Chase Tavern in Baltimore, Maryland. One night, 20 chronic drinkers, in a spirit of jest, sent two of the younger members to a temperance lecture. Upon their return, the two men presented a favorable report of the lecture, and an argument concerning abstinence began. This argument would last four days and ended when six of the members announced their decision to support an abstinence society. This became a huge movement, with a membership of almost five million Americans by 1845 -notable because it probably marks the beginning of modern-day addiction recovery.
Like Alcoholics Anonymous, the Washingtonians believed in the substitution of personal experiences for lectures, and they viewed the drunk as a sick person. Perhaps most significant, they also professed a singleness of purpose: to help the drunk. But politics became an issue and would cause the movement's demise.
America's most recognizable temperance leader may be Carrie Nation. In 1888, she began a campaign wherein she and her female followers destroyed kegs of liquor and sometimes entire saloons, using stones and trusty hatchets.
In the late 1880s and early 1900s, some bizarre forms of addiction treatment were practiced. The Keeley Cure began in 1880. Using bichloride of gold, the treatment involved withdrawing the alcohol or narcotic drug and restoring the nerve cells to their original unpoisoned condition, thus removing the craving for liquor. Enemas and laxatives then stimulated the elimination of the accumulated poisonous products. (Incidentally, Bill Wilson, co-founder of Alcoholics Anonymous, was subject to this treatment in 1934.) In 1918, it was stated that more than 400,000 people had been treated by this system at various Keeley Institutes. (NOTE: Bichloride of gold did not exist.)
While not concerned primarily with addiction, the Oxford Group, a popular religious movement in the 1930s, was to play an important role in the future treatment of the disease.
But perhaps the most successful treatment for alcoholism has been Alcoholics Anonymous. Dr. Bob Smith and Bill Wilson founded AA in 1935 in Akron, Ohio. Wilson was a drunk who, after being called on by an old friend and member of the Oxford Group, was admitted for his alcoholism to Towns Hospital in New York City in 1934. He remained sober, and his work took him to Akron, where he felt the need to talk to another alcoholic. He was introduced to Dr. Bob Smith, a prominent and persistent drunk. From this meeting emerged the basic premise of Alcoholics Anonymous: one alcoholic helping another alcoholic. The original meetings of Alcoholics Anonymous were held as adjuncts to the Oxford Group on Wednesday nights at Dr. Bob's house.
Alcoholics Anonymous is a spiritually based program, and its primer is The Big Book. Proposed names for the book were One Hundred Men, Moral Philosophy, The Empty Glass, The Dry Way, and Dry Frontiers. In 1939, 5000 copies were published. Today there are four editions of The Big Book - and millions and millions of copies. Alcoholics Anonymous exists in most countries, with meetings in just about every city in the world.
In 1950, Lois Wilson, wife of Bill Wilson, founded Al-Anon, the 12-Step program for families and friends of alcoholics. Alateen was started in 1957.
In 1951, the "Minnesota Model" was developed. The foundation for treatment from the 1970s to the present, this abstinence model is based on the 12 Steps of Alcoholics Anonymous. It has become the primary protocol for residential and outpatient treatment programs in the United States and in many parts of the world.
In 1952, the American Medical Association defined alcoholism, but it would not be until 1967 that it passed a resolution identifying alcoholism as a complex disease and recognizing that the diagnosis and treatment of alcoholism are medicine's responsibility.
While abstinence-based programs would become widespread throughout the United States, treatment in the late 1970s would focus on all chemicals, not just alcohol. The word "alcoholism" was gradually replaced by "chemical dependency." There would be a resurgence of interest in attending to the family, spouses, partners and children of addicted persons. There also would be heightened interest in both young and adult children of alcoholics.
The role of the private sector in treatment has lessened, with community-based programs taking on more responsibility. Today's recovery programs treat addictive disorders, recognizing cross addictions and the need to abstain from all mind-changing chemicals. In many cases, clients are treated for multiple addictive disorders, such as gambling, chemical dependency, eating and sexual disorders, and dual diagnoses, most commonly PTSD and affective disorders.
Addiction is a complex disease, a devastating disease and a terminal disease - yet today it is a treatable disease. History has left us a long and painful legacy of addiction. Today we are beginning a new legacy: that of the reality of recovery.