Slaying The Dragon Catherine Przybyl
Early History • Benjamin Rush: 1746-1813 • Could spring from many conditions • Father of American Psychiatry and first American authority ▫ Beer, wine and opium as alternatives on alcohol and alcoholism • Continued abstinence only • Viewed drunkenness as a hope for drunkard progressive medical condition • Sobriety included odd ▫ Drunkenness was transmitted remedies between generations • Described alcoholism as a ▫ Linking drink with painful impression disease ▫ Vegetarianism ▫ Cold baths ▫ Blistering the ankles
Temperance Movements • Initial goal: replace excessive drinking to moderate drinking • Encouraged to substitute wine and beer for distilled spirits • Tried to convert whiskey-drinking drunkards to temperate beer-drinkers
Washingtonian Societies • Shift from moderation to total abstinence • No ideology of nature of alcoholism and its recovery, but activities to turn away from alcoholism • First woman’s society opened in 1841 ▫ Martha Washington Society • Moderation Societies: 1879
Pre-Inebriate Homes and Asylums • Samuel Burton Pearson and John Armstrong described alcohol- induced “Brain Fever” ▫ Later known as delirium tremens • Legends of drunkards spontaneously combusting ▫ 1850: Mary Clues
Inebriate Homes and Asylums • 1860-1925 • Inebriate Homes provided minimal level of treatment • Inebriate Asylums large medically directed facilities ▫ Used Lower and Middle class with industrial plan • Private Sanataria had affluent clientele seeking place to dry-out
Philosophies, Methods and Outcomes of Inebriate Homes and Asylums • 1880s • Staff intoxicated while caring for inebriates • Inebriates were placed into categories for treatment • Excluded criminal degenerates or reckless characters • Affluent seen as victims of a disease ▫ Working class and poor seen as willful misconduct deserving punishment
• Commitment Laws: 1903: • Addictions in Women Inebriates could be legally ▫ Inebriety view committed for up to one year ▫ Slaves to cologne to asylum after a legal hearing ▫ Aides to nursing in which two physicians certified the need for such action
American Association for the Cure of Inebriates: 1870 • Intemperance is a disease • It is curable in the same sense that other diseases are • Its primary cause is a constitutional susceptibility to alcoholic impression • Constitutional tendency may be inherited or acquired
Critics of the Association • Philadelphia’s Franklin Reformatory Home for Inebriates withdrew from the Association • Critics viewed inebriety as a hereditary weakness and advocated alcoholics should be left to die so alcoholism would eventually disappear • Quarterly Journal of Inebriety from 1876-1914 ▫ Advertisements for cures
Institutional histories • New York State Inebriate Asylum 1864 • Boston Washingtonian Home 1858 • Chicago Washingtonian Home 1863 • San Francisco Home for the Care of the Inebriate 1859
Keeley Institution: 1880-1920 • 1879 Dr. Leslie E. Keeley: proclaimed “Drunkenness is a disease and I can cure it” • Saw drunkenness as biological in nature • Double Chloride of Gold remedy for inebriety, tobaccoism and neurasthenia (nervous exhaustion) ▫ Four daily injections Alcohol, Stychnine, apomorphine, aloin, willow bark, ginger, ammonia, belladonna, atropine, hyoscine, scopolamine, coca, opium, and morphine
Miracle Cures • Drugs promised treatment in secrecy, treatment at reduced costs, no institutionalization, didn’t interfere with daily activites • Hangover Remedies 1930: Good Samaritan • Alcoholism cures 1860-1930: ▫ Hay-Litchfield Antidote 1868 • Drug Habit Cures: Mrs. Baldwin’s Home Cure • Appeals to Wives and Family Members: White Star Secret Liquor Cure
Fraudulent Cures • Carney Common Sense Opiate Cure: contained morphine • Harrison’s Opium Cure: 20% Alcohol, 5% opium • Normyl Treatment for Alcoholism: contained 75.5% alcohol • St. Anne’s Morphine Cure: contained morphine and caffeine
Religious Conversion as a Remedy • Salvation Army • William Booth, 1890: alcoholism was a disease often inherited, always developed by indulgence, but as clearly a disease as ophthallmia or stone • Detox Cocktail: Raw eggs, Worcestershire sauce, Epsom salts • Moved towards nature of alcoholism and appropriate treatment ▫ SA members against disease concept because it reduced alcoholic’s ‘moral responsibility’
Charles B. Towns Hospital • 1901 opened hospital ▫ Tried to cure opium addictions in China in 1908 • Alcoholism was the product of the body’s systematic poisoning by alcohol and other drugs • Cure consisted of: ▫ Belladonna, hyoscyamus and xanthosxylum
Eugenics as Alcoholism Remedy • 1902: T.D. Crothers agreed with degeneracy of alcoholics as parents • People thought alcohol contributed to natural selection • Sterilization of addicted • 1905 Indiana law
‘Natural’ Therapies • Water cures • Morphine: Dr. J.R. Black 1889 ▫ Hydrotherapy ▫ Cheaper and less socially and economically devastating to • Drug Therapies: 1860-1930 alcoholic and family ▫ Whiskey and beer • Sedatives ▫ Cannabis indica ▫ Chloral Hydrate ▫ Coca ▫ Paraldehyde ▫ Hyosycamus • Convulsive Therapies: 1930s ▫ Belladonna • Lobotomies ▫ Atropine • Miscellaneous treatments ▫ Nauseants ▫ Exposure to hot-air boxes and light boxes ▫ Oxygen inhalation
Aversion Therapy • 1935 Dr. Voegtlin ▫ Injected emetine and drank alcohol ▫ Patient vomited and continued to drink and vomit until nausea was stopped ▫ Repeated every other day until four or five treatments completed
Drug Treatment for Narcotic Addiction • 1884 Freud recommended use of cocaine as cure for addiction to morphine ▫ Experimented on himself and those close to him • Three approaches: ▫ Cold Turkey ▫ Step-down of drug dosage over short period of time ▫ Gradual weaning over long period of time
Drug Treatment for Narcotic Addiction Continued • Harrison Anti-Narcotic Act 1914 ▫ Restricted use of opiates and cocaine to legitimate medical purposes ▫ Became illegal for physicians to prescribe morphine to addict to keep them comfortable ▫ Recommendations to keep addicts systems in- balance similar to those with Diabetes ▫ Prosecution of 25,000 physicians who still prescribed narcotics to addicts
Federal Narcotic Farms • 1929 Porter Act: allocated funds for U.S. Public Health Service to construct and operate two “narcotic farms” which would house and rehabilitate addicts/offenders who had been convicted of violating federal drug laws • Lexington Narcotics Farm 1935 ▫ Fort Worth, Texas 1938 ▫ Involuntary and Voluntary clients
Modern Alcoholism Movement • 1930-1955 • 1930-1956 ▫ Redefined alcoholic from ▫ 1947 Shifted responsibility of morally deformed perpetrator care of harm to sick person worthy ▫ American Medical of sympathy and support; Association 1956 declared disease was treatable chronic alcoholic should be viewed as a sick person
Mid-Century Treatment 1945-1960 • Lack of hospital beds in 1950 made difficult for alcoholics to be admitted for detoxification • Psychiatric hospitals were primary source of care during middle decades of the 20 th Century • 1946: APA recommends improvements for institutions; every hospital that received alcoholics and addicts to provide specialized unit for their care and provide adequate staffing levels for administration of specialized care
Mid-Century Alcoholism Treatments • 1960: Jellinek’s disease concept of alcoholism described five major species of alcoholism ▫ Alpha ▫ Beta ▫ Gamma ▫ Delta ▫ Epsilon
Mid-Century Alcoholism Treatments • Hypnosis 1950s • Drug Intervention • Nutrition and Vitamin Therapy • ACTH: Adrenocorticotropic Hormones • Tranquilizers, Anti-Depressants, Mood Stabilizers, and Sedatives • Benzedrine • Antabuse • LSD • Carbon Dioxide
Rise of New Approaches • Narcotic addiction more as a problem of criminal deviance than a disease • Boggs Act 1951 • Narcotic Control Act 1956
Rise of New Approaches Continued • Heroin Addiction was a • Narcotic Addict Treatment Act chronic biological condition 1974: Guidelines governing characterized by: relapse, operation of methadone incapable of abstinence, and detoxification and needed narcotic maintenance maintenance clinics for sobriety • Blockade Treatment 1965
Questions • Why do you think the Government passed so many laws to guideline the use of certain narcotic drugs but not ever alcohol? • Why do you think physicians put their job on the line during the 1900’s to help maintain addicts addiction? • Why do you think the view of addiction changed so often throughout history of treatment?
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