by Guest Blogger, Heidi Bitsoli from Sunshine Behavioral Health
Although addiction treatment has garnered media attention and public interest over the past few decades, humans have been dealing with substance use since as early as 12,000 B.C. Historians believe that these early civilizations discovered that certain plants would produce a pleasant smell and interesting effects if ground into a powder.
We’ve been picking up mind-altering substances ever since, but the treatment of addiction is a relatively new concept.
The earliest American addiction treatment efforts date around the 18th and 19th centuries. As they say, the rest is history.
Humble Beginnings of Addiction Treatment
Since the colonists first came to America, alcohol was an integral part of their culture. In the 1800s, distilleries abundantly furnished the early settlers with alcoholic beverages. Still, the colonists frowned upon public drunkenness. Much like today, alcohol was commonly available and easy to access, but overindulging earned the judgment of those who could control their drinking. Since alcohol was the first common drug in this land, it was also the first form of addiction early practitioners attempted to treat.
Between the 18th century and the 19th century, institutions and similar facilities began making space for alcoholics. Although the public held drunks in contempt, they housed them in designated spaces – including incarcerating alcoholics in jails. It doesn’t seem like reform or recovery happened very often in these cases because alcohol was served in jails at the time.
Almshouses (facilities that housed the destitute), hospitals, and asylums sometimes took in alcoholics. But even these places had limited space, which left many alcoholics to die of their disease socially stigmatized and ill.
While many people think of the “Roaring Twenties” of the 20th century as a raucous, decade-long party, it was during this time – 1920-1933 – that alcohol was also banned.
Prohibition was a nationwide effort to curb alcohol usage by outlawing it. Unfortunately, these laws seemed to have the opposite effect. Although the thinking at the time considered alcohol usage to be a moral failing, it is an illness and a maladaptive coping skill. Since prohibition only banned drinking, it did not address the root issues that cause excessive drinking.
When alcohol became illegal, it became even more popular as groups and individuals began going “underground” to purchase and drink alcohol. This failed experiment in ending alcohol use was not entirely fruitless. It showed later generations that banning a substance alone will not treat it. We have since discovered that making a substance legal and widely available can decrease usage while banning it can do the opposite, and lead to abuse.
What started as a meeting between two men (one who was having his last drink as they spoke) has become the gold standard for peer-facilitated group therapy in addiction recovery. When Bill W. and Dr. Bob S. met in 1935, it’s hard to say whether they envisioned the scope of people that their program Alcoholics Anonymous and subsequent 12-step programs would help.
Bill W. published the Alcoholics Anonymous Big Book in 1939.Since then, the principles and steps have remained largely the same. Individuals gather, work the steps, support each other in recovery, and welcome back those who have relapsed, so they can start recovering again.
Over time, a handful of meetings offered to workmen turned into countless meetings across the country that help people of all backgrounds.
National Committee for Education on Alcoholism (and Drug Dependence)
Right around the time when Alcoholics Anonymous meetings were spreading through the nation, another forerunner in addiction treatment history emerged. Marty Mann founded the National Committee for Education on Alcoholism(currently called the National Council on Alcoholism and Drug Dependence).
Mann based this committee on several key propositions. First, he defined alcohol as a disease. He then dubbed the alcoholic a “sick person.” Because of this, we could assume the alcoholic can be helped and is worth helping. At the time, he argued that alcoholism was the fourth most prevalent public health problem and it was the responsibility of the public to resolve it.
For local NCEA affiliates, Mann wanted to implement a five-point approach to tackle the problem. He believed in launching local public education campaigns about alcoholism, pushing local hospitals to hospitalize alcoholics for acute detox, creating alcohol information centers, establishing clinics for diagnostic and treatment purposes, and building what he called “rest centers” to house and care for alcoholics in the long-term.
Mann’s treatment model resembles some of the avenues of treating and preventing addiction that professionals in the field still use in this century.
Addiction Treatment Today
From simply storing alcoholics away from the rest of society in asylums and alcohol-serving jail cells to ineffectively banning alcohol to the beginnings of 12-step meetings, a lot has changed in the past few centuries for addiction treatment.
Today, addiction treatment consists of a variety of psychological and medical interventions in different outpatient and inpatient settings. For someone who is experiencing withdrawal symptoms, “medically managed withdrawal” can ease the process for those detoxing from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.
Once an individual safely comes to the other side of the detoxification process, therapeutic programs such as intensive outpatient or long-term residential treatment can help him or her deal with the underlying issues and behaviors that contributed to the substance use.
Nowadays, we have a great deal of information about addiction as a disease, and researchers are continuing to increase their understanding of this complex illness.
The Future of Addiction Treatment
As our society gains a better understanding of how addiction affects the brain, body, and culture, we will be able to develop even more effective means of treating this disease. Like the early colonists who couldn’t imagine things like the AA meetings and medically assisted withdrawals of today, we can’t even begin to picture what addiction treatment could look like decades from now.
Some experts suggest that those suffering from addiction today can expect decreased stigma around addiction, redefined success for treatment outcomes, increased recognition of co-occurring disorders such as anxiety and other mental health concerns, and evolving treatment strategies.
sunshinebehavioralhealth.com- Finding Drug Rehab Centers in Indiana
sciencetimes.com - The History of Addiction Treatment
researchgate.net - History of Substance Use Treatment
williamwhitepapers.com - Significant Events in the History of Addiction Treatment and
Recovery in America
nida.nih.gov - Types of Treatment Programs