VIEWS ON ALCOHOLISM IN 1930S & 1940S.   Term Paper ID:21289 Click to get this paper

Essay Subject: Changing popular & medical views, disease concept. A.A., socioeconomics, repeal of Prohibition, research, women alcoholics, post-war treatments.... More...

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Paper Abstract: Changing popular & medical views, disease concept. A.A., socioeconomics, repeal of Prohibition, research, women alcoholics, post-war treatments. Paper Introduction: Throughout the nineteenth century attempts were made to propagate the conception of alcoholism as a disease (Schmidt, Smart, & Moss, 1968, p. 4). In fact, there was a small number of institutions in which alcoholics were treated as ill persons. However, by the late nineteenth century, most of these centers were closed or taken over for the treatment of mental disease. Some describe the failure of the various institutions for alcoholics to inefficient management and to a lack of clarity in the formulation of the illness concept of alcoholism. Added to these causes was the nineteenth-century view, shared by the community and the medical profession, that alcoholism was a vice of the poor. In North American literature of the late nineteenth century and early twentieth centuries, there was a change of emphasis in Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. However, the success of Antabuse dependsentirely on the drinker's willingness to consistently take the drug. An 18-month followup seemed a more reliable indicatorof long-term results. Abstention is the only hope, becausethe disease is incurable. Such alcohol-related problemsare now known to come and go in a wide variety of patterns: they do notcluster in any regular way, do not emerge in any uniform sequence, and donot show up at all in the lives of many heavy drinkers. 17). Throughout the nineteenth century attempts were made to propagate theconception of alcoholism as a disease (Schmidt, Smart, & Moss, 1968, p. 83). From apparently normal social drinking, they progress todrinking ever greater amounts, to private and secret drinking, todeveloping an increased tolerance to liquor, and to experiencing withdrawaldistress if drinking is interrupted; they begin to have blackouts and theyforget the previous day's drinking bout. Women did not stop drinking, but they did so less openly andless often. 18). The only way that alcoholics can halt the progressivedeterioration of alcoholism is by complete abstinence (Fingarette, 1988, p.18). Clearly, many people were capable of drinking alcohol withoutfalling victim to it. (1968). For example, in the 193 s, physicians inlarge metropolitan areas perceived alcoholism as a disorder occurringprimarily among derelicts, and tended not to recognize alcoholism inothers. For the first decade of its history, A.A. This becomes particularly apparent,even today, when considering the patient populations of many treatmentfacilities operating in large metropolitan communities. Jellinek cautionedhis readers about the limited nature of his data, and he explicitlyacknowledged differences among individual drinkers--but from the data, hedeveloped a vividly detailed hypothesis (Fingarette, 1988, p. For example, literature on alcoholismof that period stated that contrary to popular belief, the "ravages ofintemperance" are most plainly to be traced in classes above the "pauper"class (Schmidt, Smart, & Moss, 1968, p. (198 ). In anutshell, Antabuse eliminates drinking, but the drinker can decide toeliminate Antabuse. However after the repeal of Prohibition in 1933, a marked shiftoccurred in the popular conception of the alcoholic. view. The public simply resigned itself to tolerating the sale, ifnot the excess consumption of alcohol. To increase public awareness of the problem of alcoholism, theYale Center stressed that alcoholism could afflict a man regardless of hisposition in the class structure. In order to achieve abstinence, thealcoholic needs to acknowledge dependence on the help of others(specifically A.A.) and ultimately a "higher power," but the nature of thispower is left to the individual. By the time Prohibition was repealed, however, women were less likelyto use their newly legalized right to drink. 21). 18). However, by the late nineteenth century, most ofthese centers were closed or taken over for the treatment of mentaldisease. Some describe the failure of the various institutions foralcoholics to inefficient management and to a lack of clarity in theformulation of the illness concept of alcoholism. Drinking is interpreted as a symptom ofthe disease, and ritual public confession at A.A. 85). 4). Interest now centered on the prohibition of themanufacture and sale of alcoholic beverages, and the urban worker was seenas a possible voter in the prohibitionist cause rather than as an object ofreform. Especially if abstinence was the program goal, therate of relapse rose significantly subsequent to the first six months afterleaving the program. Added to these causeswas the nineteenth-century view, shared by the community and the medicalprofession, that alcoholism was a vice of the poor. If adrinker does not have a strong will to stop heavy drinking, he may resist acasual impulse to drink because of the Antabuse he has already ingested,but he could also skip several doses and then resume drinking. Unfortunately, much of Jellinek's theory is based upon statementsfrom members of A.A., rather than upon documented scientific research.A.A. Some people, however, have a unique biological vulnerabilityto alcohol and they develop a special kind of "allergy." For these at-riskdrinkers (alcoholics), alcohol triggers an uncontrollable need for morealcohol. Jellinek,published in 1946 and 1952, proposed a scientific understanding ofalcoholism that seemed to confirm major elements of the A.A. A.A.'s teachings were derived from an amalgam of ideas that fittogether loosely. Through an insidious process ofincreasing involvement with alcohol, the alcoholic loses control over hisdrinking and cannot stop once he has started. In conclusion, the attitudes of people during 193 to 1949 changedfrom treating alcoholism as a disease that afflicted only poor people toone that respected no socio-economic class. Although women were involved in the temperance movement,which led to Prohibition, they were also involved in its repeal. 7-9)." However, the revolutionin drinking among middle-class women was the result of severe interlockingfactors operating between 1915 and 193 . By that time, with anenormous effort and with the aid of others, some alcoholics manage a courseof total abstinence. The sequence of the disease's key phasesbegan with the innocent social drinking. The Schick-Shadel treatment had early reports of high success rates.All the alcoholics taking part in the program had paid substantial sums forthe treatment, which implied that they were highly motivated and of atleast moderate socioeconomic status (Fingarette, 1988, p. 5). The descent to the "bottom" is not inevitable, and a returnfrom heavy drinking to moderation is common (Fingarette, 1988, p. (1981). Jellinek postulated a basic pattern of alcoholism that remarkablyparalleled the A.A. AlcoholicAnonymous extended its membership; disulfiram, a drug first used clinicallyin Denmark in 1948, seemed to offer a promising new treatment; and theaversion treatment, which was pioneered at the Shadel Sanatorium inCalifornia in 1949 (Schick-Shadel), also was tried. Oxford, England: OxfordUniversity Press.Sandmaier, M. New York: Mc Graw-Hill Book Company.Schmidt, W., Smart R.G., & Moss, M.K. World War I gave thousands ofAmerican women their first jobs, and their first taste of freedom fromtheir husband's or father's authority. There were some new ideas about treating alcoholism. Jellinek, then a research professor in applied physiology at YaleUniversity, was a distinguished biostatistician and one of the earlyleaders in the field of alcohol studies. 17). As the Depression settledover the country, many women, by necessity, left the workplace and returnedto the home. Toronto: University of Toronto Press.Twelve steps and twelve traditions. Not surprisingly, thenumber of woman drinkers rose from 45 percent to 66 percent during theyears, 1939-1978 (Sandmaier, 1977, p. However, treatment continuedto be based on one's socio-economic class. disease concept came when it received what seemed tobe impeccable scientific support. However, after the Second WorldWar and Jellinek's reports, the beginnings of the evolution of the presentpatterns of treatment services can be identified (Orford & Edwards, 1977,p. Important, too, isthe fact that many drinkers with numerous and severe problems "mature out"of trouble. Other people reportedthey lost control but had no problems with police, family, finances,employment, auto accidents, or social life. Despite the repeal of Prohibition, the temperance creed lingered onin some quarters. The use of Antabuse seems reasonable: the chemical effectively makesit impossible for anyone to drink any beverage with alcohol in it. Public consumption of alcohol bywomen was especially frowned upon during the Depression, although World WarII, by opening up new vistas for women, changed the public's attitude onthat issue. The great surge inpopularity of the A.A. Once the temperance fervor died down, people recalled that Europe andthe United States had a long cultural tradition of moderate social drinkingand that the vast majority of social drinkers did not become habitualdrunkards. Between World War I and World War II, the problem of alcoholism wasgenerally not accorded national priority. According to A.A. According to this theory, alcoholism progressesstage by stage in a regular, fairly standard course that does not respect aperson's individual characteristics. Thus, there were convincing reasons to believe that the socialclass of the drinker was still a significant factor influencing thediagnosis and treatment of alcoholism. By theearly 193 s, the temperance notion of alcohol as a universally addictingsubstance had simply lost its grip on the American mind and political will(Fingarette, 1988, p. Their new approach was in essence a mixture of pseudo-medical, psychological, and religious ideas (Fingarette, 1988, p. A recurring theme ofpropagandistic and educational activities stressed that alcoholism was notprimarily an affliction of the poor. The winning of the vote for womenin 192 strengthened this emerging sense of autonomy, and with it came anew resistance to double standards of behavior. It is also interesting to note that the change in public attitudethat instigated the repeal of Prohibition was a matter of sentiment andperception, and not the result of any new scientific research. Women did not teach their daughters to drink, and by 1938,according to a survey, two-thirds of the respondents believed a womanshould not be seen drinking in public. (1988). The reaction is so strong that Antabuse must beprescribed with caution; it can produce lasting harm or even death if takenin sufficient doses by people who have heart conditions or certain otherailments (Fingarette, 1988, p. In 1939, the experiences of the founders in theirstruggle to overcome their addiction were set down in a book calledAlcoholics Anonymous, and from it the organization took its name (TwelveSteps, 1981, p. 56). Berkeley: University of California Press.Orford, J., & Edwards, G. In the 196 s, national surveys revealed that many peoplehad problems with drinking but did not lose control. At best, an alcoholic learns to abstain from thefirst fatal drink that invariably triggers a new descent into drunkenoblivion (Fingarette, 1988, p. Alcoholism. The invisible alcoholics. However, World War II changed that,since many women went to war or college; began buying their own homes,divorcing, and working in non-traditional jobs. The classic disease theory,promulgated by Alcoholics Anonymous, received validation from the studiesof Jellinek, but this theory is still disputed by the medical community.The repeal of Prohibition reflected a change in public attitudes, ratherthan the result of a new scientific discovery regarding treatment ofalcoholism. Despite these developments, however, the idea that alcoholism canafflict anyone regardless of social class is by no means universallyaccepted--even by people during the 193 s through the 194 s, when thistheory was widely promulgated. ideology, most people can drink socially withoutany problem. This was because, as thetheory went, it was among those capable of earning good incomes that themost money was spent for alcohol--and consequently, the most vitality burntout by it. Surprisingly, Prohibitionitself served to encourage women's drinking rather than limit it.Furthermore, many women were actively involved in bootlegging operationsduring this time. For example,today, as in the 193 s to the 194 s, the Salvation Army facilities caterprimarily to the derelict alcoholic; Alcoholics Anonymous serves alcoholicsmainly from the middle class; and private alcoholism clinics admit theupper class who can afford their services (Schmidt, Smart, & Moss, 1968, p.6). There are some proper scientific differences ofopinion about the relevance of the term disease to some forms of chronicheavy drinking. Incontrast, over 1 charity cases were treated, but the results werediscouraging. In 1935, the old doctrine was given new life by thefounders Alcoholics Anonymous (A.A.). Most crucially: those afflictedby the disease inevitably progress to uncontrolled drinking because thedisease produces a distinctive disability--loss of control, or a loss ofthe power to make choices. New York: AlcoholicsAnonymous World Services, Inc.----------------------- 1 Inspired by the teachings of a thenpopular religious sect, the Oxford movement, two reformed heavy drinkers, astockbroker, and a physician, proposed a less extreme version of thetemperance thesis. The rapid increase in the number ofpublic treatment facilities is probably largely due to the success of theseefforts. Regardless of newer theories regarding alcoholism, almost everybodyoutside the scientific community still takes it for gospel that there is ascientifically proven, uniquely patterned drinking history to a diseasecalled alcoholism. 2-3). (1977). Although the origin of this concept cannot be traced to a singleevent or discovery, the work of the scientists and educators affiliatedwith the Yale Center of Alcohol Studies greatly influenced the theories ofthat era. 6). Furthermore, despite the scientific evidence, theclassic disease concept has been promoted by a variety of interest groupsin the public and private sectors. Eventhe description of the violent reaction can be enough to frighten a patientfrom trying to take a drink. They have often been called the"invisible alcoholics (Sandmaier, 198 , p. Women and alcoholism has been an area of research that has been givenlittle attention until recently. Heavy drinking: The myth of alcholism as a disease. was at that time still a relatively small, self-selected group.Today, the medical community does not accept Jellinek's and the A.A.'sclassic disease concept. Two landmark articles by E.M. In his first paper he presented adetailed description, statistics, and charts that depicted what heconsidered to be a typical or average alcoholic career. 5). In the political struggle which led to the passing of prohibitionlegislation, alcohol was pictured as a danger to all strata of society andthe problems of alcoholism became submerged (Schmidt, Smart, & Moss, 1968,p. picture. grew modestly. Distorted success rates also appeared in studies that usedshort followup times. 19). In fact, there was a small number of institutions in which alcoholics weretreated as ill persons. Those who are vulnerable develop the disease if they takeup drinking. meetings, the admissionthat one has an incurable vulnerability to alcohol, is a necessary part ofthe treatment (Fingarette, 1988, p. There are appeals to the alcoholic's willpower, as wellas an emphasis on his helplessness. ReferencesFingarette, Herman. Then he plunges into a lowpoint, where his drinking is out of control. Disulfiram, commonly known as Antabuse, causes nausea, vomiting,breathing difficulties, and profuse sweating when taken before anyingestion of alcohol. Social class and thetreatment of alcoholism. In North American literature of the late nineteenth century and earlytwentieth centuries, there was a change of emphasis in the discussion ofalcohol problems. Lackingscientific confirmation, it remained a relatively small sectarian movement,occasionally receiving a boost in popular magazines. The classic disease concept of alcoholism, as promulgated in the193 s, states that alcoholism is a specific disease to which some peopleare vulnerable. If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.