By Harry G. Levine

From: Levine, Harry G, "The Discovery of addiction: Changing Conceptions of Habitual Drunkenness in America" Journal of Studies on Alcohol. 1978; 15: pp. 493-506.

Introduction

"In the last years of the eighteenth century, European culture outlined a structure that has not yet been unraveled; we are only just beginning to disentangle a few of the threads, which are still so unknown to us that we immediately assume them to be either marvelously new or absolutely archaic, whereas for two hundred years (not less, yet not much more) they have constituted the dark, but firm web of our experience." --Michel Foucault

THE ESSENTIALS of the modern or post-Prohibition understanding of alcoholism first emerged in American popular and medical thought at the end of the 18th and beginning of the 19th century. Around that time a new paradigm was created (2); or, in Foucault's terms (1), the "gaze" of the observer shifted then to a new configuration -- a new gestalt.

This new paradigm or model defined addiction as a central problem in drug use and diagnosed it as a disease, or disease-like. The idea that alcoholism is a progressive disease -- the chief symptom of which is loss of control over drinking behavior, and whose only remedy is abstinence from all alcoholic beverages -- is now about 175 or 200 years old, but no older.

This new paradigm constituted a radical break with traditional ideas about the problems involved in drinking alcohol. During the 17th century, and for most of the 18th, the assumption was that people drank and got drunk because they wanted to, and not because they "had" to.

In colonial thought, alcohol did not permanently disable the will; it was not addicting, and habitual drunkenness was not regarded as a disease. With very few exceptions, colonial Americans did not use a vocabulary of compulsion with regard to alcoholic beverages.

At the end of the 18th century and in the early years of the l9th some Americans began to report for the first time that they were addicted to alcohol: They said they experienced overwhelming and irresistible desires for liquor. Laymen and physicians associated with the newly created temperance organizations developed theories about addiction and brought the experience of it to public attention.

Throughout the l9th century, people associated with the temperance movement argued that inebriety, intemperance or habitual drunkenness was a disease, and a natural consequence of the moderate use of alcoholic beverages. Indeed, the idea that drugs are inherently addicting was first systematically worked out for alcohol and then extended to other substances. Long before opium was popularly accepted as addicting, alcohol was so regarded (e.g., 3-7).

Contrary to the prevailing wisdom in the current literature on alcohol (8-10), I am suggesting that post-Prohibition thought (about the progressive character of alcoholism, the experience of the alcoholic, including loss of control over drinking, and the necessity for abstinence) is of a piece with a major strand of 19th-century thought -- the ideology of the temperance movement.
The most important difference between temperance thought and the "new disease conception" (8) is the location of the source of addiction. The temperance movement found the source of addiction in the drug itself -- alcohol was viewed as an inherently addicting substance, much as heroin is today. Post-Prohibition thought locates the source of addiction in the individual body -- only some people, it is argued, for reasons yet unknown, become addicted to alcohol.

Although that change represents a major development in thought about addiction, the post-Prohibition ideas are still well within the paradigm first established by the temperance movement. Insofar as Alcoholics Anonymous and temperance advocates share the concept of addiction, and recommend abstinence as the only solution for the afflicted individual, their differences remain in-house or intra-paradigmatic.

This article will trace the development of American thought about habitual drunkenness and alcohol addiction. Traditional colonial ideas will be contrasted with the new conceptions which emerged in the 19th century. Finally, there will be a brief discussion of the social and historical context in which the concept of addiction came to be an acceptable and intelligible way to define problems relating to alcohol.

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Traditional Views: The World Without Addiction

Seventeenth-century and especially 18th-century America was notable for the amount of alcoholic beverages consumed, the universality of their use and the high esteem they were accorded. Liquor was food, medicine and social lubricant, and even such a Puritan divine as Cotton Mather called it the "good creature of God." It flowed freely at weddings, christenings and funerals, at the building of churches, the installation of pews and the ordination of ministers.

For example, in 1678 at the funeral of a Boston minister's wife, mourners consumed 51 1/2 gallons of wine (11, p.124); at the ordination of Reverend Edwin Jackson of Woburn, Massachusetts, the guests drank 6 1/2 barrels of cider, along with 25 gallons of wine, 2 gallons of brandy and 4 gallons of rum (12, p.18).

Heavy drinking was also part of special occasions like corn huskings, barn raisings, court and meeting days, and especially militia training days. Workers received a daily allotment of rum, and certain days were set aside for drunken bouts; in some cases, employers paid for the liquor. The tavern was a key institution in every town, the center of social and political life, and all varieties of drink were available.

Americans drank wine, beer, cider and distilled spirits, especially rum. They drank at home, at work and while traveling; they drank morning, noon and night. And they got drunk (13-17).

During the colonial period most people were not concerned with drunkenness; it was neither especially troublesome nor stigmatized behavior. Even the young Benjamin Rush (18, p.22), when still urging moderation in 1772, noted how common and acceptable drunkenness was.

"Why all this noise about wine and strong drink," he wrote, anticipating his readers' complaints. "Have we not seen hundreds who have made it a constant practice to get drunk almost everyday for thirty or forty years, who, not withstanding, arrived to a great age, and enjoyed the same good health as those who have followed the strictest rules of temperance?"

Rush was willing to grant that there were indeed "some instances of this kind." In his rich and thorough study of early American drinking practices, Rorabaugh (13, Chapter 2 ) concluded that "to most colonial Americans inebriation was of no particular importance. William Byrd, for example, noted with equal indifference intoxication among members of the Governor's Council and his own servants."

Rorabaugh found that Byrd's attitude was typical, and that for most Americans in the period "drunkenness was a natural, harmless consequence of drinking" (see also 14-17).

However, from time to time some wealthy and powerful colonials complained about excessive drinking and drunkenness. In 1637 there was concern about "much drunkenness, waste of the good creatures of God, mispense of time, and other disorders, which took place at taverns." In 1673 Increase Mather (19) published his sermon "Wo to Drunkards" deploring the frequency of excessive drinking in the colonies.

By 1712 things had gotten even worse, and he reissued his pamphlet. Around the same time, Increase's son, Cotton, worried about drunkenness among members of his congregation (13). By the 1760s John Adams was so concerned about the level of drunkenness that he proposed limiting the number of taverns, and Benjamin Franklin labeled taverns "a Pest to Society" (13) .

Despite such complaints, however, and despite regulations on the amount of time one could spend in a tavern, how much one could drink there, and penalties for drunkenness including public whippings and the stocks, Americans continued to drink and get drunk (13, 14).

Colonials sometimes singled out individuals who were periodically or frequently drunk; they called such people drunkards, common drunkards, or habitual drunkards. Occasionally they described drunkards as addicted to drunkenness or intemperance, as in Danforth's (20, p.10) statement that "God sends many sore judgments on a people that addict themselves to intemperance in Drinking."

In the colonial period "addicted" meant habituated, and one was habituated to drunkenness, not to liquor. Almost everyone "habitually" drank moderate amounts of alcoholic beverages; only some people habitually drank them to the point of drunkenness. Towns circulated lists of common drunkards, and landlords who sold liquor to them could be fined or have their licenses revoked (17). Some drunkards were punished severely, others were treated quite kindly, and some did reform.

In general, however, drunkards as a group or class of deviants were not especially problematic for colonial Americans. If they had property, or were able to support themselves, they were treated much like anyone else of their class. And those that could not support themselves were grouped among the dependents in every community.

As Rothman (22) has shown, colonials did not make major distinctions among the poor and deviant: The fact of need was the important issue, not why someone happened to be needy. Further, colonials did not expect society to be free from crime, poverty, insanity or drunkenness -- from deviance. According to Rothman (22, p. 15) "they did not interpret its presence as symptomatic of a basic flaw in community structure or expect to eliminate it.

They would combat the evil, warn, chastise, correct, banish, flog or execute the offender. But they saw no prospect of eliminating deviancy from their midst."

The clergy, especially the educated and scholarly Puritans, did most of the warning and chastising about habitual drunkenness -- what they called the "Sin of Drunkenness" and the "Vice of Drunkenness." In the writings of men like Increase (19) and Cotton Mather (23), Thomas Foxcroft (24), Samuel Danforth (20) and Jonathan Edwards (25), we can see the seeds of a modern view of habitual drunkenness, as well as the absolute limits to which colonial and Puritan thought could go on the question.

Using the Bible as their text, ministers warned of the eternal suffering awaiting drunkards. Puritans also argued that drunkards tended to commit "all those Sins to which they are either by Nature or Custom inclined" (20, p. 22). Cotton Mather called drunkenness "this engine of the Devil" (23, p. 7). Some ministers noted the difficulty of getting drunkards to give up their habit. "It is a Sin that is rarely truly repented of, and turned from," wrote Increase Mather. "Hence, that expression of adding drunkenness to thrift, is a proverbial speech, denoting one that is obstinate, and resolved in an evil course" (19, p. 23).

Finally, Puritans observed that drunkards suffered in this world as well; they frequently became sick or injured, and they tended to ignore their economic, religious and family responsibilities. "Those that follow after Strong Drink, have not the Art of getting or keeping Estates lawfully," Danforth warned in 1710. "They cannot be diligent in their Callings, nor careful to improve all fitting Opportunities of providing for themselves, and for their families" (20, p. 14).

In terms of external behavior, there is little to distinguish the contemporary idea of alcoholism or inebriety from the traditional colonial view of the drunkard. The modern reader translates the behavioral description of the habitual drunkard into modern terms -- into the alcoholic.

But the understanding we have of the drunkard is not the understanding of the 17th and 18th centuries. The main differences lie not so much in the external form as in the assumptions made about the inner experiences and condition of the drunkard.

Beginning in the 19th century, terms like "overwhelming," "overpowering" and "irresistible" were used to describe the drunkard's desire for liquor. In the colonial period, however, these words were almost never used. Instead, the most commonly used words were "love" and "affection," terms seldom used in the 19th and 20th centuries. In the modern definition of alcoholism, the problem is not that alcoholics love to get drunk, but that they cannot help it -- they cannot control themselves.

They may actually hate getting drunk, wishing only to drink moderately or "socially." In the traditional view, however, the drunkard's sin was the love of "excess" drink to the point of drunkenness. Thus did Increase Mather distinguish between one who is "merely drunken" and a drunkard: "He that abhors the sin of Drunkenness, yet may be overtaken with it, and so drunken; but that one Act is not enough to denominate him a Drunkard: and he that loveth to drink Wine to Excess, though he should seldom be overcome thereby, is one of those Drunkards" (19, p. 21).

This is one important characteristic of colonial thought which radically separates it from modem ideas: Insofar as the traditional view raised the question of the drunkard's experience or feelings, it described the drunkard as one who loved to drink to excess, who loved to drink and get drunk: "Solomon's description of a Drunkard is, that he is a lover of wine, Prov. 21.17.

Such an one is an habitual Drunkard; and he whose practice is according to that inordinate affection, is actually so" ( 19, p. 5). Further, because in the traditional view there was nothing inherent in either the individual or the substance which prevented someone from drinking moderately, drinking was ultimately regarded as something over which the individual had final control. Drunkenness was a choice, albeit a sinful one, which some individuals made.

Perhaps the clearest statement of the traditional position was in Jonathan Edwards's masterpiece, Freedom of the Will, first published in 1754. Edwards's piece was one of the latest and most articulate attempts to defend the Old World view against the New World's.

He started his critique with Locke, whose ideas were, indeed, to be those of the modern world. Edwards began by countering Locke's argument that it is possible to differentiate between "Desire" and "Will." This distinction is important to much modern thought; it is also at the heart of the concept of addiction. In 19th- and 20th-century versions, addiction is seen as a sort of disease of the will, an inability to prevent oneself from drinking.

As Keller (26, p. 162) has recently explained, "An alcoholic cannot consistently choose whether he shall drink or not. There comes an occasion when he is powerless, when he cannot help drinking. For that is the essence or nature of drug addiction." For Edwards, however, desire and will must be seen as identical: "A man never, in any instance, wills any thing contrary to his desires, or desires any thing contrary to his Will.... His Will and Desire do not run counter at all: the thing which he wills, the very same he desires" (25, p. 199).

Edwards went on to confront the related philosophical issues of why people make the choices they do, and whether the words "impossible," "irresistible," or "unable" could rightly be used with reference to moral choices. In both of these cases, he used the drunkard to illustrate his points. He concluded that people choose things which "appear good to the mind," by which he meant "appear agreeable, or seem pleasing to the mind."

"Thus, when a drunkard has his liquor before him, and he has to choose whether to drink or no ... If he wills to drink, then drinking is the proper object of the act of his Will; and drinking, on some account or other, now appears most agreeable to him, and suits him best If he chooses to refrain, then refraining is the immediate object of his Will and is most pleasing to him." (25, p. 203).

The point, of course, is that in choosing to drink or to get drunk, the drunkard chooses his pleasure, his "love." Thus, Edwards rejected the idea that the drunkard can be compelled by appetite or desire to do something against his will.

"It cannot be truly said, according to the ordinary use of language that a malicious man, let him be never so malicious, cannot hold his hand from striking, or that he is not able to show his neighbor kindness; or that a drunkard, let his appetite be never so strong, cannot keep the cup from his mouth. In the strictest propriety of speech, a man has a thing in his power, if he has it in his choice or at his election.... Therefore, in these things, to ascribe a non-performance to the want of power or ability, is not just." (25, pp. 218-219).

That Edwards felt it necessary even to raise the question of volition with regard to the drunkard suggests that, by 1750, some people were beginning to view drunkards as individuals who had completely lost their ability to drink moderately.

The concept of addiction did not spring full-grown out of Benjamin Rush's head; rather, it was the result of a long process of development in social thought. Whatever the level of "folk" wisdom on the subject, however, at the time Edwards was writing the idea that someone could become an alcohol addict, in the modern sense of the term, had not yet been fully articulated or developed.

Of all colonials, Puritan ministers were the most troubled by habitual drunkenness, and in some scattered phrases and sentences we find evidence of their trying to stretch beyond the ideas of their days. Increase Mather (19), for example, declared that habitual drunkenness was a kind of madness, and Foxcroft (24, p.8) warned moderate drinkers that they were "in danger of contracting an incurable Habit."

But the ministers were not able to synthesize their observations; they were bound by the categories of their theology and psychology. As Miller (29, p. 232) has pointed out, for Puritans, other than God's will, "there can be no compulsion upon man." The individual was always viewed as having the freedom to choose to sin or not.

There were, in summary, two ways in which colonials viewed habitual drunkenness, and neither view lent itself to a definition of it as a diseased condition beyond the control of the will. For most people frequent drunkenness was not troublesome or sinful behavior. On the other hand, some individuals did see drunkenness as troublesome and sinful, but they did not regard it as therefore problematic.

Neither view led colonials to seek elaborate explanations for the drunkards behavior. Whether seen as sin or blessing, habitual drunkenness was regarded as natural and normal -- as a choice made for pleasure.

The Discovery of Addiction and the Ideology of the Temperance Movement

During the 18th century there were anticipations of a modern way of seeing the drunkard. In 1774 Quaker reformer Anthony Benezet (30) wrote the first American pamphlet urging total abstinence from distilled spirits. However, the new view of addiction had to be developed by individuals who were free from certain traditional assumptions about human behavior -- who tended to see deviance in general, and drunkenness in particular, as problematic and unnatural.

The modern conception of addiction was first worked out by physicians, whose orientation led them to look for behavior or symptoms beyond the control of the will, and whose interests lay precisely in the distinction between Desire and Will.

It is in the work of Dr. Benjamin Rush, taken as a whole, that we can find the first clearly developed modern conception of alcohol addiction. While some of his observations had been made by others (especially Benezet ), Rush organized the developing medical and common-sense wisdom into a distinctly new paradigm. According to Rush, drunkards were "addicted" to spirituous liquors; and they became addicted gradually and progressively:

"It belongs to the history of drunkenness to remark, that its paroxysms occur, like the paroxysms of many diseases, at certain periods, and after longer or shorter intervals. They often begin with annual, and gradually increase in their frequency, until they appear in quarterly, monthly, weekly, and quotidian or daily periods." (33, p.192)

The "paroxysms" are bouts of drunkenness characterized by an inability to refrain from drinking. "The use of strong drink is at first the effect of free agency. From habit it takes place from necessity." This condition he designated as a "disease of the will" and he gave a superb example of what, today, is called "inability to refrain" or "loss of control" (26):

"When strongly urged, by one of his friends, to leave off drinking [an habitual drunkard] said, 'Were a keg of rum in one corner of a room, and were a cannon constantly discharging balls between me and it, I could not refrain from passing before that cannon, in order to get at the rum'." (34, p.266)

Finally, having diagnosed the disease, Rush offered the cure:

"My observations authorize me to say, that persons who have been addicted to them, should abstain from them suddenly and entirely. 'Taste not, handle not, touch not' should be inscribed upon every vessel that contains spirits in the house of a man, who wishes to be cured of habits of intemperance." (33, p. 221)

Rush's contribution to a new model of habitual drunkenness was fourfold: First, he identified the causal agent -- spirituous liquors; second, he clearly described the drunkard's condition as loss of control over drinking behavior -- as compulsive activity; third, he declared the condition to be a disease; and fourth, he prescribed total abstinence as the only way to cure the drunkard.

In the bulk of his writings about alcohol, Rush was not only, or even mainly, concerned with diagnosing the condition of the drunkard or prescribing cures. He wanted to awaken Americans to an entire catalog of pernicious results which followed from the consumption of spirits -- particularly disease, poverty, crime, insanity and broken homes.

However, the notion that the drunkard was a victim of the widespread and socially approved custom of drinking an addicting substance remained central to Rush's entire case against liquor. He concluded his famous pamphlet, "Inquiry into the Effects of Ardent Spirits Upon the Human Body and Mind," with an appeal to "ministers of the gospel, of every denomination" to aid him in the campaign against spirits in order to "save our fellow men from being destroyed by the great destroyer of their lives and souls" (33, p.211).

The temperance movement rightly claimed Benjamin Rush as its founder. His writings on the relationship between intemperance and ardent spirits, his descriptions of the individual and social consequences of the use of liquor, as well as his recommendation of total abstinence, formed part of the essential core of temperance ideology throughout the l9th century.

As one pro-temperance historian explained in 1891: "Dr. Rush laid out nearly all the fundamental lines of argument along which the present temperance movement is pressed." The movement grew slowly in the early years of the century; there was still considerable resistance, even among elite groups, to the need for abstinence.

But by the mid-1830s, over half a million people had pledged themselves not to drink any liquor, and the temperance movement had become firmly committed to the necessity for total abstinence from all alcoholic beverages (14, p.129).

The eventual willingness of large numbers of people to accept the idea that alcohol was an addicting substance may have been influenced by the growing numbers of habitual drunkards who claimed to be unable to control their impulse to drink. The first public announcement that any temperance writers could find (and they looked hard) of someone admitting loss of control was by a James Chalmers of Nassau, New Jersey, who in 1795 made the following sworn and witnessed statement:

"Whereas, the subscriber, through the pernicious habit of drinking, has greatly hurt himself in purse and person, and rendered himself odious to all his acquaintances and finds that there is no possibility of breaking off from the said practice but through the impossibility to find liquor, he therefore begs and prays, that no person will sell him for money, or on trust, any sort of spirituous liquors."

While no colonial drunkards seem to have made such declarations, 19th-century tales of compulsive drinking were commonplace. Especially in the 1840s, when the Washingtonians demonstrated that many drunkards could indeed be cured, the speech by the reformed drunkard, telling of his trials and tribulations and his eventual victory over his appetite for alcohol, became a major organizing technique for the movement (37). In their autobiographies drunkards wrote of their battles with liquor.

Popular fiction writers incorporated the drunkard's struggle into their format, and a whole variety of temperance literature devoted to the subject blossomed (38). For example, Walt Whitman's only novel was a first person account of the life of an alcohol addict. In it the main character explains that "None know -- none can know, but they who have felt it -- the burning, withering thirst for drink, which habit forms in the appetite of the wretched victim of intoxication" (39, p. 148).

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