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Slaying the Dragon by
William White
The History of Addiction
Treatment and Recovery in America
Table of Contents
Acknowledgments
Introduction
Prologue: The Problem of Language
Section
One: The Rise of Addiction and Personal Recovery Movement in the
Twentieth Century
1. The Seeds of
Addiction Medicine and Personal Recovery Movements
Early American Drinking
Benjamin Rush and the Birth of the American Disease Concept of
Alcoholism
A New Republic on a Binge
The Rise and Evolution of the American Temperance Movement
Alcoholics and the Evolution in Temperance Philosophy
Pre-Washingtonian Involvement of Alcoholics in the Temperance
Movement
From Individual Struggle to Shared Recovery
The Tortured Saga of Luther Benson
2. The
Washingtonian Revival
Founding and Growth
The Washingtonian Program
John Hawkins and John Gough
The Washingtonian Demise
The Washingtonian Legacy
3. Fraternal
Temperance Societies and Reform Clubs
The Reform Clubs
Osgood's Reformed Drinkers Club
Reynolds's Red Ribbon Reform Clubs
Francis Murphy's Blue ribbon Reform Clubs
Reform Clubs' Operation and Spread
The Business Men's Moderation Society
Section
Two: The Birth of Addiction Treatment in America
4. The Rise and
Fall of Inebriate Homes and Asylums
Pre-Asylum Days: Care of the Addicted
The Earliest Institutions
Types of Institutions
Sponsorship and Financing
Relationship to Other Community Institutions
Early Professionalization: The American Association for the Cure of
Inebriates
The Decline of the Inebriate Asylums
A Postmortem of the Inebriate Asylum Movement
Legacy
Summary
5. Inebriate
Homes and Asylums: Treatment Philosophies, Methods, and Outcomes
The Staff
The Patients: Demographic Profile
The Patients: Clinical Profile
Treatment Philosophies
Major Treatment Methods
The Family and the Inebriate Asylum
Aftercare
Reported Treatment Outcomes
The Treatment of Alcoholism and Other Addictions in Women
6. Four
Institutional Histories
The New York State Inebriate Asylum
The Boston Washingtonian Home
The Chicago Washingtonian Home
The San Francisco Home for the Care of the Inebriate
7. Franchising
Addiction Treatment: The Keeley Institutes
Humble Beginnings to a National
Phenomenon
Keeley: On the Causes of Inebriety
The Keeley Patients
The Keeley Staff
The Keeley Treatment
The Mail Order Business
The Keeley Leagues
Reported Treatment Outcomes
Other Gold Cures
Early Controversies and Critics
Turn of the Century Decline
The Later Keeley Years: 1900-1966
The Keeley Legacy
8. Miracle Cures of Alcoholism
and Other Addictions
The Context
The Products
Promotional Schemes
Exposes and Legislative Reform
Continued Presence of Fraudulent "Cures"
Fraud as a Theme in the Early History of Treatment
9. Religious
Conversions as a Remedy for Alcoholism
Religion and Recovery: Historical Roots
Skid Row, the Bowery and the Birth of the Rescue Mission
Jerry McAuley's Water Street Mission
The Salvation Army
America's Keswick Colony of Mercy
Early Professional Views on Religion and Recovery
Conversion and Recovery: The Ideas of William James
Later Professional Perspectives
Critics of Religious Approaches to Alcoholism Recovery
Section
Three: Evolving Approaches to Alcoholism Treatment: 1860-1940
10. Alcoholism
Treatment Settings: 1900-1940
The Inebriate Farm/Colony
Alcoholism and City Hospitals
Alcoholics in Local Psychopathic Hospitals and State Psychiatric
Hospital
Drying Out the Rich and Famous: A Continuing Story
The Saga of Willie Seabrook William
Seabrook Asylum 1935
The Charles B Towns Hospital for the Treatment of Drug and Alcoholic
Addictions
11. Physical
Methods of Treatment and Containment
Physical Treatments for Alcoholism
Between 1840 and 1950: An Overview
Eugenics: Sterilization and Benign Neglect
Natural Therapeutics
The Water Cures
Drug Therapies: 1860-1930
Convulsive Therapies
Psychosurgery and Addiction: The Lobotomy Era
Miscellaneous Treatments
12. Psychological
Approaches to Alcoholism and Addiction Treatment
The Psychoanalytic Approach
The Emmanuel Clinic and the Lay Therapy Movement
Aversion Therapy: Early Efforts
Section
Four: Treating Addictions to Narcotics and Other Drugs
13. The
Treatment of Addiction to Narcotics and Other Drugs: 1880-1925
The Use of Cocaine as an Addiction Cure
and Freud's Retraction
Cocaine, Morphine and the Father of American Surgery
Opiate Addiction as a Disease
Drug Treatments and Drug Cures Before the Harrison Act
Drug Treatment, The Harrison Act, Drug Enforcement and the Supreme
Court
The Morphine Maintenance Clinics
14. The
Treatment of Addiction to Narcotics and Other Drugs: 1925-1950
Voices of Protest
1920-1950: Medical Detoxification and Hidden Drug Maintenance
Dr. Thomas Ratigan, Jr.: Villain or Hero?
Phantastica and Narcotics Research: 1920-1935
The Federal Narcotic Farms
The Addiction Research Center
The World Outside Lexington and Ft. Worth
Section
Five: A.A. and the Modern Alcoholism Movement
15. The Birth of
Alcoholics Anonymous: A Brief History
Carl Jung and Rowland H.'s Failed
Psychotherapy
The Oxford Group
The Oxford Groups, Ebby T. And Bill W.'s "Hot Flash"
Bill W. Meets Dr. Bob
A.A. Identity and Early AA. Group
Grandiose Visions
The "Big Book"
Early Rituals
The Period of Explosive Growth
A Maturing A.A.
Those Who Shaped the A.A. Treatment Relationship
16. The Program
of Alcoholics Anonymous
Defining the A.A. Program
A.A. Steps and A.A. Practices
A.A. Experience and A.A. Logic
Identity Reconstruction Within A.A.
Reconstruction of Personal Relationships
Reconstruction of Daily Lifestyle Within A.A.
Reframing: The Curse that Became a Blessing
The Recovery Program of A.A. and Its Predecessors: Shared
Characteristics
Innovations in A.A.'s Program of Recovery
A.A.'s Organizational Structure and Practices
A.A.'s Mission
A.A.'s Philosophy of Addiction
A.A.'s Prescription for Short- and Long-term Recovery
Carrying the Message of A.A. Recovery
Internal A.A. Relationships
Defining A.A. Membership
The Expected Duration of A.A. Participation
Power and Decision-making in A.A.
The Voice of A.A.
A.A. Relationships with Allied Fields and Related Causes
Managing Member Growth
Leader Development
Managing the Issues of Money, Property and Personal Ambition
Social Context and Organizational Endurance
17. A.A. Critics
and A.A. Legacy
Stretching A.A.'s Gateway of Entry: Women
and People of Color in A.A.
Were the experiences of women and people of color instrumental in
shaping the Twelve Steps and Twelve Traditions of A.A.?
Has A.A. adapted its program to address the special needs of women
and people of color?
What is the degree of participation of women and people of color in
A.A.
A.A.'s Place in History
18. A.A. and the
Professional Care of Alcoholics: 1935-1960
Visions of A.A. Hospitals
The Knickerbocker Paradox: Actions of A.A. Versus Actions of A.A.
Members
St. Thomas: The Beginning of a Model
Model Evolution: A.A. Involvement with Public and Private Hospitals
Model Extension: A.A. and Private Hospitals, Sanitaria
A.A. Members as Moral and Business Entrepreneurs
The Boundary Between Treatment and A.A.: The Story of High Watch
The Distinction Between A.A. and Treatment
A.A. and Alcoholism Treatment: A Synopsis
19. The
"Modern Alcoholism Movement": The Core
The Context
The Alcohol and Alcoholism Movements
The Volatility of the Post-Repeal Period
Research Council on Problems of Alcohol
The Yale Center of Alcohol Studies
The National Committee for Education on Alcoholism
20. The
"Modern Alcoholism Movement": The Periphery
Changing Medical Opinion on Alcoholics
and Alcoholism
The Alcoholism Movement in the Workplace
Alcoholism Movement Within the Church
Municipal, State and Federal Responses to Alcoholism
R. Brinkley Smithers: Private Philanthropy and the Alcoholism
Movement
The Role of A.A. and Recovered Alcoholics in the Alcoholism Movement
The Role of the Alcohol Beverage Industry in the Alcoholism Movement
The Legacies of the Alcoholism Movement
Origin of the Modern Disease Concept
Section
Six: Mid-Century Addiction Treatment
21. The Birth
and Spread of the "Minnesota Model"
Pre-A.A. History
The Beginning: The Story of Pat C.
Pioneer House
Hazelden: The Early Years
Willmar State Hospital
Hazelden: The Continuing Story
Further Minnesota Developments
Defining the Minnesota Model
Why Minnesota
The Spread of the Minnesota Model
Further Contributions of the Minnesota Model
22. Mid-Century
Alcoholism Treatments
Organizational Activity in the Alcoholism
Field: 1950-1960
Expanding Knowledge and Ideas About Alcoholism
Mid-Century Alcoholism Treatment: An Overview
A.A., Al-Anon, Alateen and Mutual Aid: 1950-1971
Other Mutual Aid Societies: Alcoholics Victorious and the Calix
Society
23. Mid-Century
Alcoholism Treatment: Treatment Methods
Hypnosis Revisited
Physical Methods of Alcoholism Treatment: An Overview
Nutrition, Alcoholism, and Vitamin Therapy
ACTH: Alcoholism and Endocrine Dysfunction
The Use of Tranquilizers, Anti-depressants, Mood Stabilizers, and
Sedatives
Benzedrine in the Treatment of Alcoholism
Antabuse and Other Antidipsotroopics in the Treatment of Alcoholism
LSD and the Treatment of Alcoholism
Miscellaneous and Multi Drug Therapies
The Carbon Dioxide Treatment for Alcohol and Drug Addiction
Advances in Psychosocial Rehabilitation Technology
The Halfway House Movement
24. Mid-Century
Addiction Treatment: The Rise of New Approaches
The Legal Context
Medical and Psychiatric Context
Juvenile Addiction: The Story of Riverside Hospital
Community-based Support of Institutionalized Addict
Religious Approaches to Addiction Recovery
Narcotics Anonymous
Synanon: The Birth of Ex-addict Directed Therapeutic Communities
The Therapeutic Community Movement
The Therapeutic Community: Treatment Methods
25. Mid-Century
Addiction Treatment: Part Two
Civil Commitments
Methadone and Modern Narcotic Maintenance
The Methadone Critics
Methadone, Watergate and Federal Narcotics Control
Narcotics Antagonists
Multimodality Treatment Systems: The Story of the Illinois Drug
Abuse Program
Lexington and Forth Worth: The Twilight Years
Section
Seven: Addiction Treatment in the Late Twentieth Century
26. The Modern
Evolution of Addiction Treatment
Reaching Critical Mass
The Cooperative Commission on the Study of Alcoholism
The Deluge of Addiction Treatment Legislation
Local Sponsorship and Organization
Two Worlds: Alcoholism and Drug Abuse
Early Programs: What it Was Like
Alcoholism: An Insurable Illness
Program Accreditation and Licensure
Three Worlds: Public, Private and Military
The Rebirth of Addiction Medicine
An Evolving Workforce
A Hidden Story: The Exploitation and Relapse of Recovering
Alcoholics and Addicts
Professionalization: Training, Credentialing and Worker
Certification
Explosive Growth
Early Intervention Programs
Recovery as a Cultural Phenomenon
Expansion and Diversification of Mutual Aid Societies
Competition, Profit, and Profiteering
Ethical Context and Breaches of Ethical Conduct
The Financial Backlash
The Ideological and Cultural Backlash
The Crash
A Panicked Field in Search of Its Soul and Its Future
27. Modern Addiction Treatment:
Seminal Ideas and Evolving Treatment Technology
Eleven Seminal/Controversial Ideas
1. The Concept of Inebriety Reborn
2. From a Single to a Multiple Pathway Model of Addiction and
Recovery
3. The Biology of Addiction
4. Toward a Developmental Model of Alcoholism Recovery
5. Addiction asa a Chronic Disease
6. The Continuum of Care Concept
7. Rethinking Motivation: Pain versus Hope
8. Needle Exchanges: A Harm Reduction Case Study
9. Natural Recovery, Spontaneous Remission and Maturing Out
10. The Question of Controlled Drinking and Drug Use
11. Codependency: Popularization and Backlash
Treatment of Special Populations and Treatment in Special Settings
The Public Inebriate
Changing Responses to the Drunk Driver
Gender Specific Treatment
Adolescent Treatment
The Employed Alcoholic/Addict
Treating Impaired Professionals
Treatment in the Military
Culturally Competent Treatment
The Addicted Offender
Treating Addicts with HIV/AIDS
The Multiple Problem Client
Modern Addiction Treatment Technologies
28. Parkside: A
Rich Legacy and a Cautionary Tale
The Birth
Early Influences
The Early Program
Contrasts Between Lutheran General and Hazelden
The Treatment Team
The Role of the Alcoholism Counselor
The A.A. Treatment Center Relationship
Al-Anon and Family Programming
Early Diversification
Evaluation Research
Model Dissemination
Explosive Growth
Later Diversification
The Demise
Lessons and Legacies
A Lasting Legacy
29. Some Closing Reflections on
the Lessons of History
Approaching History
Addiction Recovery
Addiction Science
The Rise of Treatment Institutions and Mutual Aid Societies
Observations on the Treatment Field
Treatment in Relationship to Community and Society
The Fall of Treatment Institutions and Mutual Aid Societies
The Future of Treatment
Final Words
Endnotes
Index
About the Author/CHS
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