For what it's worth here is an attempt to relate history with current alcohol and drug policy. > Historical Overview of Prevention > > Alcoholic beverages have been a part of the Nation's past since the > landing of the Pilgrims. According to Alcohol and Public Policy: > Beyond the Shadow of Prohibition, a publication commissioned by NIAAA > and prepared by the National Academy of Sciences, the colonists > brought with them from Europe a high regard for alcoholic beverages, > which were considered an important part of their diet. Drinking was > pervasive because alcohol was regarded primarily as a healthy > substance with preventive and curative powers, not as an intoxicant. > Alcohol was also believed to be conducive to social as well as > personal health. It played an essential role in rituals of > conviviality and collective activity, such as barn raisings. While > drunkenness was condemned and punished, it was viewed only as an abuse > of a God-given gift. > > The first temperance movement began in the early 1800s in response to > dramatic increases in production and consumption of alcoholic > beverages, which also coincided with rapid demographic changes. > Agitation against ardent spirits and the public disorder they spawned > gradually increased during the 1820s. In addition, inspired by the > writings of Benjamin Rush, the concept that alcohol was addicting, and > that this addiction was capable of corrupting the mind and the body, > took hold. The American Society of Temperance, created in 1826 by > clergymen, spread the anti-drinking gospel. By 1835, out of a total > population of 13 million citizens, 1.5 million had taken the pledge to > refrain from distilled spirits. The first wave of the temperance > movement (1825 to 1855) resulted in dramatic reductions in the > consumption of distilled spirits, although beer drinking increased > sharply after 1850. > > The second wave of the temperance movement occurred in the late 1800s > with the emergence of the Women's Christian Temperance Movement, > which, unlike the first wave, embraced the concept of prohibition. It > was marked both by the recruitment of women into the movement and the > mobilization of crusades to close down saloons. The movement set out > to remove the destructive substance, and the industries that promoted > its use, from the country. The movement held that while some drinkers > may escape problems of alcohol use, even moderate drinkers flirted > with danger. > > The culmination of this second wave was the passage of the 18th > Amendment and the Volstead Act, which took effect in 1920. While > Prohibition was successful in reducing per capita consumption and some > problems related to drinking, its social turmoil resulted in its > repeal in 1933. > > Since the repeal of Prohibition, the dominant view of alcohol problems > has been that alcoholism is the principal problem. With its focus on > treatment, the rise of the alcoholism movement depoliticized alcohol > problems as the object of attention, as the alcoholic was considered a > deviant from the predominant styles of life of either abstinence or > "normal" drinking. The alcoholism movement is based on the belief that > chronic or addictive drinking is limited to a few, highly susceptible > individuals suffering from the disease of alcoholism. The disease > concept of alcoholism focuses on individual vulnerability, be it > genetic, biochemical, psychological, or social/cultural in nature. > Under this view if the collective problems of each alcoholic are > solved, it follows that society's alcohol problem will be solved. > > Nevertheless, the pre-Prohibition view of alcohol as a special > commodity has persisted in American society and is an accepted legacy > of alcohol control policies. Following Repeal, all States restricted > the sale of alcoholic beverages in one way or another in order to > prevent or reduce certain alcohol problems. In general, however, > alcohol control policies disappeared from the public agenda as both > the alcoholism movement and the alcoholic beverage industry embraced > the view, "the fault is in the man and not in the bottle." > > This view of alcoholism problems has also been the dominant force in > contemporary alcohol problem prevention. Until recently the principal > prevention strategies focused on education and early treatment. Within > this view education is intended to inform society about the disease > and to teach people about the early warning signs so that they can > initiate treatment as soon as possible. Efforts focus on "high risk" > populations and attempt to correct a suspect process or flaw in the > individual, such as low self esteem or lack of social skills. The > belief is that the success of education and treatment efforts in > solving each alcoholic's problem will solve society's alcohol problem > as well. > > Contemporary alcohol problem prevention began in the 1970s as new > information on the nature, magnitude, and incidence of alcohol > problems raised public awareness that alcohol can be problematic when > used by any drinker, depending upon the situation. There was a renewed > emphasis on the diverse consequences of alcohol use--particularly > trauma associated with drinking driving, fires, and violence, as well > as long term health consequences. > > The history of nonmedical drug use, and the development of policies in > response to drug use, also extends back to the early settlement of the > country. Like alcohol, the classification of certain drugs as legal, > or illegal, has changed over time. These changes sometimes had racial > and class overtones. According to Mosher and Yanagisako, for example, > Prohibition was in part a response to the drinking practices of > European immigrants, who became the new lower class. Cocaine and opium > were legal during the 19th century, and were favored drugs among the > middle and upper classes. Cocaine became illegal after it became > associated with African Americans following Reconstruction. Opium was > first restricted in California in 1875 when it became associated with > Chinese immigrant workers. Marijuana was legal until the 1930s when it > became associated with Mexicans. LSD, legal in the 1950s, became > illegal in 1967 when it became associated with the counterculture. > > By the end of the 19th century concern had grown over the > indiscriminate use of these drugs, especially the addicting patent > medicines. Cocaine, opium, and morphine were common ingredients in > various potions sold over the counter. Until 1903, cocaine was an > ingredient of Coca-Cola(R). Heroin, which was isolated in 1868, was > hailed as a nonaddicting treatment for morphine addiction and > alcoholism. States began to enact control and prescription laws and, > in 1906, Congress passed the Pure Food and Drug Act. It was designed > to control opiate addiction by requiring labels on the amount of drugs > contained in products, including opium, morphine, and heroin. It also > required accurate labeling of products containing alcohol, marijuana, > and cocaine. > > The Harrison Act (1914) imposed a system of taxes on opium and coca > products with registration and record-keeping requirements in an > effort to control their sale or distribution. However, it did not > prohibit the legal supply of certain drugs, especially opiates. > > Current drug laws are rooted in the 1970 Controlled Substances Act. > Under this measure drugs are classified according to their medical > use, their potential for abuse, and their likelihood of producing > dependence. The Act contains provisions for adding drugs to the > schedule, and rescheduling drugs. It also establishes maximum > penalties for the criminal manufacture or distribution of scheduled > drugs. > > Increases in per capita alcohol consumption as well as increased use > of illegal drugs during the 1960s raised public concern regarding > alcohol and other drug problems. Prevention issues gained prominence > on the national level with the creation of the National Institute on > Alcohol Abuse and Alcoholism (NIAAA) in 1971 and the National > Institute on Drug Abuse (NIDA) in 1974. In addition to mandates for > research and the management of national programs for treatment, both > Institutes included prevention components. > > To further prevention initiatives at the Federal level, the Anti-Drug > Abuse Act of 1986 created the U.S. Office for Substance Abuse > Prevention (OSAP), which consolidated alcohol and other drug > prevention activities under the Alcohol, Drug Abuse, and Mental Health > Administration (ADAMHA). The ADAMHA block grant mandate called for > States to set aside 21 percent of the alcohol and drug funds for > prevention. In a 1992 reorganization, OSAP was changed to the Center > for Substance Abuse Prevention (CSAP), part of the new SAMHSA, > retaining its major program areas, while the research institutes of > NIAAA and NIDA transferred to NIH. > > The Office of National Drug Control Policy (ONDCP) was established by > the Anti-Drug Abuse Act of 1988. Its primary objective was to develop > a drug control policy that included roles for the public and private > sector to "restore order and security to American neighborhoods, to > dismantle drug trafficking organizations, to help people break the > habit of drug use, and to prevent those who have never used illegal > drugs from starting." In early 1992 underage alcohol use was included > among the drugs to be addressed by ONDCP. > > While Federal, State, and local governments play a substantial role in > promoting prevention agendas, much of the activity takes place at > grass roots community levels. In addition to funding from CSAP's > "Community Partnerships" grant program, groups receive support from > private sources, such as The Robert Wood Johnson "Fighting Back" > program. > > While alcohol and other drug problems continue to plague the Nation at > intolerably high levels, progress is being made. National surveys > document a decline in illicit drug use and a leveling off of alcohol > consumption. And indicators of problem levels, such as > alcohol-involved traffic crashes, show significant declines. > > [-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- ] > > References > > A Promising Future: Alcohol and Other Drug Problem Prevention Services > Improvement. CSAP Prevention Monograph 10 (1992) BK191 > > National Household Survey on Drug Abuse: Main Findings 1990 (1991) > BKD67 > > Mosher, J.F. and Yanagisako, K.L. "Public Health, Not Social Warfare: > A Public Health Approach to Illegal Drug Policy," Journal of Public > Health Policy 12(3):278-322, 1991 > > [-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-] > > [Image] Return to the Index > > [Image] Healthy People 2000 > > [Image] Impaired Driving >