Running Head: COMBATTING AMERICAS DRUG PROBLEM

FONS 1

America at War:
Combatting Our Nations Drug Problem
Many individuals do not understand why some become addicted to drugs or alcohol.
They mistakenly view substance abuse strictly as a social problem and may be quick to
characterize addicts as morally weak, arguing that they should be able to stop taking drugs if
only they were willing to change their behavior. This proves they lack an adequate understanding
of complexity of addition; that it is a disease that impacts the brain, and because of that, stopping
drug use cannot be explained simply as a matter of willpower.
For this reason, it appears appropriate to view the concept of drug abuse as a socially
constructed phenomenon. However, as unanticipated problems involving the use of substances
arose, including tolerance, abuse and dependence- the social phenomenon of substance use
evolved into a social and public health issue. In result, both realistic and nonrealistic concerns
regarding health and social consequences of substance use established parameters for the
medicalization, criminalization and resulting regulation of substances and their users. While
attempts to understand and improve the treatment for substance abuse have largely focused on
structural barriers, research has shown that the negative beliefs and resulting stigmatization
attached to addiction have been equally destructive in the treatment process.
Addiction as a Moral Failure
The earliest signs of substance use were documented centuries ago. Society consumed
alcohol on the daily, and even though the idea of being drunk was stigmatized, there was no
recognition of alcoholism as we know it today. Problems resulting from drunkenness were
viewed as a moral or criminal matter rather than a medial or public health problem. Often,
addicts were given prison sentences or shut away in inebriate asylums because it was assumed
they permanently lacked the moral or mental capacity to be productive members of society

COMBATTING AMERICAS DRUG PROBLEM

FONS 2

(Popple & Leighninger, 2011). For most of the 18 th and 19th centuries, there was still a
widespread assumption that people got drunk because they wanted to, not because they had to.
From the start, the approach to treating this mental disorder was largely influenced by
the idea that there are hidden motivations to human behavior and certain personality aspects
affect why people become addicted. It was thought that drugs and alcohol did not permanently
disable the will, they were not addicting, and consequently, habitual abuse of substances was not
regarded as a disease. However, as time went on, many Americans began reporting for the first
time that they were addicted to alcohol; stating, they had an overwhelming, overpowering and
irresistible desire for alcohol (Levine, 1978). Adding to the rise of alcohol and drug related
problems during this time we first see the discovery of addiction.
First Attempts to Eradicate Alcoholism
Temperance organizations began developing theories about addiction and brought the
negative experiences of these addicts to the publics attention. At which point, they pointed out
that abstinence held the key to sobriety. They were not particularly concerned with diagnosing
the condition or prescribing cures but more concerned with awakening the public to the broad
spectrum of pernicious results which resulted from the habitual consumption of alcoholparticularly disease, poverty, crime and an overall state of insanity. We began seeing the
development of sober homes where drunkards could get special treatment. Temperance
advocates argued that asylums, or sober homes, were necessary because of the very nature of the
disease of inebriety (Levine, 1978). These individuals functioned in much of the same manner
that modern A.A does today. They provided addicts who joined their organization with
encouragement, friendship and a social life free from alcohol. The movement continued growing
for in the early years of the 19th century, but there proved to be considerable resistance. However,

COMBATTING AMERICAS DRUG PROBLEM

FONS 3

by the mid 1830s, over half a million people had pledged themselves not to drink any liquor
(Scheel, 2001).
Federal Government Intervenes: Prohibition
New advocates followed the temperance approach and focused on the general problems
related to alcohol consumption and the rise of recreational usage. It was suggested that the use of
these substances was leading to social and health problems of pandemic proportions. The evil
effects of alcohol, including its role in accidents, and effects on worker efficiency and crime
were driving the need for intervention. Their solution revolved around implementing nationwide
prohibition of alcohol consumption. However, this victory was short lived; only 20 years later
the legislation was repealed, largely because many people believed that its enforcement had
created more problems than it resolved (Scheel, 2003). The collapse of prohibition left society
with feelings of ambivalence. What constituted acceptable drinking patterns? Unfortunately,
neither a coherent nor acceptable answer to this question was well understood at the time. The
negative effects of substance abuse were virtually ignored while attention was focused on
societal issues of the time, including the Great Depression and economic hardship (Popple &
Leighninger, 2011).
Post Prohibition: Creating the Modern Disease Concept
In the wake of prohibitions failure, we saw the birth of addiction as a disease.
Advocates argued that inebriety, and habitual drunkenness was to be seen as a disease and a
fairly natural consequence to the moderate to heavy use of alcoholic beverages. They stressed
that habitual drunkenness resulted from an individuals compulsive activity and loss of control
for their drinking. More and more physicians were beginning to view addiction as a disease,
based in large on a growing awareness of what these substances could do to the human body.
They began arguing that humane medical treatment, rather than punishment, was necessary.

COMBATTING AMERICAS DRUG PROBLEM

FONS 4

Founding of Alcoholics Anonymous

The disease model was largely impacted by the foundation of Alcoholics Anonymous, a
self-help organization. Advocates of A.A displayed sympathetic and supporting attitudes, similar
to those in the temperance movement. This eventually led to an understanding that alcohol was
as a socially acceptable drug that was only addicting to some people, even though the cause was
unknown. Besides its belief in the necessity of abstinence, the common theme shown in both A.A
and the temperance movement stressed the importance of interpreting the inner experiences of
the addict himself. Two early recovery centers, run by A.A members, created a treatment model
that combined counseling and education with the Twelve Steps of A.A. They implemented the
use of professional staff in recovery, patient and family education, the Twelve Steps, and a belief
in the notion of addiction as a disease. The theory that addiction treatment should incorporate
detox and isolation from day to day stresses by living in a treatment community, proved its
effectiveness over time.
Strategies for Effective Substance Abuse Counseling
Substance Abuse is A Societal Problem
Research on the effectiveness of specific interventions for individualized addiction
treatment may not always present an adequate picture of the complexity substance abuse has
entailed as a longstanding societal issue. Treating addiction is different than treating other
chronic illnesses, because of the impact it has on the family and society. Therefore, addiction
treatment providers need to extend their responsibilities and focus on broader social goals.
Strategies should do more than simply produce abstinence: they should also address the costly
and damaging addiction-related problems placed upon societies public health and safety
(UNDCP, 2003).

COMBATTING AMERICAS DRUG PROBLEM

FONS 5

To accomplish this, professionals should work with employers and social welfare
agencies to help the client find work, criminal justice agencies to keep clients from engaging in
criminal behaviors and with family agencies towards the goal of returning to family roles,
especially parenting (UNDCP, 2003). Effective treatment of substance abuse requires
professionals to organize the structure and delivery of interventions in a way that improves the
public health and social problems of their individual clients.
Individualized Treatment
It is known that the consequences of alcohol and other drug addictions include and are
not limited to losses of income, jobs, educational opportunities, health, family relationships and
self-esteem because of dysfunctional social behavior related to substance abuse. As we know,
there is no quick-fix for addictive disorders. However, different people respond to various
approaches in diverse ways, making individualized treatment matching essential to successful
treatment. When relapses occur, we see a compilation of biopsychosocial influences to be the
cause, making a comprehensive assessment of the clients particular strengths, problems and
needs of utmost importance. The type and duration of drug use, treatment history and individual
client characteristics should be taken into consideration in which they can be placed in the
appropriate program. Examples include but are not limited to traditional outpatient programs,
inpatient programs, pharmacological interventions, group therapy, or Alcoholics Anonymous.
Keeping in mind the goals of successful treatment, including abstinence, improvement of health,
employment and educational circumstances and a reduction in criminal activity, the necessary
and most efficient way to arrive at these goal is likely to vary depending on the individual.
Addressing Addiction in the Criminal Justice System
What happens to substance use, personal and public health and social function of
addicted individuals if they are denied treatment? While it seems unethical to deny treatment to

COMBATTING AMERICAS DRUG PROBLEM

FONS 6

those whose condition requires it, a denial of treatment is still occurring, especially in the legal
system. The legal system has a long history of stepping in as an alternative to traditional
substance abuse treatment. Assigning alternatives such as jail, probation, parole and more
recently boot camp, have been the major choices. While the public may feel protected from the
effects of drug-related crime while addicts are incarcerated, almost all will eventually be released
(UNDCP, 2003).
There is little indication that incarcerating individuals has been effective in teaching
them a lesson, due to the fact that so many addicts continuing use upon their discharge.
Involvement by the legal system will only prove effective in combatting our countries problem
with substance abuse when in conjunction with traditional treatment interventions. This may be
accomplished by referring drug offenders to specialized drug courts mandating treatment as an
alternative to incarceration. In an attempt to reduce an individuals risk for relapse in the legal
system, criminal justice personnel need to coordinate their efforts with treatment professionals
and work together on treatment planning through the implementation of screening, testing,
monitoring and supervising their clients.
Conclusion
When compared to other helping professions the field of addiction counseling is a
relatively new field, whereas professions such as medicine, psychology and sociology have been
around for much longer. However, the substance abuse field with regard to both counselors and
treatment can trace its existence back over two centuries. Thats not to say that concerns and
problems related to people using and consuming substances was not an issue long before that. As
time progressed, society began experiencing problems and difficulties related to the consumption
of such chemicals. Throughout the years both the professional and the publics perception of the
dangers of substance abuse changed. The disease concept was introduced a shift from moral

COMBATTING AMERICAS DRUG PROBLEM

FONS 7

indecency as the cause of addiction was replaced with the notion that addiction was a disease of
the brain which should be treated as such. Treatment efforts which focused on family education,
usage of the Twelve Steps and abstinence then appeared. Unfortunately, even today, society still
has difficulty understanding the seriousness of addiction and the need for comprehensive
treatment, therefore, we must continue educating and informing the public on the importance of
making treatment both accessible and affordable to those who need it.

References
Levine, G. Harry. (1978). The Discovery of Addiction: Changing Conceptions of Habitual
Drunkenness in America. Journal of Studies on Alcohol. 15: pp. 493-506.

COMBATTING AMERICAS DRUG PROBLEM

FONS 8

Popple, P.R. & Leighninger, L. (2011). Social Work, Social Welfare, and American Society (8th
ed.). Boston, MA.: Allyn & Bacon
Scheel, R. Kevin. (2003). Theory and Practice of Addiction Counseling. The Distance Learning
Center for Addiction Studies (DLCAS). United States of America: DLC, LLC
UNDCP. (2003). Investing in Drug Abuse Treatment: A Discussion Paper for Policty Makers.
New York: UNDCP