From Inebriate Asylums to Narcotic Farms

Book excerpt: The inebriate asylum movement of the 19th and early 20th century was guided by a dystopian vision which sought to incarcerate all drinkers until they were cured, and to incarcerate incurable inebriates for life. This plan to create a nationwide chain of state-run inebriate asylums to rival the insane asylums of the era, which was promoted by the American Association for the Cure of Inebriates, ended in abject failure. Few inebriate asylums were ever established, and those that were established did not last long. Many were shot through with political corruption and graft. Moreover, no state government was willing to pass a law to incarcerate drinkers indefinitely, perhaps for life. Most states never built an inebriate asylum or passed a law to commit inebriates to specialized inebriate institutions, for the few states which did pass such laws, the typical commitment was six months or one year. A rival movement of the same era sought to establish inebriate homes rather than asylums. Inebriate homes were run on the honor system and sought to cure with kindness and a client-centered approach which foreshadows Rogerian Therapy. Inebriate homes had more success than inebriate asylums; the Boston Washingtonian Home was in existence for more than a century. This book tells the story of the government-run and the non-profit addiction treatment facilities which were founded prior to the Repeal of Prohibition in 1933: inebriate asylums, homes, and farms, as well as the municipal narcotic clinics which dispensed morphine to addicts, the Federal Narcotic Farms at Lexington and Fort Worth, and the alcoholic ward at Bellevue Hospital in New York City. This book also discusses the close ties between the temperance movement and addiction treatment in the 19th and early 20th centuries and the automaton theory of inebriety, which presages today's hijacked brain theory. This book also discusses the genesis of the 12-step Minnesota Model at the State Inebriate Farm at Willmar, the introduction and disastrous ending of Synanon-based therapeutic communities at the Lexington Narcotic Farm, and the introduction of methadone programs at Bellevue and at the Boston Washingtonian Hospital. Groundbreaking studies of opiates, marijuana, barbiturates, alcohol, naloxone, and LSD conducted at the Lexington Narcotic Farm are also covered, as is the research at Bellevue Hospital on Korsakoff's Syndrome and the protective effect of vitamin B1.