Alcohol monopolies in the U.S.: challenges and opportunities.
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Biomedical subjects
Publications and source records attributed to R Room.
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This chapter recounts what is known about the international development of treatment institutions for inebriates in the century before 1940. It begins with the origins of treatment in the self-help temperance movement of the 1830s and 1840s and the founding of the first inebriate homes, tracing in the United States the transformation of these small, private, spiritually inclined programs into the medically dominated, quasipublic inebriate asylums of the late 19th century. A similar institutional development occurred in other English-speaking countries. Both in the United States and Britain, these institutions almost disappeared by the end of the First World War. In Germany and Switzerland, a three-tier system of community advice bureaus, inpatient sanatoria, and work camps developed at the turn of the century; an analogous system, with temperance boards at the community level, developed in Nordic countries between 1912 and 1940. The societal emphasis on the problem of impoverished inebriates often turned inebriate treatment efforts in the direction of coercive and custodial handling.
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Over one-half of famous American authors with reputations for drunkenness were born between 1888 and 1900. Although college students of their generation seem to have been "drier" than earlier or later cohorts, many of the writers were already drinking heavily in college. Several reasons are suggested. After World War I, many fledgling authors spent time in Paris, becoming known as the "lost generation" and adding French and other drinking styles to their existing drinking patterns. Bohemian Americans during Prohibition found a resonance with the residual political symbolism of drinking in France as a statement of autonomy against the state. The community of expatriate writers provided a supportive environment for heavy drinking. In turn, the lost generation became a transmitter of new values concerning drinking to American culture in general. Their writings inadvertently promoted mass middle-class tourism to Paris in the late 1920s. Their lives and works strengthened the association between writing and drinking as a model for later literary generations. Both in written form and as films, their works conveyed an attractive image of drinking and often of drunkenness to the wider public. The decisive shift in drinking patterns among middle-class youth in the late 1920s ushered in a lasting change in the cultural position of drinking, as it became a cosmopolitan, progressive and eventually respectable behavior. At a minimum, the writers of the lost generation served as harbingers, carriers and catalysts of this change.
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Quantitative information on alcohol consumption patterns derives from four possible sources: indirect measures, observational studies, aggregate consumption statistics, and sample surveys of general populations. The potentials and problems of each method are briefly discussed, with primary attention to the various traditions of survey questioning and data analysis. While medically oriented epidemiologists have often used only an overall drinking volume measure, social scientists have pointed to the importance also of variability in characterizing drinking, particularly in relation to social and casualty as opposed to chronic health problems with drinking. The dimensions of drinking patterns which might be relevant to hypothesized linkages of alcohol and cancer are discussed. It is suggested that measurement will need to extend beyond volume of drinking and may indeed involve studies of new kinds of dimensions in the patterning of drinking.
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