alcoholic and Narcotic Addict Rehabilitation Act (1968)

Steven Harmon Wilson

Excerpt from the Alcoholic and Narcotic Addict Rehabilitation Act:

The handling of chronic alcoholics within the system of criminal justice perpetuates and aggravates the broad problem of alcoholism whereas treating it as a health problem per mits early detection and prevention of alcoholism and effective treatment and rehabilitation, relieves police and other law enforcement of an inappropriate burden that impedes their important work, and better serves the interests of the public.... It is the purpose of this part to help prevent and control alcoholism through authorization of Federal aid in the construction and staffing of facilities for the prevention and treatment of alcoholism.

Congress regulates activities, including alcohol or drug use, pursuant to the "police powers" enumerated in the Constitution, which include the power to promote health, safety, welfare, and morals. Moreover, because a major portion of the traffic in both legal and illegal drugs flows through either interstate or foreign commerce, the commerce clause authorizes Congress to regulate drugs. On these bases, Congress has regulated drugs since the early 1900s. For example, possession of narcotics without a prescription was illegal under the 1914 Harrison Act, and alcohol use was illegal under the 1919 Volstead Act. Although Prohibition ended in 1933, Congress nevertheless continues to regulate the use of drugs.

THE MEDICAL VIEW OF ADDICTION

The Alcoholic and Narcotic Addict Rehabilitation Act (P.L. 90-574, 82 Stat. 1006) was an amendment of the Community Mental Health Centers Act of 1963 as well as an indirect complement to the Narcotic Addict Rehabilitation Act of 1966. These statutes reflected the idea that addiction is a form of illness, and therefore addicts could benefit more from medical treatment than from criminal punishment.

The proponents of a medical response to addiction have often competed with the proponents of a punitive, or punishment, model of law enforcement. During the 1920s medical doctors opened clinics to provide morphine and heroin addicts with regulated "maintenance" doses of the drugs that would enable the addicts to function in society and wean themselves from drugs rather than turn to crime. But the federal government argued, and the U.S. Supreme Court held in various cases, that the Harrison Act made it illegal for doctors to prescribe any narcotic to addicts. Several thousand doctors were jailed for dispensing narcotics, and private attempts at such treatment were abandoned. Nevertheless, congressional interest in rehabilitating addicts emerged even as federal penalties for narcotics trafficking increased. Congress created a Narcotics Division (soon renamed the Division of Mental Hygiene) within the U.S. Public Health Service in the Porter Act in 1929. The Porter Act also established two "narcotic farms" for the separate confinement and treatment of addicts serving time in the federal prison system. These were built at Lexington, Kentucky (1935), and Fort Worth, Texas (1938). They continued to operate until the early 1970s.

The view that addiction was an illness, and specifically a mental illness, revived in the 1960s. The federal Community Mental Health Centers Act and its amendments provided grants for assistance in constructing and staffing facilities that emphasized preventive, community-based, outpatient care for persons with mental illness as an alternative to institutionalization in state mental hospitals. The movement to improve treatment for the mentally ill soon converged with efforts to treat drug addiction as a public health problem. In 1965, with the Drug Abuse Control Amendments, Congress established a Bureau of Drug Abuse Control within the Department of Health, Education, and Welfare (HEW, later Health and Human Services).

Some states began to experiment with programs to divert addicts charged with crimes into a civil process of treatment and rehabilitation. U.S. Senators Jacob Javits and Robert Kennedy of New York sought similar federal legislation, and on November 8, 1966, Congress passed the Narcotic Addict Rehabilitation Act (NARA). NARA provided that judges could offer addicted defendants in federal court civil commitment for an unspecified period up to several years, plus a probationary period, as an alternative to criminal prosecution. If the offender returned to drugs during the period of treatment and probation, the government could reinstate criminal prosecution. Like the Community Mental Health Centers Act, NARA authorized grants for the development of narcotic addict rehabilitation and treatment programs.

SUBSEQUENT LEGISLATION

Although NARA did not address alcohol abuse, federal lawmakers regarded this as another major public health problem. On October 15, 1968, in the Alcoholic and Narcotic Addict Rehabilitation Amendments to the 1963 Community Mental Health Centers Act, Congress specifically provided federal support to establish facilities for the prevention of alcoholism and the treatment and rehabilitation of alcoholics. Two years later, Congress amended the statute again, to give priority to those seeking grants for programs operating in areas suffering from high rates of poverty. At that time, Title I of the Comprehensive Drug Abuse Prevention and Control Act dealt with education, treatment, and rehabilitation, and opened federally funded community treatment centers to non-narcotic drug abusers as well as narcotic addicts (Title II of the Comprehensive Act was the Controlled Substances Act). Finally, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act established the National Institute of Alcohol Abuse and Alcoholism within the National Institute of Mental Health.

See also: Anti-Drug Abuse Act; Drug Abuse Prevention, Treatment, and Rehabilitation Act; Narcotic Addict Rehabilitation Act.

BIBLIOGRAPHY

Inciardi, James A. The War on Drugs II: The Continuing Epic of Heroin, Cocaine, Crack, Crime, AIDS, and Public Policy. Mountainview, CA: Mayfield Publishing, 1992.

Jonnes, Jill. Hep-Cats, Narcs, and Pipe Dreams: A History of America's Romance with Illegal Drugs. New York: Scribner, 1996.

Marion, Nancy E. A History of Federal Crime Control Initiatives, 1960–1993. Westport, CT: Praeger, 1994.

Musto, David F. The American Disease: Origins of Narcotic Control, 3rd ed. New York: Oxford University Press, 1999.

Rachal, Patricia. Federal Narcotics Enforcement: Reorganization and Reform. Boston, MA: Auburn House, 1982.

Sharp, Elaine B. The Dilemma of Drug Policy in the United States. New York: Harper-Collins, 1994.

Walker, William O. Drug Control in the Americas. Albuquerque: University of New Mexico Press, 1981.

The Twelve-Step Program

The Twelve Steps of Alcoholics Anonymous (AA) is a program of recovery suggested by AA based on the group's sixty years of experience in helping alcoholics overcome their addictions. Based in spirituality, the program directs alcoholics to admit that they have become "powerless over alcohol," turn their lives over to a power greater than themselves, make "a searching and fearless inventory" of themselves, compile a list of everyone they have harmed, and try to "make amends to them all." The Twelve-Step Program has helped tens of thousands of recovering alcoholics and has been adapted for use with other addictions, including narcotics. Proponents of the program maintain that it is the best method of treating addiction, particularly when combined with counseling or therapy.