The Roots of Disease Theory in Addiction

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The earliest historical roots of the disease theory of addiction are known to begin with early writers and their thoughts on habitual alcohol consumption. Habitual alcohol consumption and habitual drunkenness are the names used by the earliest writers who discussed any kind of drug addiction or substance use disorder in print. John Coakley Lettsom, born in 1744, was an English physician and philanthropist who was an important early thinker in the abolition of slavery movement, but he is also generally considered to be one of the first medical writers to discuss something akin to a disease theory of habitual drunkenness, or alcoholism. Today we will discuss some even earlier examples of disease theory in early historical medical writing. If you or a loved one needs help with alcoholism or drug addiction, call us today to speak to an intake expert at the best drug and alcohol rehab in Florida, Florida Springs in Panama City.

The Gin Craze

One very important period in the formation of the disease theory of addiction, and a theory that alcoholism was its own disease, was the “Gin Craze” of the 18th century in Europe. The Gin Craze was a period in the first half of the 18th century when the consumption of gin increased rapidly in Great Britain, especially in London. Daniel Defoe, one of my favorite writers and the author of “Robinson Crusoe”, had this to say about the beginning of the Gin Craze,

“The Distillers have found out a way to hit the palate of the Poor, by their new fashion’d compound Waters called Geneva, so that the common People seem not to value the French-brandy as usual, and even not to desire it.”

Alcohol Consumption levels skyrocketed during this period, rising to the highest levels in the history of Western Civilization, as far as historians can tell. There were both social and economic reasons for the Gin Craze. According to “The History of Alcohol”, from The University of North Carolina Chapel Hill Press,

“The production and consumption of English gin, which was then popular amongst politicians and even Queen Anne, was encouraged by the government. This encouragement was shown in the reduced taxes on the distillation of spirits. Additionally, no licenses were needed to make spirits, so distillers of spirits could have smaller, simpler workshops than brewers, who were required to serve food and provide shelter for patrons.”

The government likely saw the immediate economic benefits of this new alcohol boom but did not foresee the greater downsides of increased alcoholism, which we understand much better today. Daniel Defoe mentioned that the Gin Craze seemed to hit the poor and working classes like never before, and the literature does suggest that alcohol consumption was mainly limited to the upper classes in London before the Gin Craze.

Benjamin Rush

Benjamin Rush was a founding father of the United States of America, and another important anti-slavery speaker and writer, like John Coakley Lettsom. Rush was also a physician and is a candidate as the first American or Western writer to discuss the idea of alcoholism. According to “The Drinking Man’s Disease” by Roy Porter, conventional wisdom about habitual drunkenness and the disease concept of Alcoholism and Drug Addiction essentially stems from the late writings of Benjamin Rush. This was shortly after the founding of the United States, and before his death in 1814. In addition to his discussion of Alcoholism and other mental health challenges in his writing, Benjamin Rush is the preeminent thinker in the history of early American Occupational Therapy for the treatment of mental health disorder, including habitual drunkenness, based on this passage and others,

“It has been remarked that the maniacs of the male sex in all hospitals, who assist in cutting wood, making fires, and digging in a garden, and the females who are employed in washing, ironing, and scrubbing floors, often recover, while persons, whose rank exempts them from performing such services, languish away their lives within the walls of the hospital.”

We now know that feeling useful is a key part of recovering from many ailments, but Rush was ahead of his time on this and many other subjects, including discussing Alcoholism as a disease and not a moral failing, a thought that was incredibly prevalent in the Puritan early United States. We can thank him for several concepts that we take for granted today, although we have discussed on this blog many times how much Puritan thinking still exists on the topic of substance use disorder. Many people still make the “moral failing” argument in the face of all medical science. We will hopefully discuss more of this fascinating history in a future article. If you need expert help with a substance use disorder, call us today to speak to an intake specialist at Florida Springs, one of the best drug and alcohol rehabs in Panama City Florida.

By T.A. Cannon (Contact me at



Rush, Benjamin (1773). “An Address to the Inhabitants of the British Settlements in America, Upon Slave-keeping”. Philadelphia: J. Dunlap. Retrieved January 1, 2017.