It was an idea whose time had come. Not long after Marty Mann became the first woman to stay sober in Alcoholics Anonymous (AA), she resolved to let America know that alcoholism is a disease and that the alcoholic is a sick person. She knew it would be an enormous undertaking that would need the support of an established academic institution so she turned to her friends at Yale University where E.M. Jellinek--father of the modern disease concept--and some of the most progressive minds in the country had been working to transform alcoholism from a moral problem into a public health issue. They recognized that Marty could popularize their cause.
But Marty recognized from the very beginning that she could not change America's attitudes about alcoholism all by herself. Her earliest goals included establishing community organizations which would operate "information; centers" as well as procure beds in hospitals for alcoholics, whose disease was then more likely to land them in jail. She even envisioned that these organizations would eventually establish their own "rest; centers" for the long-term treatment of individuals who could not recover any other way from their disease.
A decade later NCADD was strong enough to stand on its own, thanks to the recruitment of a volunteer board of directors. It amicably had severed formal ties to Yale to avoid being too closely identified with a single school of thought about alcoholism. It also had changed its name to the National Committee on Alcoholism and acquired "NCA;," the acronym that would identify it for the next forty years.
Marty and the board had good reason to celebrate NCADD's
tenth anniversary. More than 50 communities in 27 states
had established Affiliates to continue NCADD's work at the
local level. State governments had begun developing
alcoholism programs with tax dollars instead of relying on
punitive sanctions to deal with the problem. The disease
concept was beginning to take root among the medical
community. And most importantly, alcoholics had better
access to care than ever before. When Marty founded NCADD,
fewer than 100 general hospitals accepted acute cases of
alcoholism. By 1953, 3,000 hospitals offered such care.
NCADD was clearly on a roll. It also was broke.
Like most young organizations, NCADD struggled with finding enough money to accomplish the work it set out to do. Despite a 1957 Roper poll showing that 58% of the nation viewed alcoholism as a disease (compared to just six per cent in 1943), stigma still made fund raising a difficult proposition. Although Affiliates originally were expected to give ten per cent of the money they raised locally to support NCADD, this proved to be an unreliable base of financial support.
But NCADD's prospects improved greatly with the election of R. Brinkley Smithers to the board of directors in 1954. Brink, as he was known, had just begun his recovery from alcoholism when he met NCADD's Yvelin Gardner, who was the first person ever to tell him that he suffered from a disease. That was news to Brink, who then dedicated the rest of his life to making this as widely known as possible. The alcoholism movement--and NCADD in particular--had found its greatest patron.
Though Marty's charisma, writing and PR skills already had given NCADD a high public profile--in the days before television the huge movie audience learned about it in a March of Time newsreel--Brink's financial resources allowed NCADD to thrive throughout the 50s and early 60s. This period also marked NCADD's full-time entry into the medical and research field with the appointment of Ruth Fox, MD to the staff in 1959. Through her evaluations of new treatment methods and professional education programs, NCADD legitimized its role as a public health organization. "AMERICA;'S AGENCY FOR ALCOHOLISM"
Recognition from the federal government quickly followed. During NCADD's 15th anniversary dinner at the Waldorf Astoria Hotel in New York City, the Secretary of Health, Education and Welfare called NCADD "America;'s agency for alcoholism." This official embrace soon translated into federal funding for research projects, including a groundbreaking statistical analysis of the socio-cultural, economic and psychological characteristics of alcoholics.
Dwight D. Eisenhower was the first of three presidents to hail Alcoholism Information Week, a new project launched by NCADD. It offered an opportunity to capitalize on television exposure which by 1960 had long replaced the movies and radio as America's favorite entertainment medium. Pat Boone, Art Carney, Jonathan Winters and Shirley Jones were among the early celebrities to join Marty Mann in recording TV spots to promote the campaign. NCADD also assisted the producers of the Armstrong Circle Theater and the Alfred Hitchcock show in developing early dramatic programs that sympathetically explored the subject of alcoholism. These productions reached vast new audiences in their living rooms and gave NCADD an incredibly influential audience for its message.
As NCADD's second decade drew to a close, things had changed so much that the Washington, DC Affiliate and the local American Civil Liberties Union were confident enough to challenge in court the constitutionality of laws that treated alcoholics who were apprehended for public drunkenness as criminals.
NCADD had come of age.
While social change swept through America, NCADD also went through a period of transition that would have a profound affect on the organization. The offices moved downtown from their original location in upper Manhattan. Affiliates, who started their own professional association, were given a stronger voice with the creation of the delegate assembly where policies were debated and national board members were elected. Marty Mann stepped down as executive director in 1967 to become founder consultant and concentrate on her world-wide speaking engagements.
Both an advertising and a public relations agency were brought in to professionalize the communications efforts of NCADD. This resulted in NCADD's first coordinated use of the print, radio and television media with the creation of a PSA campaign called "The; Silent Treatment Is the Worst Treatment for the Disease of Alcoholism." Oscar-winning actress Mercedes McCambridge bravely assumed the highly visible role of NCADD's first honorary chair and publicized NCADD's message in an extraordinarily personal way.
The federal government also was taking alcoholism more seriously than it ever had before. By 1965 Congress began holding hearings about the need to establish a federal agency to deal exclusively with the problems caused by alcoholism. A year later, around the time that President Johnson appointed Marty Mann to the first national advisory commission on alcoholism, the Washington, DC Affiliate won a precedent-setting legal victory when two federal courts recognized alcoholism as a disease.
Congress passed the Hughes Act in 1970, a year after NCADD's 25th anniversary. The legislation established the National Institute on Alcohol Abuse and Alcoholism (NIAAA). United Press International called passage of the Hughes Act a "signal; victory" for groups such as NCADD. It also provided the impetus for the NCADD board to form its first public policy committee and to open an office in Washington, DC.
Now NCADD had a permanent voice in the nation's capitol.
When NCADD turned 30, public interest in alcoholism was at an all-time high. Government, industry, labor and medicine all had acknowledged its terrible toll on American society and the combination of these forces provided NCADD with what appeared to be unlimited opportunities for major expansion.
With its charge to develop and conduct comprehensive health, education, training, research and planning programs in the areas of prevention and treatment of alcoholism, NIAAA, the "new; kid on the block," logically began contracting with NCADD for assistance. As a result, in 1976 NCADD's budget peaked at $3.4 million, nearly five times what it had been before passage of the Hughes Act. Government funding accounted for more than 75% of the budget.
The federal government also facilitated rapid growth in the EAP movement. Eleven years of NCADD campaigning culminated in 1974 with AFL-CIO president George Meany and General Motors director James M. Roche agreeing to chair NCADD's all-star labor management committee. When NIAAA provided NCADD with funding to establish task forces in ten major cities a year later, NCADD published the first labor-approved EAP guidelines. By the end of the 70s, employees had access to 5,000 EAP programs.
But not long after NCADD had perhaps its greatest triumph in reducing stigma, the board was forced to face an extremely unpleasant reality. Though the Washington office effectively had used the collective power of NCADD Affiliates to rally constituent support for NIAAA appropriations, it also was clear that in a souring economy government money would not last forever. In 1977, the board resolved to rely only on private funds in the future and once again Brink was there to ease the transition.
The "medicalization;" of alcoholism also was in full swing. In 1975, NCADD had funded a fetal alcohol study group which urged researchers to standardize techniques in their investigation of this recently discovered phenomenon. NCADD also offered homes to both the National Nurses Society on Addiction and the Research Society on Alcoholism which, with ASAM, began publishing Alcoholism: Clinical and Experimental Research. Attendance at the annual medical/scientific conference had swelled to more than a thousand, and NCADD and ASAM jointly developed their own definition of alcoholism in 1976.
Meanwhile a relatively new NCADD office had crafted an enormously influential--and radical--position statement that would keep the Washington office in particular very, very busy for the next decade.
The era of prevention had dawned at NCADD.
As NCADD entered its fifth decade, it seemed that many of Marty's early goals had been achieved. 80% of the American public understood that alcoholism is a disease, the majority of the middle class had access to treatment through private health insurance and attendance at self-help groups had soared.
Membership in ASAM, which began certifying physicians specializing in addiction medicine, had grown so large by 1984 that it no longer made sense to remain under NCADD's umbrella. However, the two groups continued to meet together annually until 1991 and today are represented on each other's boards.
Different kinds of problems now confronted NCADD and an increasingly fragmented field. When it became clear that younger alcoholics were commonly addicted to more than one substance, NCADD expanded its mission to include other drugs in 1987, adding Drug Dependence to its name in 1990 to reflect this change. And with kids using alcohol at earlier ages and in greater numbers than ever before, NCADD gradually shifted its focus to preventing alcohol-related problems through educational efforts targeted at youth and by addressing environmental factors that shaped public attitudes about drinking.
At the national level, President Reagan signed legislation in 1984 that resulted in a minimum drinking age of 21, just two years after NCADD had outlined this goal in its controversial prevention position statement. By 1990, NCADD would see two more of its prevention strategies implemented at the federal level: excise taxes were raised on beer and wine for the first time in almost 30 years and warning labels began appearing on alcoholic beverage containers.
Women's issues also came to the forefront of NCADD's agenda during the 80s. A grant from the Ford Foundation in 1987 made possible an important study of publicly funded women's alcoholism programs. This put NCADD in a position to lead a coalition to demand improved access to treatment for alcohol and other drug dependent women and their children. And what today is known as Alcohol- and Other Drug-Related Birth Defects Awareness Week was initiated by a joint congressional resolution signed by President Reagan in 1984.
Alcohol Awareness Month, NCADD's other major awareness program--which had evolved from Alcohol Information Week and was now kicked off by Alcohol-Free Weekend--drew support in 1990 from Surgeon General Antonia Novello, MD who agreed to serve as honorary chair, and the federal Center for Substance Abuse Prevention. Dr. Novello urged the nation "to; draw the line against underage drinking" and hundreds of grassroots group across the country participated in the greatly expanded campaign with NCADD-developed materials distributed by the government.
But even as it made progress in preventing alcoholism and
other drug addictions, NCADD began facing a critical
challenge in the 90s: a national health care crisis all but
eliminated insurance coverage for the treatment of these
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