When considering the present state of alcoholics and alcohol rehabilitation, and it's lack of effectiveness, a look back into the history of thought towards both alcoholics and alcohol rehabilitation explains much of the problems associated in these areas today.
In 1784, Dr. Benjamin Rush expressed his theories about alcoholics and alcohol rehabilitation. Often referred to as, "The father of American psychiatry", Rush believed that ingestion of, "distilled spirits", (liquor, Not wine or beer, they were good for you, according to Rush) constituted a, "disease". He also believed murder, lying, political opinions (that differed from his own), and being of African decent also constituted diseases. Rush also favored involuntary commitment to asylums for the, "mentally ill", as well as for, "Alcoholics", "intemperance", "Inebriety", or "dipsomania" as were the various terms used to describe drinking a lot. Rush also expressed a fear that intoxicated voters would have a disastrous effect on the country, and that this must be prevented by, "treating" people.
Rush's outlook on alcoholics and alcohol rehabilitation sees Physicians as,"social engineers" who dictate policy for, "the greater good". Rush felt that the danger to the public, and it's impact on society was the mandate for medical authority in this matter. The asylums which he advocated committing people to were basically prisons, the conditions were horrible, yet the public was protected. However, this quarantining was at the expense of alcoholics, and there was very little alcoholic rehabilitation that occurred.
Temperance groups were also a considerable factor in the history of inpatient alcohol rehabilitation. Groups like The American Association for the Cure of Inebriates, The American Society for the Promotion of Temperance, The Women's Christian Temperance union, and The Washingtonians all heavily lobbied the government, and influenced social policy. The focus of these groups was aimed at, "King Alcohol", a temptation from the Devil himself, and saloons were seen as dens of inequity and vice. The temperance movement also sought to play the role of social engineer, and to protect the public first and foremost. However, they were much less concerned with alcohol rehabilitation for individuals. What they advocated for individuals was religion that was portrayed as science.
In today's treatment climate, alcohol rehabilitation is still sadly viewed with emphasis on social control, rather than being helpful and effective in helping people with their problems. The main considerations are often making the financial burden as small as possible and isolating people in modern day asylums. These facilities are less costly than jail, and people are taught the philosophy of the disease concept of alcoholism, to their detriment. After this indoctrination, (very much based on religion from the temperance era, mixed with deterministic philosophy) they are directed (often mandated) to join a subculture of the, "church of Twelve steps", which is also, "cost effective", yet keeps the person locked in a climate of fear, disease, and failure.
Empowerment and treating alcoholics and the alcohol rehabilitation process with emphasis on helping individuals, rather than protecting society from them is the only solution which merits consideration. If you had cancer, would you want people to refer to you as cancerous? Alcohol or drug overuse is not remotely like cancer, and these problems can be fixed without confining and segregation of people, or forcing them into religious groups that exacerbate their problems. This paradigm of change is gaining momentum, and growing through advances in neuro-science that are exciting and dramatic.
"Those that fail to learn from history are doomed to repeat it" and the problems inherent in the field of alcoholics and alcohol rehabilitation are clearly demonstrated in the history alcoholism movement. It's time we stopped repeating history, and started learning from it.