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June 5, 1987

A Review of Medical Education in Alcohol and Other Drug Abuse

JAMA. 1987;257(21):2945-2948. doi:10.1001/jama.1987.03390210093032

RECOGNITION of the deleterious effects of alcohol and other drugs is not a recent phenomenon. Over 200 years ago America's first Surgeon General, Benjamin Rush, MD, labeled "intemperance" a disease. He also described the symptoms of tolerance and alcohol withdrawal, which are still pathognomonic of alcohol dependence.1,2 Medical concern about the widespread abuse of other drugs began in the post-Civil War period when addiction resulting from the indiscriminate prescribing of opium and its derivatives for pain relief was recognized. In 1929, Congress passed a law establishing "two United States narcotic farms for the... treatment of persons addicted to the use of habitforming narcotic drugs." Three decades ago, the American Medical Association (AMA) formally acknowledged alcoholism as a medical illness,3 and, a decade later, as a disease.4 Despite this long history of medical concern, physicians still do not diagnose alcoholism or other illnesses related to substance abuse with