Ethics and the Law
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Ethics and the Law
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The Early History of
RCW 70.96A Like most laws dealing with social policy, RCW 70.96A has experienced an exciting and, often times, controversial evolution. Although it initially became law in 1972, the movement that created it started many years before. That movement was motivated by pain and suffering caused by addiction. The process it followed to create this law allowed for some opportunity for many to heal, but it also created a new layer of scares that remain today a part of the addiction service professional landscape. Prior to the enactment of this law, alcoholics had few options for treatment, and drug addicts had virtually none. The alcoholic could go to the community mental health centers for services, but usually found only limited help addressing their chemical addiction problem. At the time, little was known about alcoholism. The concept of addiction as a disease was not widely supported within the psychological community. Many mental health professionals assumed alcoholism was merely a symptom of other hidden psychological disorders. The treatment focus centered on discovering that dysfunction, leading to a variety of diagnosis, and often the prescription of drugs to ameliorate the assumed condition. The lack of attention to the addiction itself, and the use of drugs as treatment, caused many alcoholics to suffer even worse than when left untreated. Those that acted out, and failed to respond to community-based treatment, were institutionalized in state mental hospitals. For many, that commitment represented a life sentence for crime that had not happened. The only other option for alcoholics was the growing trend toward anonymous self-help groups. One of the originals, Alcoholics Anonymous (AA), offered a rare opportunity for hope. Unlike any other alternative, its strongest advocates were those for whom it had worked. The alcoholics who knew from personal experience what addiction was like, and the devastation it caused, were its most convincing agents. However, despite its success, and the fact that no other alternative was nearly as successful, the establishment refused to acknowledge that option. The problem was really simple. AA was not treatment, even its advocates acknowledged that. And even worse, those promoting it were not trained professionals. And even worse yet, the loudest advocates were acknowledged alcoholics. This differing view point would become a chasm of philosophy as the evolution toward passage of 70.96A progressed.
In the early 1970's, a collection of people, recovering alcoholics and those touched by the addict's addiction and recovery experience, started to work toward greater public awareness and increased state support for alternatives for alcoholics. They worked with a number of elected officials to fashion a major shift in public policy and public attitude toward alcoholism and alcoholics. They wanted to change the public perception of alcoholism from the image of the skid-road drunk to the every-day person suffering from an insidious disease. They were alcoholics and they knew what it was like. They knew many others like them were alcoholics, still very much suffering from the progressive malignancy of addiction. They knew its destructive potential and the human hurt it caused. They knew that the current system not only wasn't helping, for many it made things worse. They knew a change was necessary to stop the harm. The original legislation crafted was entitled the Omnibus Alcoholism Act. Its official title was the Uniform Alcoholism and Intoxication Treatment Act. It offered a major shift away from the current system. For the alcoholic it was intended to offer dignity and hope. For the mental health system it represented an assault on the profession, an intrusion on the supreme clinical authority of trained professionals, and a giant chasm in the public's confidence in their judgment. The battle-lines were clearly drawn, and both sides considered it a life-or-death struggle, literally. For the law's proponents, the change was necessary to protect the lives of the alcoholic. It provided for a pragmatic separation of alcohol services from the mental health system. The funding, enforcement, and decision-making authority would be severed completely from mental health. Further, it would emphatically recognize the disease concept, and empower development of a community-based system that recognized the role of recovery in helping others. The proponents charged that passage of the Act was necessary to prevent further mistreatment by those who did not know or understand the condition. They railed against the mental health system's institutional arrogance and called those who refused to treat alcoholism as a primary condition murderers. On the mental health side, things were no less passionate. Though there was not complete solidarity, most psychiatrists, psychologists, and other mental health practitioners were deeply concerned. Many saw this challenge to their authority as a major threat to the foundations of the profession. It had taken many years for the practice of psychology and psychoanalysis to achieve a place of respect in science and mainstream medicine. This disruption by untrained plebeians threatened to push the field back to the dark-ages. Some considered the proposed law as little more than a sanction to practice witchcraft or voodoo. Even calling it "treatment" caused an angry furor, since term treatment gave it a medical basis. Many mental health professionals truly believed turning the alcoholic over to those they saw as untrained and unskilled was a death sentence.
The Uniform Alcoholism and Intoxication Treatment Act In the long run, the law was passed in 1972. It substantially changed, from a policy point of view, how alcoholics and alcoholism were seen. It also provided for a shift from the mental health system to a new community-based alcohol system. Although enactment was delayed for a brief period, the eventual result was a continuum of care designed to accommodate the needs of alcoholics at any point in the progression of their disease. Some of the key elements of the law were:
And, possibly of greatest importance,
Although it has endured many amendments since its initial passage, much of that original law remain. The system it created has been reinforced, and the principals it fostered remain the bulwark of the modern law. For more information about the major changes that have occurred to this statute, click here.
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