Prohibition was a disaster. You can find lots of analysis from people far smarter and more experienced than me attesting to that. What’s most interesting to me though is how Prohibition was effectively a culture war.
The science of addiction, recovery, and treatment has always been very underdeveloped compared to other aspects of health. We can see that it’s in the nature of something as complex as addiction that it takes longer to discover patterns, assemble theories, and test solutions than other issues tied to a physiological function. That being said, Benjamin Rush, who signed the Declaration of Independence and held close relationships with a few US Presidents, wrote a very substantial argument in defense of treating alcoholism (“habitual drunkenness”) as a disease back in the 18th century. He argued that immoral behavior tied to drinking should be seen as a symptom of a disease that has afflicted one’s will and sanity. He added that Christians have an obligation to try and help all sinners, including someone lost to a substance.
So it’s interesting that the temperance movements which later praised Rush also abandoned the disease model for something between a moral model and a temperance model, blaming either the drinker or the drink at various points rather than assuming a public health perspective with a generous touch of communal spirituality. A ton of interests were at play that didn’t make the cut for Boardwalk Empire. There were saloons looking out for their bottom line, women’s groups fighting against domestic violence and family neglect, churches of different denominations that ventured into politics, politicians who were going to drink no matter what but needed to ride an issue into office, organized crime taking over the manufacture and distribution of alcohol, urban workers seeking a cleaner and safer environment as cities began to hold most of the American population, rural workers and labor unions seeking to disadvantage immigrants (especially Catholics) with a strong saloon culture, African-American coalitions seeking to prove their legitimacy as free Americans by holding up higher moral standards and allying with white church networks, and many others.
Before Prohibition and in the run-up to the Civil War, temperance movements were gaining steam but lost the moment when the sociopolitical framework for the institutions of slavery were challenged. The (im)morality of slavery and racism took priority over temperance, especially when it was leaned on heavily to cope with the brutal traumas they experienced. It wasn’t until the post-Civil War and post-WWI concerns about excessive drinking among soldiers and the struggles veterans had in reintegrating into daily life (which is actually the basis for America’s legal concept of disability) that temperance movements carried out a culture war.
One of the consequences of temperance movements having such a huge influence on the culture was a decline in institutions that researched alcoholism. After all, if the policies worked, millions of people who depend on that science would be completely liberated from that concern. Fewer hospitals, more factories and churches for the good sober Christian get-back-to-work mindset they would now have instead of cravings for drinking. Obviously, no such miracles happened, but the scientific, medical, and philanthropic communities had braced themselves for a massive decline in drinking that didn’t ever materialize.