Television drunks were once mined for laughs; now characters like Don Draper and Tommy Gavin make us feel compassion for them in their struggles with drinking.

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Television saw the comedy in drunkenness long before it saw the tragedy. From Shakespeare's Falstaff to Mark Twain's Pap Finn, the "town drunk" has been a source of amuse, ridicule, and scorn for centuries—and the small screen was once no different. Television's greatest early example is The Andy Griffith Show's Otis Campbell—a man described by Barney Fife as "smashed, buzzed, tiddly, gassed, off the wagon and back on the sauce, or just plain drunk." Otis' drunkenness was the one-note source of a thousand jokes over the series' 249-episode, seven-year run, until its finale in 1967.

But as The Andy Griffith Show was ending, public perception of alcoholism was beginning to change. In 1973, Alcoholics Anonymous referred to alcoholism as a "disease" in its official literature for the first time. The American Psychiatric Association followed suit in 1980, dividing what was formerly called "alcoholism" into two categories: alcohol abuse ("repeated use despite recurrent adverse consequences") and alcohol dependence (alcohol abuse "combined with tolerance, withdrawal, and an uncontrollable drive to drink"). As the American public got used to the idea that alcoholism was an actual disease, alcoholics gained widespread sympathy and support. Cultural attitudes about alcohol abuse had changed enough that by the release of 1986's TV movie sequel to The Andy Griffith Show, Return to Mayberry, Otis had sobered up and taken a steady job as town's ice cream man.

America's internal conflict about alcohol use is best summed up, appropriately enough, by Homer Simpson, who once called beer "the cause of—and solution to—all of life's problems." As both doctors and the American public as a whole have begun to take alcoholism more seriously, TV has walked an uneasy line, alternately playing up the comedy of alcohol use and the tragedy of alcohol abuse. Critiques continue today; in a 2010 article for the New York Times, critic Alessandra Stanley argued that "television has a drinking problem," saying that contemporary depictions of alcohol use on TV create "a conflicted, all-or-nothing portrait that isn't realistic" but is rather an example of "the American love-hate relationship with liquor—all or Prohibition."

There are shows that fall neatly into Stanley's argument that alcohol use on television is extreme. Two and a Half Men is an unusually mean-spirited sitcom, but its constant trivialization of Charlie's alcohol abuse—particularly in light of Charlie Sheen's real-life addiction problems—is one of its greatest sins. (In a typically cynical exchange between the show's brothers, Alan says that drinking makes his depression worse and Charlie replies, "The key is to drink past that. It's not a sprint; it's a marathon"). Other sitcoms find ways to avoid addressing alcoholism altogether; though the lead characters of It's Always Sunny in Philadelphia are almost certainly alcoholics, they aren't responsible or self-aware enough to question their own drinking habits. But Stanley's argument oversimplifies television's attitude toward drinking; there are plenty of characters who regularly imbibe—the barflies of How I Met Your Mother or the wine-swilling protagonists of Cougar Town—but are presented to us as aficionados, not addicts.

But the use of alcohol in comedy has nothing on contemporary drama, where the "noble, recovering alcoholic" protagonist has become a cliché unto itself. I spoke with Dr. Ken Winters, a University of Minnesota professor and associate editor for the Journal of Substance Abuse Treatment, about alcoholism on television. "We don't make jokes about the skid-row drunk anymore," said Dr. Winters, who gives credit to TV's more nuanced portrayals of addicts in recent years. He pointed to Tommy Gavin, the lead character of FX's Rescue Me, as the most accurate depiction of alcoholism he'd personally seen on television. "He relapsed, and defied his sponsor, his recovery group [...] It was all bad, and that tends to be the reality, especially if you're a chronic [abuser]. In some ways it was providing a message to a lot of people who might think, 'I can slip back into some functional line of drinking.'"

Tommy Gavin isn't the only major TV character on a TV drama in recent years to battle alcoholism. Mad Men (which returns after a 17-month hiatus on Sunday) has more alcoholic main characters than any series in television history, and its honest depiction of its characters' addictions has been groundbreaking for both the disease and the series. Last season's "The Summer Man" was the first time Mad Men has used voiceover to get us into the head of protagonist Don Draper, and tellingly, the subject of his musing was alcohol. "They say as soon as you have to cut down on your drinking, you have a drinking problem," said Don, closer to rock bottom than we'd seen him before or since. The episode offers an equally rare point-of-view shot from Don's perspective as he broodingly watches two colleagues sipping whiskey at a meeting. Don is one of the most flawed protagonists on television, but even in his lowest moments, his alcoholism is being offered to audiences as an opportunity to understand and sympathize with him.

And Mad Men isn't afraid to depict the consequences of alcohol abuse. Ad executive Freddy Rumsen was fired after he drunkenly wet himself during a meeting. Off-the-wagon alcoholic Duck Phillips lost his job at Sterling Cooper after an emotional outburst during a merger meeting ("He never could hold his liquor," said a former colleague ruefully). And Don's drinking habits have hurt him as much professionally as they have personally: He was forced to hire the incompetent Danny after drunkenly, inadvertently stealing the prospective employee's slogan during a client meeting.

But Mad Men's relationship with alcohol is a little more problematic than it may initially appear. It's telling that the only characters who have faced serious professional repercussions for their drinking—Duck Phillips and Freddy Rumsen—are a villain and a supporting character, respectively. Despite their alcohol problems, Don Draper and Roger Sterling remain half of Sterling Cooper Draper Pryce—and spend the vast majority of the series looking immaculate and functioning well. There's a pragmatic (and arguably) cynical reason for that; though the series serves many functions for viewers, one of them is a kind of lifestyle porn, and publications like Slate and Esquire have spotlighted the cocktails of Mad Men because the series makes drinking look very, very cool. That was less problematic in the series' early episodes, before the characters' alcohol problems were so apparent, but the evolution of its plot has made its veneration of cocktail culture a little queasier (a series with a lead character who's battling alcoholism should not be using that character to promote a "Cocktail Culture" app for the iPhone).

As Mad Men's conundrum indicates, there are still strides to be made in televised depictions of alcoholism. For all the credit that TV dramas deserve, there's a disappointing gender imbalance in their depictions of alcohol abuse; though real-life female alcoholics have alcohol-related death rates 50 to 100 percent higher than those of male alcoholics, the primary alcoholic characters of TV drama are all men. Female characters who routinely abuse alcohol, like Will & Grace's Karen Walker or Arrested Development's Lucille Bluth, are played for laughs (with a single exception: There are innumerable things to praise about NBC's Community, but its raw, surprisingly moving treatment of Shirley's past alcohol abuse in season two's "Mixology Certification" ranks very high). Perhaps the most troubling of all are the recent studies that claim showing alcohol in film or on television has an immediate, measurable effect on the amount that viewers will drink.

But it's hard to imagine a non-alcoholic watching Mad Men, Rescue Me, or Terriers without gaining a deeper understanding of alcoholism. And if understanding a fictional alcoholic is the first step toward sympathizing with a real one, it's worth taking a moment to appreciate just how far TV's treatment of alcoholism has come—and how much it still stands to accomplish.

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