A Strange Medical “Exemption”
On January 17, 1920, the Prohibition era began in the United States under the Eighteenth Amendment and the Volstead Act. The law banned the manufacture, sale, transportation, and importation of “intoxicating liquors.”
But physicians were allowed to prescribe liquor as “medicinal alcohol” for health conditions. To do so legally, doctors had to obtain a permit from the U.S. Treasury Department. Pharmacies and distillers also had roles under regulated permits.
A Booming Business of Medicinal Booze
In the first few months of Prohibition, thousands of doctors applied for permits to prescribe alcohol, and demand grew rapidly. During Prohibition’s first year, doctors prescribed millions of gallons of medicinal alcohol. Pharmacies often charged high prices for prescribed liquor, and some diluted alcohol to maximize profits.
Certain physicians issued overly generous prescriptions, and in many cities, alcohol prescriptions became a major source of income.
Laws, Loopholes, and Limits
The Volstead Act allowed doctors to prescribe up to one pint of spirituous liquor every ten days. In 1921, Congress passed the Willis–Campbell Act, also known as the Beer Emergency Bill.
It prohibited prescribing beer as medicinal, reduced the maximum amount per prescription to a half-pint, and limited physicians to 100 medicinal alcohol prescriptions every 90 days. Records had to be kept by physicians and pharmacies, and refills were prohibited, yet enforcement remained inconsistent.
Profits, Practice, and Oversight Challenges
Some doctors and pharmacists treated their permit rights as business opportunities, and lax oversight enabled widespread abuse. In New York, the number of licensed pharmacists tripled during Prohibition despite no significant population growth.
Securing a permit required minimal effort, and many practitioners charged high fees for both prescriptions and filling them. Although regulations attempted to restrict misuse, few physicians faced penalties, and medicinal alcohol remained an expensive workaround for wealthier Americans until the repeal of Prohibition in 1933.
In 1920 the United States banned liquor, yet a doctor’s note could still buy whiskey.
Physicians with Treasury permits wrote prescriptions. Pharmacies filled them.
The medical exemption opened a major route to alcohol during Prohibition…🧵👇 pic.twitter.com/fE2dgiVGi1
— Fascinating True Stories (@FascinatingTrue) September 11, 2025