In the 1967 case of Powell v. Texas, the U.S Supreme Court ruled that a state could constitutionally criminalize public intoxication. The appellant, Leroy Powell, was a chronic alcoholic who had been convicted numerous times for being drunk in public places in Austin, Texas. He argued his conviction violated the Eighth Amendment's prohibition against cruel and unusual punishment because his alcoholism was an illness he couldn't control. However, the court rejected this argument with a 5-4 decision stating that it would be difficult to distinguish between individuals who are unable to resist drinking due to an addiction and those who simply choose not to resist. The majority opinion held that while compulsive behavior might exist among some drinkers, it did not excuse them from violating laws they were aware of when sober.

In the dissenting opinion for Powell v. Texas, Justice William O. Douglas argued that chronic alcoholism should be viewed as a disease and not a crime. He believed that punishing someone for having an illness was cruel and unusual punishment, which is prohibited by the Eighth Amendment of the Constitution. He also noted that it was unfair to punish people who were unable to control their drinking due to their addiction while those who could afford private treatment escaped punishment entirely. Furthermore, he criticized the majority's reliance on Robinson v California (1962), arguing they misinterpreted its ruling about criminalizing status rather than behavior; in his view, being drunk in public - when one cannot help but drink excessively due to alcoholism - is more akin to 'status' than 'conduct'. Thus, he felt this case represented an opportunity missed by the court system to address societal issues regarding mental health and addiction.