This paper analyses two contemporaneous types of 19th-century North American inebriate institutions and attempts by their promoters to develop a public treatment system. Inebriate 'homes' or 'retreats' descended from a tradition of therapeutic temperance that originated in the Washingtonian Movement of the 1840s. They were small, urban, private and charitable, dedicated to voluntaristic and Christian principles, and were intimately connected with local temperance groups that provided support after residential treatment. Inebriate asylums took inspiration from insane asylums and were large, public, coercive and isolated in rural areas. Their promoters were steeped in the deterministic, hereditarian neurologism of Victorian psychiatry. Asylum enthusiasts dominated the public treatment movement, but developed a largely disciplinary and custodial vision that undermined their political appeal. As inebriate asylums could not easily be distinguished from insane asylums, almshouses or jails, legislators regarded them as superfluous and very few were established. Prohibition destroyed what public inebriate institutions existed. Inebriate colonies, usually connected with county jails, were the only survivors of the 19th-century treatment movement apart from private sanitaria and a few inebriate wards in city or county hospitals.