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Freaky Friday: Grand Rounds with Dr. Dave Smith, Founder of the Haight-Ashbury Free Clinic

Updated: Aug 30, 2023

Poster for Haight-Ashbury Free Clinic Benefit, 1967, Mari Tepper

Thanks to the wonders of technology, Points readers interested in the secret history of addiction medicine and the psychedelic ’60s can check out a Grand Rounds talk that Dr. Dave Smith, founder of the Haight-Ashbury Free Clinic, gave at the University of Florida’s College of Medicine in December of 2010.  (Click on the link above, then scroll down to the date and click “watch presentation.  It takes a while to load.)  Accompanied by a series of powerpoint slides (including images of some of the many rock stars whose financial contributions supported the Clinic early on), the fifty-five minute talk is wide-ranging, but the through line is the ideological connection between the founding of the Free Clinic and the creation of the AMA-recognized specialty of Addiction Medicine.  Addressing medical students who are pursuing Addiction Medicine in one of the new residency programs that have sprung up around the country, “Dr. Dave” draws on his own experience to urge them to be mindful of the connections among the biochemical, sociocultural, and political dimensions of addiction, treatment, and recovery.

Dr. Dave, ca. 1967

Smith is a fascinating person, and one whose work as a public health innovator and a central figure in the counterculture deserves to be better known.  (And while we’re on the topic, there’s similar work to be done on Rev. Cecil Williams, Pastor at San Francisco’s Glide Memorial Church, which has played a similarly revolutionary role in community-based addiction treatment.) Richard Seymour’s book (with Smith) The Haight Ashbury [sic] Free Medical Clinics: Still Free After All these Years 1967-1987, is now both out of print and out of date, and Smith’s own writing on the clinic, Love Needs Care: A History of San Francisco’s Haight-Ashbury Free Medical Clinic and Its Pioneer Role in Treating Drug-Abuse Problems is more of a primary source for contemporary historians than a history itself.  Smith talks briefly in his Grand Rounds address about the conditions that spurred the creation of the clinic (a topic that will receive more attention in Anthony Ashbolt’s forthcoming A Cultural History of the Radical ’60s in the San Francisco Bay Area) and about how his own engagement with Alcoholics and Narcotics Anonymous influenced his approach to drug treatment.  He also notes– but refuses to give details about– the American Psychiatric Association’s resistance to the creation of a clinical category of Addiction Medicine, and suggests that their aversion had something to do with the long history of enmity between 12-Step proponents and the psych trades.

I haven’t even talked about his friendships with Jerry, Janis, etc., and you already want to know more about all this, don’t you?  Well, Smith’s website contains a useful archive of interviews, historic photos of the clinic, and his own writings (the link to The Journal of Psychoactive Drugs, which Smith began publishing in 1967, is, sadly, a re-direct to the subscription-only Taylor & Francis page).  Also available are some stills and transcripts from 1967’s “The Hippie Temptation,” a CBS News documentary in which Harry Reasoner visits the Haight (and interviews Smith, among others), and Speedscene, a 1969 anti-speed documentary made at the clinic.

Dr. Dave Smith (center) Talks Some Hippies Down from a Bad Trip

In his talk, Smith mentions the long history of the persecution of physicians who sought to treat, rather than just to detain drug addicts, a trend that made it a criminal offense in late ’60s California to detox an addict anywhere other than in an in-patient setting.  “History was our guide,” he notes, when it came to determining what agitation for free clinics and addiction medicine was against.  Similarly, he concludes by reminding his audience to think historically and remember that “the ’60s produced some good things.”  His central argument is that the mainstreaming of the disease concept of addiction was one of them.  That’s a very complicated claim, and one that may not get the sustained and deliberative attention it warrants from a roomful of medical students.  So Points readers, what exactly is the connection between the countercultural ethos of the ’60s and this most hegemonic discourse of our own era?  Anybody?

The Grateful Dead in Concert, with Jerry's fMRI in Background

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