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Methadone: An American Way of Thinking

Updated: Jul 24, 2023

In 1976, the East German government stole and repurposed for its own broadcasts a copy of Julia Reichert’s and James Klein’s documentary film, Methadone: An American Way of Dealing. The theft was clumsy, almost unabashedly so, in the way that GDR intrusions often could be. Reichert and Klein had submitted the film for consideration in the 19th annual Leipzig Documentary Film Festival, but it was rejected for having been delivered to the committee after the deadline. When the film print was returned to the directors, it obviously had been cut and only partially reassembled. The original reels on which it had left the U.S. were gone, replaced by film cores. The leaders (the length of cellulose attached to the beginning or end of a film to assist the projectionist) were in German, not English. To add insult to injury, the package arrived with an exorbitant bill for cash-on-delivery shipping.


In time, West German television executives discovered that their East German counterparts had taken parts of An American Way of Dealing and incorporated them without attribution in their own film, Tödliche Träume (“Deadly Dreams”), which in part described the plight of Black Americans and their encounters with the drug culture, racism, and corrupt police. When confronted by the press, East Berlin said that the director of Tödliche Träume had been hospitalized with a brain disorder and would not be available for comment.


That parts of An American Way of Dealing would be misappropriated for broadcast on East German television is not surprising. After all, Eastern Bloc governments were fairly notorious for such acts. Directors the world over complained that state media outlets routinely made unauthorized duplicates of whole films for their libraries and broadcasts. As in the case of An American Way of Dealing, they were also known for passing off purloined excerpts as original to Party-produced films. Only a few years before the 1976 scandal, the president of the Leipzig Festival’s jury (an American) had the startling and surreal experience of being asked to judge a Bulgarian documentary in which appeared unlicensed parts of his own documentary, which itself had taken the top honors at Leipzig the previous year (Hitchens, 1976).


More to the point, a propagandist’s attraction to the Reichert-Klein film is easily explained by, as its title implies, its depiction of the U.S.’ calamitous drug policy and its oppression of Black Americans. Since well before the Cold War, America’s treatment of its Black population had been an embarrassment to U.S. diplomats and government officials in ideological contest with the Soviet Union. Indeed, as Carol Anderson, Dayo Gore, Erik McDuffie, Mary Dudziak, and other historians have noted, this contest was not merely the backdrop for postwar Civil Rights events, but a powerful though limited point of leverage used by Civil Rights leaders in their demands for federal protection of basic rights and freedoms. Centrist and mainstream leaders such as Martin Luther King, Jr., and the NAACP distanced themselves from the left, but frequently challenged the United States to live up to the claims of equality it made on the international stage. Meanwhile, Black leftists such as Claude McKay, Paul Robeson, Claudia Jones, W.E.B. DuBois, Benjamin Davis, Robert Williams, Angela Davis, and the Black Panthers were just some of the many Black intellectuals and political leaders who looked to communism as an antidote to racial capitalism. In Methadone: An American Way of Dealing, Reichert and Klein make no such claim, of course. However, their argument that America had resolved its race and class problems along with its drug problem, through the mass distribution of a narcotic, is a pointed and apt one. Like so many 1970s-era denunciations of methadone maintenance, Reichert’s and Klein’s is as much an indictment of medical and state racism and classism in post-Civil Rights America as it is a critique of a specific treatment modality. In this regard, Reichert and Klein aren’t wrong, but that doesn’t mean that they got it entirely right.


Running a bit more than an hour, the film itself has a two-part narrative structure. The first portion, about 42 minutes, is a treatment of Dayton, Ohio’s, only methadone clinic, operated by the city’s Bureau of Drug Abuse (BUDA). The opening scenes show a man, Patient No.1045, entering the BUDA clinic, greeting staff and fellow patients alike with the familiarity that comes from daily interactions. He takes a seat in a dingy waiting room, where he chats with other patients while smoking cigarettes. In the next cut, he approaches the dispensary desk, asks how much methadone he is to receive, and is told by the woman behind the desk, “You know I can’t tell you that.” They both chuckle as though the whole exchange was a time-worn joke between the two. The desk clerk informs the man that he must first submit to a regular urine test before receiving his medication. A man at another desk hands the patient a cup. Both men enter a bathroom and close the door behind them.


Immediately following that is Reichert’s voice-over introduction of Dayton, “a typical midwestern city” which “has a large black ghetto” but also is home a “poor white ghetto.” Most families support themselves either by a dwindling supply of factory work and lower-skilled occupations. Black and poor families are in a pinch. Like many American cities, Dayton, a city of 750,000 souls, has a high crime rate. Dayton, Reichert tells us, has a thousand bars and four hundred policemen. It also has a methadone clinic which serves four hundred patients daily, more than half of whom are under the age of 25, and about 20% of whom had been using heroin for less than a year. As Reichert describes methadone maintenance, we see more scenes of a vibrantly active waiting room in which dozens of jovial conversations are being had. Over a loud speaker a woman calls out patient numbers, much like a clerk might at a butcher shop or a deli. The majority of the patients are Black.


This description and the scene of monitored urination set the stage for further dehumanization and social control at the hands of the city and its BUDA clinic. Interviewed on the street outside the clinic, a Black man describes methadone as the same dependency as heroin, except that a methadone addiction is harder to kick. Another Black man tells Reichert inside the clinic, “We’re addicted worse now than when we came in here. … You just take your drink [methadone] and you get no therapy, no counseling, nothing.” A White couple, interviewed at their home with their infant child, estimate that they and 50% of the other patients continue to use heroin and other drugs, using the methadone mainly to stave off withdrawal sickness, while cocaine, amphetamines, barbiturates and heroin allow them to enjoy a high. Some patients allege that counselors themselves sell drugs to their patients, and the filmmakers capture on film a patient selling drugs outside the clinic.


Two other White patients, men interviewed in a living room, explain that methadone had been advertised as a “wonder drug,” but that they had been duped, having exchanged one bad addiction for a worse one. Both men are factory workers, and when asked if many of their coworkers also used drugs, one chuckles grimly, “all that place is, is junkies … man, there’s so much dope there it’s pathetic.” The other explains that heroin use is common among factory workers because they want to escape the tedium of the job, to be “in their own little world.” The first man describes assembly line work as “degrading.” Their generation witnessed what factory work did their fathers, and no one finds it attractive anymore. Black men interviewed on the street or in their homes say the same thing. A group of women patients explain that most of them don’t even have factory jobs and subsist on food stamps and the ADC program. A man and woman in their living room explain how the man had “turned out” the woman into sex work to support their heroin habit. Another woman says that she started heroin because her husband used heavily and she wanted to know why he was more interested in it than in her. Another tells Reichert that she was in the program simply because her parole officer mandated it.


The patient interviewees make themselves clear in expressing their disdain for methadone and the clinics which dispense it. More of Reichert’s voiceover describe methadone and antipoverty programs as measures to fight crime and, even more sinister, to neutralize political unrest after uprisings in Watts, Detroit, Newark, and elsewhere. That the political class of both major parties were concerned with these problems explains in part the massive funding and explosion in the ranks of methadone patients to 86,000 by 1970. Two Black men express their belief that the government put methadone in the community to pacify Black people, one asking Reichert, “notice that there haven’t been any riots since methadone has been in use?” A Black woman describes side effects she’s seen in herself and others, and complains frustratedly that the clinic won’t even tell her the amount of methadone they give her every day. She and other patients resent being controlled and demeaned by the clinic. Psychiatrist Dr. William Dobbs, a White former clinic director turned methadone critic, argues that high doses of methadone dull the senses, make patients somnolent and passive, and remove any ambition to do anything else. A filmed group therapy session reveals six or more of the participants nodding off. An interview with Dr. Peter Bourne, a methadone proponent and assistant director of President Nixon’s Special Action Office on Drug Abuse Prevention (SAODAP), reveals that he himself isn’t aware of how the treatment modality works (or doesn’t) in reality. In a statement he probably later regretted, he tells a stunned Reichert, “The fact that it’s addictive is probably one of its most important qualities in terms of its success. If it wasn’t addictive, it would be very hard to get the addict to come back on a daily basis.”


Reichert and Klein constructed the film with the expectation that a long intermission and guided audience discussion would follow their treatment of the BUDA clinic. After that, in a much shorter segment the film suggests an alternative to methadone maintenance, the program called the Regional Addiction Prevention Center, or RAP, Inc. RAP is a “drug free” (non-methadone) community-based and -supported addiction rehabilitation program in Washington, DC., and the first private addiction treatment program in the District. Those familiar with this history will recognize RAP as one of the more nationally famous and often embattled therapeutic communities operating in the nation’s underserved ghettos. The ideological and programmatic similarities between RAP and the survival programs of organizations like the Black Panthers is clear. At RAP, members are made to understand themselves as having been caught in a vicious system of racial capitalism which profits from the misery of Black people. In contrast to Dayton’s BUDA, RAP emphasizes education, political awareness, and activism. Community is essential in the rehabilitative process. Residents and members can avail themselves of GED classes, legal and medical referrals, and opportunities for welfare rights and housing rights organization. Members work collaboratively inside the residential site, and also get involved outside in the community through service on school boards or in volunteer work providing food and clothing to members of the local community. Though not described in the film, RAP was also known for its acupuncture services, using techniques pioneered at the famous Lincoln Detox program in the South Bronx (which is thanked in the end credits). A group therapy session has elements of the “encounter sessions” practiced in therapeutic communities around the country, in which the group confronts a member for their faults and habits. Encounter sessions later became known for their potentially abusive dynamics (an alarming minority of therapeutic communities, though not RAP, became cults or cult-ish), and I found myself holding my breath as an emotionally overwhelmed resident was ordered not to leave the circle. Extensive footage of group singalongs and meal preparation signals the communitarian vibe at RAP. This segment is entirely uncritical.


The cinematic world loved the film for its gritty aesthetic and powerful message. Not surprisingly, treatment professionals involved with methadone protested. In the journal Contemporary Drug Issues, Susan Davidoff of the Camden County (New Jersey) Drug Abuse Clinic decried the film as less documentary and more “an editorial statement designed not only to discredit methadone maintenance as a viable treatment modality, but also to denigrate the human resource potential of the patients themselves.” In the final analysis, An American Way of Dealing “ends up stigmatizing both drug treatment and the patients themselves” (Davidoff 1975). Nor was the Leipzig affair the only or even most sensational controversy surrounding the film. Prior to its premiere in the Fall of 1974 at the Museum of Modern Art, MoMA was the recipient of numerous letters and phone calls from methadone physicians, researchers at Rockefeller University (where methadone maintenance was developed), and the Committee of Concerned Methadone Patients (CCMP, now National Alliance for Medication-Assisted Recovery), all demanding the film’s retraction from the museum’s slate of programming. The following Spring, members of the CCMP picketed a screening at the Whitney Museum and distributed leaflets to members of the audience until they were ejected from the theater. Threats of law suits dogged Reichert, Klein, and nearly every venue that offered to show the film (“Attempted Suppression of Methadone Documentary,” 1976).


Methadone: An American Way of Dealing is not an easy film to watch. I don’t mean that elements are cringe-worthy or emotionally disturbing, although that certainly is the case. And I don’t mean that it is not well constructed. Aesthetically it is arresting and masterful. Instead, the challenge is in figuring out, even with the benefit of a digital copy with which one can review scenes as often as one wants, the entirety of what is going on in the film’s sixty-five minutes of content. The 1960s and 1970s were, if anything, complicated and contentious, and any discussion of methadone unavoidably touched on the era’s hot-button issues: crime, economic dislocation, political uprisings, the US war in Vietnam, sexual liberation, racial liberalism versus nationalist or anticapitalist radicalism, the human potential for self-actualization in the face of stultifying postindustrial social alienation, antipoverty politics, the nation’s failure to guarantee full civil and economic rights to all of its citizens, etc… All of these show up in An American Way of Dealing, sometimes explicitly, sometimes subtly, like Easter eggs that are easy to miss if you’re not looking closely.


Reichert’s and Klein’s assertions don’t leave much room for nuance. Although Reichert later became known for her work in “direct cinema” (a cinematic aesthetic similar to cinema verité, eschewing filmmaker participation in the narrative), in An American Way of Dealing she is actually quite participatory as an occasionally on-camera interviewer and voice-over narrator, a presence which further distances viewers from their own conclusions and analyses. If one reads the film with some resistance, however, one might think about what questions and opportunities for actual inquiry Reichert and Klein may have missed in their determination to condemn methadone maintenance. Indeed, like many of the era’s other critics of methadone, Reichert and Klein seem unable to make a distinction between methadone policy and methadone the drug. Patient complaints of uncaring and even abusive staff at the Dayton clinic were entirely credible and, in fact, common throughout the country. That many clinics then (and even today) do little more than dispense methadone certainly is a problem. It is a completely viable critique that federal, state, and municipal governments generally seemed to be more interested in stopping drug-related crime than in providing actual rehabilitation or even educational and vocational opportunities for the working classes most vulnerable to the heroin epidemics. But those observations all point to the failure of methadone policy; do not address the thousands of people then, and hundreds of thousands over the years, who were helped by methadone; and do not suggest how methadone could be liberated from those constraints and malign uses.


At no point, for example, do Reichert and Klein take seriously the possibility for political subjectivity deriving from one’s membership in a methadone program. For all of the discussion of community formation at RAP, the filmmakers don’t recognize that in their footage of the lively BUDA waiting room they have shown us a community of another sort. Further, with some exceptions both White and Black patients offered essentially the same analysis of the methadone situation. In a period when cross-color working-class alliances were not particularly common in rustbelt cities like Dayton, the BUDA clientele (if not BUDA itself) would have constituted fertile ground for organized demands for the liberalization of methadone policy to allow take-home doses and less surveillance, to not have one’s parole status tied to membership, and to include the provision of educational and vocational counseling and better therapy. This has been the argument of methadone patient rights organizations who for half a century averred that the origins of FDA restrictions on methadone beginning in 1970 lay not in clinical research but in the politics surrounding the treatment.


Reichert and Klein depict those patients who are not especially critical of methadone as politically undirected and unaware. At least two Black patients describe themselves as active or aspirational “pimps” who live off of women. Very rarely do moments emerge in the film where patients describe how methadone has helped them. In a scene intended to prompt viewers to shake their heads with disapproval, one man asserts that the clinic is “the best thing to come to Dayton, Ohio,” mainly because it allows him to maintain himself during periods when he has no money or when the dope in the street is either scarce or of low quality. When those conditions change, however, he leaves the program because, he exclaims, “I like to shoot dope!” However, in a more private, heart-rending discussion between him and Reichert, he almost tearfully informs her that he’s been addicted for seven years, and the five years of his life before the BUDA clinic opened were hard on him. With his membership in the clinic, he is able “get myself together after having a stuff [heroin] habit for so long. It gives me a chance to get some clothes, get some more money, and beat a couple of court cases, to get my nerves back.”


Filming in 1972, a decade and a half before the emergence of the harm reduction movement and the “any positive change” approach advocated by Dan Bigg and others, Reichert and Klein unfortunately had no access to the philosophical challenges which harm reduction offered to insistence on abstinence as the sine qua non of recovery. Nonetheless, viewers could expect that Reichert might have asked the man about what was important to him or about his long-term goals. After all, in 1972, Abraham Maslow’s hierarchy of needs model—a powerful concept which informed innovative social work, community service organization, and, later, harm reduction—was nearing its thirtieth anniversary.


In 1974, Reichert and Klein forcefully entered the debate of methadone maintenance vs. drug-free programs, but they didn’t change the grounds on which that debate unfolded. Aside from fractious federal regulatory politics, there is no reason why, for example, community-based programs like RAP could not have been allowed to use methadone in their own multi-modality programs. Similarly, what of our puritanical stigma, or at least our Cartesian mind-body dualism, which has insisted that a mind upon which a drug has acted is not true to itself? (Not incidentally, this stigma extends itself also to antidepressants and other drugs used to treat emotional dysregulation.) Absent that, one wonders what else might have prevented the militantly “drug-free” (non-methadone) programs from using methadone in creative ways and embracing its users with no more disapprobation than they would a diabetic using insulin on a daily basis. Aside from perhaps methadone’s most enthusiastic zealots, few would have claimed that it alone was sufficient to help a patient embark on recovery. In another, less ideologically encumbered, universe, one which Reichert and Klein themselves could not imagine, could autonomously-used methadone, free from onerous regulation and White control, have been incorporated a radical recovery movement claiming “methadone for the people?”


Of course, this is not what happened. Instead, methadone fell into the sole proprietorship of the FDA, the BNDD/DEA, and government War on Poverty programs– which duly earned criticism for being more active in social control than in actual community development and empowerment and for promoting methadone more for its anti-crime properties than for its therapeutic potential. Meanwhile, excluded from methadone licensure and watching it deployed for purposes more nefarious than therapy, programs like RAP and Lincoln Detox quickly and understandably equated political liberation with chemical liberation, and methadone dependency with social enslavement and genocide.


Reichert’s and Klein’s failure of vision was not their own. It was the entire country’s. At no point, at least not until the twenty-first century alliance between the methadone patients’ rights and critical harm reduction movements, had anyone’s most imaginative freedom dreams or wildest fancies of political futurism accommodated a vision of radical societal change brought about by people using and yet in control of methadone. As methadone maintenance approaches it sixtieth anniversary in 2025, we might do better to think more creatively about how to do just that.

 

References

“Attempted Suppression of Methadone Documentary.” (1976, April ). Cinéaste, 7, 49.

Davidoff, S. (1975). Methadone: An American Way of Dealing, by Julia Reichert and James Klein.” Contemporary Drug Problems, 4(4), 509-511.

Hitchens, G. (1976). “East Germans Pirate Leipzig Fest Pix: Scandal Exposes Multiple Cases.” Variety, 285(7), 7, 32.

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