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Telling Methadone Stories: Men in Ties

Updated: Jul 24, 2023

Time has a way of turning lived experience into memory and from then into stories that seem, by turns, improbable and fantastical (yes, kids, I used a typewriter to prepare my college research papers!). In the improbable category, one might include my attendance at the Yale School of Medicine’s conference marking the centennial of heroin, held in New Haven from September 18-20, 1998. Organized by the late David Musto, billed as a sweeping review of the heroin’s past and present, it lives in my memory as reunion of Nixon administration drug policy alumni. Egil “Bud” Krogh was there, handing out copies of his short volume The Day Elvis Met Nixon, which described in detail the culturally resonant meeting that Krogh helped arrange (a meeting in which the King asked the President for a federal drug enforcement badge). Daniel Patrick Moynihan was there, delivering an opening-night address that embarrassed some of us younger historians in the audience with its confident declaration that no one had heard of a drug problem back in his childhood days. And, of course, the Special Action Office for Drug Abuse Prevention (SAODAP) was well-represented, with both of its Directors—Jerry Jaffe and Bob DuPont—in attendance and giving presentations. In between the addresses and presentations—for which junior folks like myself had been invited to offer commentaries—they told stories, especially methadone stories.

It was an auspicious time for Nixon reunions and methadone stories. The former president had died just four years earlier, having to some degree or another managed to rehabilitate his public image. Nixon’s drug policy was also getting a thorough rehabilitation—Michael Massing’s The Fix was published just days after the New Haven meeting (David Musto reviewed it for the New York Times Book Review on October 18). Massing’s book cover left little to the imagination: “Under the Nixon Administration, America Had an Effective Drug Policy. WE SHOULD RESTORE IT. (Nixon Was Right).” The Fix told a methadone story, one in which methadone maintenance was the cornerstone of the “striking success” of Nixon’s investment in a national treatment infrastructure. Like all good stories, the legacy assessments of Massing and the Nixon alums in New Haven featured heroes (an executive office unafraid to wield power over the federal bureaucracy, Jerry Jaffe, methadone itself) and villains (war on crime types, pinheads at the NIMH, and slow, expensive, ineffective psychiatric approaches everywhere they appeared, from Lexington to therapeutic communities).

Eventually, Musto and his colleague Pamela Korsmeyer published the New Haven proceedings as One Hundred Years of Heroin (main presenters only; commentaries ended up on the cutting room floor). The meeting also inspired Musto and Korsmeyer to publish The Quest for Drug Control: Politics and Federal Policy in a Period of Increasing Substance Abuse (1963-1981). In a review of the latter volume, David Courtwright was “struck by the number of photographs of powerful men seated around conference tables…their ties provide a visual clock: the wider they become, the deeper we are into the 1970s.” The methadone stories in New Haven were “men in ties” stories, by and about the men who directed the federal drug policy response.

There’s a man in a tie in James Klein and Julia Reichert’s astonishing 1974 documentary film, Methadone: An American Way of Dealing. The wide, patterned tie belongs to Peter Bourne, wearing it in his capacity as an Assistant Director of SAODAP (his tenure was short, arriving in 1973 and departing in 1974 to help boost the nascent presidential campaign of Jimmy Carter, for whom he later served as drug policy chief). The film’s methadone story is a decidedly non-heroic one, in which the men in ties (represented by Bourne) are smooth but dissembling and out of touch. Bourne is almost too good in the role—every bit the character Massing would later introduce to readers as “urbane, erudite, and charming”—his every easy reassurance about “comprehensive services” or “eliminates the craving” immediately challenged by the film’s powerful footage from the Dayton, Ohio clinic.

It isn’t entirely fair. Bourne came to SAODAP with a lot of a real-world treatment experience in Georgia, just as Jaffe had in Chicago and DuPont had in the District of Columbia. Nothing in Dayton would have surprised them in the least. Still, the film effectively undermines the “heroic” stories told by Massing and at the New Haven reunion—and most certainly puts lie to the idea that methadone somehow stood apart from the larger drug war. David Herzberg and others have started breaking down many of the classic binaries of drug history—“licit/illicit” “treatment/punishment” “medical/criminal”—and looking for a more interwoven and complex history. Methadone: An American Way of Dealing forces us to see methadone not as a challenge to the war on drugs, but fundamentally a part of it (an idea one finds in Kathleen Frydl’s indispendable The Drug Wars in America, 1940-1973).

Mical Raz has published a pretty definitive history along these lines in the Journal of Policy History, so I will simply note here that in Dayton, Ohio, we see no contradictions between methadone and the control of the addict population generally; rather, we see surveillance, drug-testing, a focus on criminality and a segregation of this kind of “treatment” into an isolated system of clinics. Near the end of her own outstanding article on methadone in the Social History of Alcohol and Drugs, Claire Clark considers the idea that “the treatment revolution was over before it started.” There’s not time enough here to fully explore this, but I think this film supports the idea that methadone in practice was never revolutionary and instead a foundational element of an expanded war on drugs in the United States.

That’s an interesting story. The film highlights another, more interesting still than its methadone policy critique—the collective “acts of persistence” on display in both the Dayton clinic and the DC therapeutic community. Acts of persistence, resistance, and social solidarity are somewhat easier to spot in the film’s sections on the DC drug-free group, since it is mostly told on their terms and using their language. Deliberately organized outside of the state’s regulatory apparatus (and therefore without its financial support), the group functions as a social network and mutual support in the face of an overwhelmingly hostile environment.

It isn’t perfect, and, as I have written before, social networks can carry both good and bad elements for participants. But it must be understood on its own terms by historians. The collective actions in Dayton are harder to spot because they’re mainly used as foils for critiquing federal policy, but they’re there. The clients may feel the counselling is bullshit, they may be deeply suspicious of methadone and its effects, but they’re there—traveling distances, disrupting daily lives, just to turn this treatment program to whatever useful end they could. For all the back and forth between historians, policy makers, men in ties, there’s that simple fact we need to reckon with—folks showed up in massive numbers to methadone clinics. That story—persistence, survival, life, death—is the story most interesting to me.


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