NO PARTIES PLEASE-A Subdued “Happy Birthday” To Methadone
Wednesday, June 6th, 2012By Mark Elliot - What would happen if we won the war on drugs?
What if we could deal successfully with the problems of addiction with treatment and see the tangible evidence of success in lower crime rates?
We only need to look at Washington D.C. in 1972 to have a sense of might have been. You wouldn’t necessarily connect Richard Nixon and drug-legalization, but the biggest advance in drug treatment, the legalization of the opiate drug, methadone, for use as a “maintenance medicine” in treating heroin addiction, began during his term of office.
This month, a new opiate, buprenorphine, for treating heroin addiction has been introduced with a lot of fanfare. And still, no one has said “Happy Thirtieth Birthday” to methadone. Even the man responsible for methadone’s legalization in 1972, Dr. Robert Dupont, told PBS Frontline: “Methadone was just horrible from a political point of view, just a total disaster. It was an orphan from beginning to end, and it is today.”
Before Ecstasy, crack cocaine, LSD, or even pot were common, the scourge of heroin was the nightmare.
Heroin held inner cities captive and desperate and this resulted in criminal activity.
It was in the late 60s when Dupont ran studies on prison inmates in Washington D.C. that revealed the link between heroin and crime. With urine cups in hand, he and a team of young researchers tested prisoners for one month and found that 44% tested positive for heroin. As Dupont recollected, “Nixon had promised to do something about rising crime rates and the most embarrassing thing of all was the rate of crime in Washington D.C.” By introducing a methadone treatment program, Dupont was able to treat the addicts and D.C. crime rates dropped a whopping 50% - enough to get him the attention of the White House, and the appointment as U.S. Drug Czar. Nixon told Dupont that he would back him on anything promising if he didn’t try to legalize marijuana.
“I didn’t come out in favor of marijuana,” Dupont said. “I legalized methadone.”
According to Dupont: “The search for medicines to treat addictions for the most part has not been very helpful. If the alternatives are active heroin addiction and criminal behavior versus getting methadone or buprenorphine from a clinic, I think the answer is very clearly that methadone or buprenorphine is better.
I’d like to think that the alternative should be to be drug free, but the question is: How realistic is that for a lot of heroin addicts?” So was the introduction of methadone treatment valuable? “I think it was a good thing.
It’s hard to imagine today that in 1970 ‘the drug problem’ was ‘the heroin problem.’”
That’s not the case today because so many other drugs have become as big or even bigger problems, but in 1970 ‘addiction’ meant ‘heroin addiction.’ “Initially the drug problem was approached entirely as a law enforcement problem and it was in the Nixon administration that for the first time a presidential administration made a significant commitment to treatment…”
Dupont continued: “I don’t think Nixon was particularly drawn to the idea of methadone or treatment at all. The issue was that he was the president at that time when the country was facing the epidemic of heroin addiction, and the right thing to do was to add treatment as a major component of his program. And he did that even though that didn’t fit with his politics.”
Dupont added, however, that “there are problems with methadone which I don’t think were obvious to anybody at the time.” One had to do with diversion of methadone to the streets where it is also a drug of abuse. Also, overdose deaths. “So, methadone became a major contributor to overdose deaths on the streets, which I certainly did not foresee at the beginning.”
Dupont noted that drug diversion from legitimate use is a huge problem today. “I think it’s also going to be a problem with buprenorphine.”
So what happened to the massive crime reduction in Washington with the introduction of methadone?
“That’s the sad story of what happens when you succeed,” said Dupont. In short, people walked away from what had been accomplished and the crime rate rose.
“I’ve had some thoughts since then that when you are successful in this field, it’s almost worse than when you fail, because when you are successful nobody cares about it anymore.”
