Soldiers, Hippies and Richard Nixon – An American History of Methadone
In the 1950s, the U.S. government’s response to heroin addiction was based on law and order. Treatment services available at the time rarely worked (with an estimated 70 to 90 percent of “treated” heroin addicts returning to drug use), which is not surprising considering that the most common treatment response to heroin addiction was civil confinement, essentially time spent in a prison cell while going through detox.
Over the ensuing decades, three forces led to the creation of methadone maintenance as a new and better way to handle opiate addiction, and America would soon start looking at heroin addiction as a medical problem that demanded treatment, as well as public menace demanding suppression.
The following three social forces/occurrences that changed public perception of heroin addiction treatment:
- Escalating drug use during the 1960s and 1970s.
- Vietnam War soldiers returning home with heroin addictions.
- The discovery of methadone as an effective treatment for opiate addiction.
Changing Times and Vietnam Heroin
The counterculture revolution embraced by the hippies and those around them led to a proliferation of drug experimentation and addiction — so much so that by the 1970s Americans were very concerned about the domestic drug problem. A Gallup poll issued in 1971 revealed that Americans of that era saw drugs and drug addiction as the third most serious threat to the nation.
Headlines from Vietnam stoked public fears. A New York Times front page headline from 1971 screamed “G.I. Heroin Addiction Epidemic in Vietnam,” and media covered the problem in detail and in depth. This coverage of addiction within the military featured fearful imagery such as a photo of a syringe through a helmet.
As a result, many Americans worried about what would happen when American soldiers who were addicted to $5-a-day heroin in Vietnam returned home to a daily habit that would cost $100 or more.
Estimates published in the New York Times during the 1970s put heroin use among American troops in Vietnam at between 10 and 25 percent of military personnel who were stationed in Southeast Asia.
‘Public Enemy Number One’
President Richard Nixon reportedly worried about the influx of addicted soldiers returning to the United States. A congressional report on the overseas heroin addiction problem (from Congressmen Robert Steele and Morgan Murphy) warned of a coming domestic epidemic of crime and addiction.
In a speech in 1971, Nixon called drug addiction “public enemy number one.”
In response to pressures of escalating drug use, the real problem of returning addicted soldiers and the availability of a treatment that seemed to work, President Nixon shifted federal government policy on opiate addiction away from its strictly punitive philosophy. In 1971, Nixon ordered the creation of the first federalprogram for methadone treatment of opiate addiction.
Although Nixon recognized the need for treatment as a solution to the “heroin epidemic,” he retained strong law and order sensibilities. Along with establishing federal heroin addiction treatment programs, Nixon also called for increased enforcement and penalties for drug offenders.
German scientists first synthesized methadone during World War II (when morphine was in short supply) for use as a pain reliever by German troops. After high dosage testing led to adverse drug effects, the German military abandoned the idea of using methadone, thus failing to realize the drug’s full potential.
After the war, the Americans came into control of the medication, which the American pharmaceutical company Eli-Lilly began manufacturing under the brand name Dolophine in 1947.
By the 1950s, American doctors were using methadone for the treatment of opioid dependence, but doctors still poorly understood how best to use this new medication for addiction treatment. In the 1960s, Vincent Dole, M.D., of Rockefeller University, won a New York City Health Research Council Grant to study heroin addiction treatments. It was Dole who eventually developed the modern methadone protocol of a single daily dose.
Dole experimented with a variety of opioids for addiction treatment, giving different medications to heavy heroin users access and observing their reactions. When heroin users took high doses of methadone, Dole noted a startling transformation: Addicts were no longer obsessed with getting and taking drugs.
By 1971, Dole’s methadone treatment program was in use by 25,000 opiate addicts. But by 1973, controversy over the medication program (which critics dismissed as just switching one addiction for another) led to strict government controls over the prescription and use of methadone – controls that exist to this day.
Today, about a half million people are participating in methadone maintenance treatment programs — but methadone remains controversial in some circles.
Advocates of a harm reduction approach to heroin addiction point to methadone’s impressive track record and to countless improved lives as evidence of its merits. Methadone critics still consider the treatment another form of addiction, and still favor abstinence based treatments for opiate addiction.
No form of addiction treatment has proved to be as effective as methadone maintenance in keeping people in treatment and away from opiate abuse.