Author: David Frank People on methadone maintenance treatment (MMT) are in a difficult position. I should know since I’ve been on it for close to 20 years. They are caught in the space between a program that helps them in a way that is primarily pragmatic – by providing access to a safe and consistent supply of opioids outside of the difficult and dangerous conditions created by prohibition/criminalization – and our culture’s need to frame everything drug related through the ideological narrative of “addiction” and “recovery.” In short, MMT enables criminalized drug users to decriminalize thei ..read more

In Methadone: An American Way of Dealing, work is everywhere. Dayton, Ohio, the film’s primary location, is introduced to us as a “manufacturing community” beset by crime. These two types of work—factory and crime—come up again and again while we are in town. Straight work, at GM, or at a foundry, leads to getting high just to bear it, to “paint over the factory,” as one young worker puts it, and get through another soul-killing shift. Staying in the plant and getting by on methadone instead is tough. We meet only one worker doing this; he is trying to taper off and not making it, missing shif ..read more

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 o ..read more

I’ve watched Methadone: An American Way of Dealing five times now. Each time, I’m taken aback by how skillfully directors Julia Reichert and James Klein present this moment—a period of peak tension in the addiction treatment community. By 1974, when the film was released, the early promises of methadone were butting up, often painfully, against the era’s difficult realities. Through interviews with patients at the Dayton, Ohio, Bureau of Drug Abuse clinic (BUDA) at the center of the film, Reichert and Klein make it clear that methadone, once hailed as the solution to the decade’s twin problems ..read more

“To what extent can social problems be circumvented by reducing them to technological problems? Can we identify quick technological fixes for profound and almost infinitely complicated social problems, fixes that are within the grasp of modern technology and which would either eliminate the original social problem without requiring a change in the individual’s social attitudes or would alter the problem as to make its resolution more feasible?” Dorothy Nelkin asked the questions above in her  slim volume, Methadone Maintenance: A Technological Fix (New York: George Braziller, 1973), whe ..read more

Welcome to the home page for the Points Methadone Marathon! January marks ten years since the launch of the Points blog, and to celebrate this historic milestone, we’re invoking another, larger anniversary: passage of The Drug Abuse Office and Treatment Act of 1972 (Public Law 92-255). The ramifications of this law were far-reaching, not only in the “war on drugs” but also in the less-scrutinized evolution of substance abuse treatment. Methadone was the place where theorists of criminal justice and treatment met and—briefly—danced. In the shadow of the radical critiques both had suffered durin ..read more

January 6, 2021: Smoke ‘Em If You Got ‘Em. Image Source: Ayamann Ismail, “What I Saw Inside the Capitol Riot,” Slate, Jan. 7, 2021. Editor’s Note: Founding Points Co-Editor Trysh Travis wraps up 2021 for us and gives a preview of what’s to come on Points in 2022. See you in the new year! As another Covid year closes out, Points readers may find themselves wondering whether a historical perspective on alcohol and drugs is really useful—or even possible, given the unprecedented nature of our lives right now. Maybe critique is overrated and use and abuse is where it’s at? While the editorial team ..read more

Among Facebook friends familiar with my work, dozens of conversations have started by their linking me to relevant pieces on, for example, the racial disparities of marijuana legalization, the therapeutic application of psychedelics, and, perhaps less pressing but no less appreciated, the varieties of ways our ancestors got high. As much as I try to stay up on my drug news, sometimes people scoop me. This most recently happened last month when I received an article with a fantastically understated title: “Groundbreaking Treatment could be the End of Cocaine Addiction.” It was certainly enough ..read more

Editors’ Note: Here’s the second of Michael Durfee’s reports from the recent ADHS conference.  Readers interested in more about Michael should consult his first post. Biomedicine and its Critics in Addiction On Saturday, Caroline Acker spun the tale of methadone’s multiplicity.  Acker presented a case for the five lives of methadone:  First, as a powerful German analgesic and replacement for morphine.  Second, as a detox drug in the Lexington Narcotic Hospital.  Third, as a maintenance drug intended to treat what doctors believed to be the metabolic disease of addictio ..read more