Tonight from Boston, coast-to-coast and in color,
"The Advocates." Lisle Baker; guest advocate, William Bailey; the moderator,
Victor Palmieri, and the man faced with a choice, the Honorable Kevin White,
mayor of Boston.
Good evening. Every Sunday at
this time, "The Advocates" looks at an important public problem in terms of
a practical choice. And tonight the problem is drug addiction. The practical
choice is this: "Should your city pro-vice methadone to heroin addicts upon
their request?" Advocate Lisle Baker says, yes.
Mayor White, the issue tonight is whether our general fear of narcotic drugs
will keep us from distinguishing the illegitimate, dangerous abuse of one
drug from the use of another drug to help fight the problem. Now, our cities
and your city have it within your power to do something about the terrible
scourge of heroin addiction, and what you can do is support methadone
maintenance treatment centers. The question is whether our fear of the word
drug will keep you and will keep other cities from seizing that
With me tonight to convince you that a
properly run program of methadone maintenance can restore many addicts to
useful lives in the community is Dr. Jerome Jaffe. Dr. Jaffe is associate
professor of psychiatry at the University of Chicago in Illinois and head of
the drug abuse division of the Illinois department of mental health. Dr.
Jaffe is one of the country's leading experts on the treatment of heroin
Also with me is Mr. Pleasant Harris,
administrative assistant in the methadone maintenance program at Bronx
State- Hospital in New York. Mr. Harris will tell you how methadone
maintenance helped him deal successfully with 17 years of heroin
Our guest advocate, William Bailey
Mayor White, I'm glad that Mr., Baker
said "a properly run program" because I want you to focus your attention on
the specific proposal before us tonight. You see, this proposal would let
all addicts of all ages and all temperaments go on an indefinite methadone
maintenance program. Not at all tied to this program is any rehabilitative
program whatsoever. And also they're not required to demonstrate before they
get into this methadone maintenance that they've tried something else, that
they've tried to become drug-free and failed.
with me tonight, Mayor White, I have Dr. Karl Deissler. Dr. Deissler is a
private physician from Oakland, California and has long personal experience
in working with drug addiction and for the past four years; Dr. Deissler has
been the national medical director of the Synanon Foundation. Dr. Deissler
will tell you, Mayor White, why he feels that drug-free existence is a goal
that's within reach of every drug addict.
witness will be Mr. Gene Haislip. Mr. Haislip is the special assistant to
the deputy director of the Federal Bureau of Narcotics and Dangerous Drugs.
Later on Mr. Haislip is going to tell us what the federal government's
position is on methadone maintenance.
you, gentlemen. Now, let's take a look at the record about heroin.
Heroin. One of the most addictive narcotics on
the books and for our country an increasingly deadly problem. For an addict
it's a precious, expensive drug — precious because he lives from one fix to
the next; expensive because he has to buy it illegally at ever increasing
prices and in larger and larger doses, often $100 worth a day. To raise that
money the addict turns to robbery, theft, prostitution and/or drug peddling.
For his $100 the addict must steal and pawn about $500 worth of goods and
the longer he uses heroin, the more he needs every day. And each day the
odds against him increase.
Hepatitis from dirty
needles or a heroin overdose may kill him or he may end up in jail. Deprived
of his drugs, the addict cannot escape the torture of withdrawal. (Sounds of
a person in withdrawal) When his body has finally adjusted to the lack of
the drug, he's free technically of his addiction. But the odds are better
than 9-1 that soon he'll be right back under the needle. Almost any addict
will swear he wants to kick his habit. Most have tried to do it. Most of
them don't make it.
There are an estimated
2-300,000 addicts in this country and their number grows each day,
particularly among teenagers. Heroin addiction is a major source of crime,
now costing all of us over one billion dollars per year. Police admit
they've been unable to solve the problem or even stop its growth. But the
addicts themselves can be reached.
attempts to end addiction through withdrawal and psychotherapy have been
successful but for only a tiny percentage of the addict population. Now
attention is focusing on methadone, a synthetic narcotic. Given to the
addict every day in orange juice, this inexpensive drug blocks the hunger
for heroin as well as its effects allowing the addict to return to a more
normal life. Methadone, however, is just as addictive as heroin. Little is
known about its long-term effects or about the possibility of freeing
addicts from their dependence on methadone itself.
Well, gentlemen, before we begin I'm going to ask Mr.
Baker to clarify his proposal.
what we propose tonight is a program of methadone maintenance. That means —
like you saw on the statement of facts — giving hard-core heroin addicts a
dose of methadone in a glass of orange juice or tang or some other similar
drink every day. That dose will help them fight their drug problem. We
advocate that if necessary you give them a dose every day for an indefinite
term of time. We also advocate that you make it available to all addicts who
Well, Mr. Bailey, tell us now
exactly where you disagree.
Mayor White, we’re
opposed to this program for two specific reasons. Number one, we say
methadone maintenance alone is not enough. Unless you tie it to some
rehabilitative social program you are not going to accomplish curing the
drug addict's problem. Therefore, we say that must be a necessary goal
written into any program. Now, secondly, you're going to hear the federal
government position is, methadone is still classed as an experimental drug.
Therefore, we say if you use it, use it with great caution and only as a
Well, our guest tonight is the
Honorable Kevin White, the mayor of Boston. Mayor, I know like all big city
mayors that you must be very concerned about drug abuse problems and I think
our audience would like to know what you're doing about it in
Well, Vic, I don't think anyone in a
public or private capacity can afford to be complaisant about the issue. I
mean drug abuse is without question one of the most important problems in
our society today, and it affects not only the big city but the small town
as well. In Boston, we've tried to respond to it with a program called
Operation Turn-Off, and Turn-Off has four major components. What we've tried
to provide is comprehensive treatment centers, new educational programs,
intensifying law enforcement and what we call neighborhood coordinated
councils between parents and teenagers.
tonight's question is a fundamental one and I look forward to hearing the
respective arguments of counsel. I think only by understanding the degree of
this problem and the proper response to it are we going to be able to at
least curb what is adequately described as a cancer in our society
And methadone clinics are part of your
plan, isn't that right?
Part of the program
that we're putting forth is concerned with methadone treatment.
Okay, let's start now to go to the cases. Mr. Baker,
Mayor White, heroin addiction is a
national scourge. It wrecks the lives of the users and it destroys
individuals who are average citizens who are set upon by addicts who commit
crime to support their habit. Now, cities have within their power a means to
deal with this problem and help many of the addicts who prey upon you who
watch this program. That's methadone maintenance treatment centers and to
show you how one of these centers works...
...call him Dave. He lives in Elbaria, Spanish Harlem. Dave started
using heroin when he was 13. He was addicted for 7 years. It cost him $80 a
day to support his habit. He got the money by pimping, mugging and stealing
and he himself has been stabbed and shot. But now Dave is clean. He's been
clean for a year. The reason is a drug called methadone.
This is a methadone clinic. Every day Dave comes here to get
his medication as do about 100 other former heroin addicts. The procedure is
simple. He leaves a urine sample which is tested for the presence of other
drugs in his system. Then he gets his medication — a prescribed dose which
he drinks in a glass of orangeade. That's all there is to it. The busiest
hour at the clinic is lunch hour because most of these former addicts are
now working or like Dave, in school again. What has methadone meant to Dave?
These are his words.
Methadone is what
helped me out, what really got me together again. Don't get me wrong. I’m
not trying to say that methadone is the answer for all your problems. That's
not true. Methadone just takes care of your drug problem. The other problems
you have to take care of yourself. I don't think it's the best thing they
have to cure an addict but at the present time it is.
Mayor White, despite what critics of the
program will say, it's important to recognize there is a distinction between
heroin addiction and methadone maintenance. Heroin addicts alternate between
a sick feeling or drug hunger and a high or euphoria which he gets after he
gets a fix. And these fixes only last from 4 to 6 hours so he's got to go
out and get another fix three or four times a day. So he swings up and down
and up and down and he spends almost no time in this zone of normal
Now, methadone maintenance given to him
in stabilizing doses in a glass of orange juice or tang, do away with this
sick feeling or drug hunger. It's medicine to solve this problem and in
large doses it can black any high or euphoria if an addict decides he wants
to go ahead and shoot it up, some heroin. And so in effect you've made it
impossible for him to move outside this zone of normal feeling and he can
begin to act and feel and be just like you and me through methadone
Now, I'd like to call one of the
country's leading experts on this program, Dr. Jerome Jaffe, to the stand.
Dr. Jaffe is associate professor of psychiatry at the University of Chicago
and head of the drug abuse program for the state of Illinois.
Welcome, Dr. Jaffe.
Jaffe, many of the people are afraid of using one drug to fight another
drug. Can you help us out on that?
think that the problem is in the way it's expressed. Medicine has for a long
time used drugs to fight problems. In this instance, we're using a drug to
fight a human feeling, a compulsion to seek out heroin. We have for a long
time accepted the idea of using medication to fight anxiety, to fight
depression and if we could, I think most of us would be willing to find a
medicine that would be used to fight the compulsion to smoke cigarettes. We
don't have such a medicine right now, but I would have no hesitation in
using it if it were a safe medication for people who wanted to discontinue
And methadone is safe for
We can find no long-term toxic effects of
orally administered methadone as it's used in well regulated
How well does methadone work compared
to other forms of treatment like abstinence or therapy?
Without question for the overwhelming majority of long
term, chronic heroin users in urban areas methadone maintenance is the most
acceptable form of treatment and for those people who stay in it — and most
of them do — the rate of gainful employment more than doubles and the arrest
rate drops from anywhere from 1/5 to 1/10 to what it was prior to their
entering treatment. So I would say that it's quite successful as compared to
other treatment programs.
Mr. Bailey advocates
for instance that you require an addict to have failed in some other program
before you give him methadone. What do you think of that?
Well, we've explored that in a very specific, controlled
way and what we've found is that we can give methadone to people even if
they haven't been long term users and at some point transfer them into
programs in which absence is the goal. So we have found it is not necessary
to insist that somebody die of an overdose or spend time going in and out of
jails or treatment programs that they're not ready for before we're ready to
provide them with methadone.
Dr. Jaffe, if I might ask a few questions
here. You use the words "safe" and "long range" and Mr. Baker in his opening
presentation said on that chart that there was a distinction between heroin
and methadone. Aren't there some frightening similarities, and by that I
mean, isn't there at least some evidence that there can be physical damage
to the use or withdrawal of methadone? And secondly, doesn't methadone have
at least a chance of leading to the use of other drugs in the course of
Well, I think first of all we
have to recognize that we're dealing with a potentially lethal disease call
it addiction. The death rate is high; the complication rate is high. I think
compared to that, methadone has few complications.
Is it similar to pharmacological agents classified as
It's classified as narcotic drug,
and it produces a form of physical dependence. This is inconsequential in
comparison to the disease under treatment. So that most of us look at this
and weigh it and find no difficulty in accepting this as effective
Do you mean the words dependence and
damage to be synonymous?
Let's hear from Mr. Bailey on
Dr. Jaffe, before I begin I
just want to state that I think everyone who's concerned with the heroin
addiction problem has great admiration for the work that you've been doing
in Chicago and even previously. In fact, in preparation for this evening I
did my research, and I found quite a number of informative articles written
by you, so I'd like to refer to some of your previous statements and ask you
about your present opinions. Doctor, for example, is it your position today
that given the wide differences between drug addicts and their
personalities, do you believe that it would be irrational to establish large
scale programs using only one specific kind of treatment approach?
Yes, I do think that would be irrational. The issue is
not — as I understand it ~ whether or not there should be only methadone but
whether there should be well-regulated methadone clinics. Obviously, I
advocate a wide range of opportunities so that methadone is not the only
treatment available. However, I think it's essential at least in large urban
areas it be one element in the spectrum of services made available to
which would include therapeutic
. . . Confrontations…
. . .
and a possibility for withdrawal and after care . . .
. . . even Synanon-type situations?
We support them in Chicago.
In fact you expressed admiration for the Synanon and considered it a most
advantageous development in America at one point.
I haven't changed that.
All right. All
right. I'm just trying to understand your position, Doctor, because maybe
v/e are apart on the proposition tonight. The proposition is to give a
person methadone — he may submit a urine, he may have to be above a certain
age but that's all he has to do — come in, submit a urine, get his methadone
and leave. No tie-in of any kind of program whatsoever. No requirement that
ultimately he would put into a therapeutic type situation.
It wasn't my understanding that that was the proposition.
To me, at least, a good methadone clinic provides opportunities for
rehabilitation, staff for rehabilitation and it's usually tied in to
programs which permit the drug user at some point to elect to move into
abstinence programs if he feels ready for that.
But isn't it true, Doctor Jaffe, isn't it true that in Chicago the results
were tested against a methadone program where no rehabilitation was included
and that the control group showed just about as good results as the group
where rehabilitative programs were part of it?
I don't think that would be accurate. We have tested a number of
possibilities including pure methadone with no other rehabilitation,
methadone with much rehabilitation. Methadone with rehabilitative efforts is
better than no rehabilitative efforts but without question providing
methadone to people as they come in from the street is better than denying
them access to any treatment whatsoever.
. . .
one thing I'd like to say . . .
... and right
now we don't have enough facilities available for people who elect
One thing I learned from you, Dr.
Jaffe, in one of your articles that it is a problem of drug addicts that
they constantly seek out the company of their own kind, other drug addicts.
And I found a statement that simply issuing methadone will not stop a person
from associating with other drug users, halt his anti-social behavior or
give him vocational skills or hope for a better life. And that to be
effective methadone must be a part of a broad program of social
rehabilitation. Now that's what I'm contending. Do you disagree with that
I think it has to be modified in
this way. That you can get a certain degree, a certain amoung of
amelioration of the syndrome with nothing but the medication but you can do
much, much more by tying it in with major rehabilitative programs. It's my
understanding that when we talk about a well-regulated methadone clinic that
it almost by definition includes efforts at rehabilitation.
So you would recommend to Mayor White of Boston that he
include some kind of rehabilitation program when he starts issuing
methadone. Is that correct?
If he can afford
Suppose you had to choose though? Suppose
you have to choose where you put your dollars?
If that is the case, then I'm afraid you get into a kind of a triage
in medicine, you know, who you're going to save if someone must die.
Methadone treatments turn out to be less expensive than other rehabilitative
efforts and if you must choose I think you'd get more rehabilitation, more
decrease in crime and more increase in vocational adaptation with methadone
programs than others. I ...
Dr. Jaffe, excuse
me, did you have a point? Go ahead.
meant to say I hope that we won't find ourselves in the position of having
to choose in that way.
I hope so, too. Thank
you very much for being on "The Advocates."
Mayor White, lest we seem to be
sliding together here, I think it's important to recognize that we don't say
that you shouldn't have available, if addicts want them other services. Mr.
Bailey's arguing that you should make those services a prerequisite for use
of methadone. We say it's important to get out and help these people now,
and if you can build the other services, that's fine. But you don't force
people to walk through a program they don't want, to get into methadone
which they do.
Now, I'd like to call on a man
whose had personal experience with both methadone treatment and heroin
addiction. He is Mr. Pleasant Harris who is assistant director, I'm sorry,
he's administrative assistant of the methadone treatment program at the
Bronx State Hospital in New York City.
Harris, we're glad to see you.
you're taking methadone now. Do you feel any euphoria or do you feel sedated
No, there is no high, no euphoria
involved with the taking of methadone. Possibly in the beginning with some
addicts there might be some sedate-ness, you might say, but this very
quickly wears off. Usually once the man's stabilized there is no feeling
whatsoever from his drinking his methadone.
That's right. You bring him up to a certain level and you hold him there for
a period of time.
Now, has methadone helped the drug hunger that you used
Well, that's its main function,
really, there are two things that it does. It eliminates the urge to use
drugs and if one does use heroin — and it's just the opiate based drugs that
methadone works for, or works on you might say — if one does use heroin, you
will not feel any effect from it, you see. It blocks the high of the
Now, some people charge that because
you are dependent, on methadone to take every day on methadone medication,
that you're a second class- citizen. How do you feel?
Well, I guess you have to include many people who are
diabetics, and those who are heart patients also as second class citizens.
There are many people who find it necessary to take a medication, you see,
and this is no different. The addict, he has been ill. And he is receiving
medication from a doctor. If anything it releases him from being a second
class citizen, you might say, as far as being a heroin addict and allows him
to function in a normal way as anyone else may be able to.
What about the emphasis on being drug free. This is a
great sort of pie in the sky idea that somehow if you're drug free you're
different or a better human being than you are, for instance, who take
methadone every day.
Well, that's the so-called
Utopia, you might say, that so many of us are looking for, but it's rather
unrealistic when you consider that his man has been addicted for quite a few
years and it might be possible that he might need a drug to function
correctly for the rest of his life but there would be many who would not
need the drug for the rest of their lives. But the main thing is this, that
the man is able to function and function correctly, you see, and we can't
get away from that fact.
Let's hear from Mr.
I want to correct one misconception
first, Mr. Baker made a point. I don't want to force people under any
program even on methadone maintenance but I do want to make sure that they
can't succeed at going clean before I'll give them methadone for
Mr. Harris, I do want to say that I think
you're a very dramatic testimony to a successful methadone maintenance
program at least for some addicts. And you're one of those I'd like to if I
may, just ask you a few questions about your own background to establish the
parameters of that proposition. Mr. Harris, would you mind telling us how
long you took heroin before you went on methadone maintenance?
Over a period of 17 years.
How about how regularly?
Every single day?
Were you arrested during this
Not too often fortunately.
or three times.
Only about two or three times
in 15 years.
Seventeen years? And did you ever come off heroin for a
period of time?
Many times you came off?
You were clean for a period of
For about a day or two.
Only a day or so.
Did you ever go to a hospital and
And for how long would you be off heroin after
The same day I left the hospital,
You'd go right back to it.
So you tried
to get off. Now, would you say it's fair to say about your background that
there were times during that seventeen year experience when you had
tremendous motivation, you told yourself I'm going to be free of drugs. Did
that happen to you?
Of course it did. It
happened every time I wanted to stop using drugs.
But it didn't succeed. You went right back.
There's more to it than that.
But you went
back, isn't that right?
Right. But this is
towards the individual now who might have the so-called will power or the
motivation to stop using drugs does not necessarily mean that he is going to
stop, you see. And this is where methadone plays a very important
I only want to ask you about that one
did have, make an effort to get off and didn't succeed.
Harris, did you ever go to a therapeutic community or any kind of
... no, because I felt that
the therapeutic community was to some extent an affront to my
So you never tried that.
I didn't think it would work for me and I had never
known it to work for any of my friends.
right. So that you've never gone to a therapeutic community and you've not
succeeded at coming off heroin after 17 years. And during that 17 years
period, Mr. Harris, did you get married?
Do you have a family?
Do you have a
He's nine years old
Nine years old. So you had very
substantial motivation to at least get away from heroin, didn't you, when
you went onto methadone? You had to take care of a family...
Well, I was married for eight years when I was
But when you finally did come off,
was that one of your principal motivations?
So you had that working for
Well, I was seeking help. I was
seeking help, and I found it through methadone maintenance...
To get back to your son, Mr. Harris, I'm sorry for
... that's quite all
With regard to your son, if your son
came to you in the future and said,
caught up in heroin, I think I may even be an addict," before you let him go
on methadone maintenance, wouldn't you want him to at least try one other
program to go back and be completely clean?
Let's put it this way, sir. If it were possible for him to remain drug free
going through a therapeutic community program, fine.
You'd let him try it anyway?
I would let him definitely try it.
Wouldn't you want him to try it, though?
Here's the thing, though. I have seen so many youngsters who have tried it
this way especially when they've gone through a detoxification program. And
the same day they came out of the hospital, they've taken overdoses and
died. Possibly if this person had been placed on methadone, he would not
have died, you see. And I would be more concerned about my son's life rather
than the means in which he would attempt to come off the drugs.
Mr. Harris, let's let the mayor wrap this one
Well, I just wanted to ask one question.
Now that you're on methadone, has it aborted or has it stopped your own
personal desire for therapeutic help?
Well, I was one of the fortunate ones you might say due to the extent that
once I came on methadone — and I happened to have a job and when I did come
onto methadone — I was able to more or less continue, you see, without any
need of group therapy or psychiatric help or what have you.
Okay, Mr. Baker you wrap it up for yourself.
Thank you, Mr. Harris, we appreciate your being here.
Mayor White, heroin addiction and crime are highly intertwined. Heroin
addiction accounts for half of the major crimes in New York City and
Washington, D.C. and almost 40 percent of the major crime in your own city
of Boston. This year heroin addiction will cost citizens of New York City
one half a billion dollars in stolen goods. New York has already treated
2,000 addicts on the methadone maintenance program. Columbia University made
an evaluation of that program, and it found that it saved the city
45,000,000 dollars in thefts for 2,000 addicts, not to mention all the
hospital costs, the welfare costs, the jail costs, the taxes that these
people pay cause they're not employed and it cost $250,000 for the city and
many methadone maintenance programs are self-supporting because the
ex-addicts pay for it themselves. A properly run methadone maintenance
program can do more for law and order than almost any similar expenditure of
public funds today. Now not all addicts support themselves by crime and
The Mayor has a question, so I'm
I think this is an
important point because you said that the program could do more for law and
order. It seems it's very difficult for me to distinguish the course that
you advocate I think from one that was advocated recently in our injection
into Cambodia. One is on military grounds. Yours seems to be on economic
grounds. They both seem to dismiss the moral grounds to the individual
Well, Mayor, if I may...
Can you draw the distinction for me?
Yes, I can. I think that Mr. Harris has told you that
it's immoral to let addicts go out on the streets and die from overdoses.
It's immoral to have them set upon citizens in your town and beat them over
the head and steal their money. That the morality is helping these people
solve their problem and not in saying, let's make them go through something
else. Just one other point about crime. Many heroin addicts sell dope to
make their enough money to handle their own addiction. Now, if you use
methadone maintenance program, you will reduce the number of addicts who
have to push dope to maintain their habit. This moans there're less people
out there selling dope to your kids. Now methadone is a cure it's not a
...I can't let you take the rest
of the program for this closing speech. Very well done, but I want to hear
from Mr. Bailey with his side of the case.
Incidentally, I read that same study of the Columbia University and I'd just
like to point out a couple of things on the other side, if I may, Your
Honor. For example, the average median age of the person enrolled in the
program was a little over 33 years. And it v/as also stated in the study
that it was emphasized the need for careful selection of addicts for a
methadone program. Dr. Henry Brill, Mayor White, just came to Boston at your
request on a seminar that was run in Samuel Hall and I was there when he
said, by no means the majority of drug addicts would find an answer in
long-term methadone maintenance. I want to focus on the specific issue
before you, Mayor White. We aren't against methadone. We are against it's
issuance before other efforts have failed and we're also against not at
least tying in at least some social rehabilitative program if you give it
out. Now as my first witness I'd like to call to the stand Dr. Karl
Deissler, the national medical director of the Synanon Foundation.
Welcome, Dr. Deissler.
Deissler, is a drug free existence a reasonable alternative for drug
Indeed it is. 1,600 people live drug
free in Synanon today.
Well, now, Doctor, are
you therefore saying that Synanon or any one kind of program is the only
Well, Doctor, coming back as I have constantly to this
proposal tonight, this would permit a heroin addict to go on an indefinite
methadone maintenance program without tying in any kind of social,
rehabilitation program. What is your opinion of that proposal?
That's the way I understood the proposal and if it were
accepted in this form it would produce a personal disaster for the recipient
and a social disaster for the community.
you explain that please?
Contrary to Mr.
Baker's statement, every addict you put on methadone liberates X units of
heroin, of course. And the heroin which the methadone man no longer needs
will go into community. I assure you. It will change the situation from a
seller's market into a buyer's market and if the Mafia finds competition
through methadone, they really will push.
about the individual that gets into this program?
In my opinion it deprives the majority of human beings who get on
methadone of any motivation to do anything else, and they carry on the same
social inhuman problems with them they had before. They're just as lonely,
just as alienated, just as miserable, just as sick in some way as they were
before. And the statement that the methadone program solves crime is
fallacious. 20 percent of those on methadone use other drugs which in their
effect are escalated beyond what they would do without the methadone basis.
Alcohol is twice as bad for a methadone man as it is otherwise.
Mr. Bailey, let's get into that first film of yours
Yes. Mayor White and Dr. Deissler,
recently we went to New York City, and we interviewed 24 ex-addicts. And we
asked them specifically, "what do you think of the proposal in terms of this
methadone maintenance?" I'd now like you to see what they had to
I don't think anybody that's
using methadone is any more of a well-adjusted or well-functioning human
being than a person who is using heroin.
It's really just a substitute, just another dependency.
I wouldn't want to do it because I'd be the same
person. I'd have the same problems that I had when I used drugs. I'd only be
covering them up. I'd still be the same unhappy person, only on methadone
instead of on heroin.
It's the dependency
that's created by methadone. A person has to have it. It's just feeling of
having to have methadone that puts me against it.
I wouldn't want it for myself, and I wouldn't want it for nobody
To me it was like using another form
To me it's just like being in
a shell just as if I was putting heroin in my arm.
While I was being maintained on methadone, as I say
I had the old similar interests that of the general drug world, the mystique
surrounding drug addiction and the whole scene.
Methadone didn't work for me because even though it helped me clean
up, get off my habit, the main thing that it didn't do was it didn't take
away any of the problems of why I started to use heroin and try and block
out the world to begin with.
I think this
is a great shortcoming of a methadone maintenance program is that again
they're just treating the symptom. The public is ready to seize upon it as a
panacea that is going to sort of cure all the ills of drug addiction.
Dr. Deissler, I'd like to ask you
just one final question. What do you see as the potential impact on young
people — young people like in those films — if tonight's proposal were put
As I said, I think it would be
disastrous. It will lead to the notion they'd it is safe to experiment with
heroin because if you get into trouble you always can go on methadone.
Number two, you really willing to contemplate the possibility that the
Vietnam returned veterans who are addicted — some of whom are addicted—will
be offered methadone as the only solution for their problems which is what
this proposition poses? Are you willing to put 14, 15, 16, 17 year old
youngsters on methadone for life? Are you prepared to abandon a whole
generation of youngsters who get caught up in the drug scene by putting them
on methadone despite the fact that they are well known to be multiple drug
abusers? That proposition to me seems to be preposterous and as the Mayor so
beautifully said, it is immoral in it's consequences and
Let's hear from Mr. Baker now on
Dr. Deissler, you said so
many outrageous things, I just don't know where to begin. Let's take one of
them right at the top.
Oh, wait a minute
In the first place you said that if we
dried up the heroin market, the Mafia would go out and push. Assuming that
...dried up the heroin
I-said nothing of the kind.
You said that
if methadone were introduced that the Mafia deprived of the methadone users
as a source of buying power, would go and really push.
Doesn't that seem logical?
That same thing is exactly true. If Synanon were any good. If Synanon were
really good, you would see send those addicts into the program, they would
come out clean, they wouldn't buy any heroin and the Mafia would push. Isn't
that patently absurd?
Is it much more so
because the ones who are in Synanon are permanently taken out of the drug
They stay in Synanon, however, don't
they? They don't go into the outside world any more...
No it's not true.
Let me ask you another
question. You said, for instance, that young — people the people who come
back from Vietnam —- we're not advocating, for instance that you exclude any
other form of treatment.
That isn't what your
proposition tells us.
No, our proposition is
make methadone available to all addicts who request it for an indefinite
period. That does not say that you cannot take any other program and use it,
does it? That you're just saying addicts are locked in a cage of
And there are many doors out and one of these is
methadone maintenance. And we're saying, let's open that door. Now what's
wrong with that?
I say do not do it because it
is an experimental approach; It isn’t proven. We do not know what the social
consequences will be. It is immoral in the concept of the Mayor, and I think
it should be the last thing to try. It should be the product of the council
of desperation. It should be the last resort. Everything else should be
Doctor, isn’t it true, though,
that the other program that they had in the past before methadone were not
very good in terms of returning these addicts to society at least socially
acceptable. And before we methadone, isn't that true?
May I ask you what programs you refer to?
Well, Synanon, one in terms of significant
The numbers are what they are and far
below what they should be because this most worthwhile experiment has not
found the public support which we are apparently trying to waste on
But isn't it true that methadone
has turned large numbers of addicts back into society at least as being
socially acceptable for a start?
I doubt that
the total number is substantially larger than what Synanon has done,
Go on, Mr. Baker.
Doctor, you know that there are at least two theories of
heroin addiction. There's a theory that part of heroin addiction is
psychological in origin, that there are individuals who have hang ups and
they take heroin to escape from those hang ups. Now, Drs. Nole and
Neiswander who have done a considerable amount of research with methadone
posit that heroin addiction is in effect a metabolic change in the human
chemistry and that you have to do something about the change in metabolism.
Now, assuming their theory is right, doesn't methadone maintenance offer a
chemical means of solving a chemical problem?
There is no reason whatsoever to assume that their assumption is right. The
very simple refutation is that apparently Synanon has 1,600 people who are
distinguished by the fact that they do not share this metabolic disorder.
Isn't that strange?
Isn't it strange . .
Doctor, Mr. Baker. Mr. Bailey has a second
film which he's going to show. Dr. Deissler, I thank you very much for being
on "The Advocates."
Mayor White, Dr. Deissler
told you that he does feel that at least some effort towards a drug-free
existence should be made and that it is a realistic goal for most addicts.
While we were in New York, we asked the same people you saw before what it
felt like to lead a drug-free existence and I'd like you to hear what they
had to say on that question.
always thought it was a mystery to stay clean but it's not. It's just a
matter of facing reality, facing the realities of life and
I think there is no choice. If
you are going to clean up from drugs, you've got to do it
Yes, I believe for the majority
of drug addicts, yes, that they can make it; they can live without using
Since I've been clean now for seven
years, I can definitely say that there is no comparison between being
maintained on methadone and being clean from the use of drugs.
How does it feel to be clean. That's a question that
I find very difficult to answer. I feel good. I feel great. It's wonderful
to wake up in the morning and not have to worry about hustling money for
drugs. It's wonderful to wake up in the morning and not have to worry about
getting a hit. It's wonderful to be happy again.
I can just be myself, be accepted as myself and get good feelings
from myself without any outside chemical or alcohol or anything.
I'm beginning to like myself now which is a new
Emotionally, I'm a human being
again. I can feel the changes around me. The whole world is out there for
everybody. I'm meeting people that — people, people that have nothing to do
with drugs; people that are sort of like, you know, people that have some
interests in life that are pretty interesting that are groovy and I'm
looking forward to this.
no comparison whatsoever between somebody being maintained on some kind of
drug and somebody that's leading a drug-free, learning kind of
At this time I'd like to call to the stand
Mr. Gene Haislip, special assistant to the deputy director of the Federal
Bureau of Narcotics.
Mr. Haislip, has the federal government found it necessary to undertake
a study of methadone and methadone maintenance programs?
Yes, we have. We've been concerned over this for several
reasons. First, there is a growing illicit traffic in methadone itself, and
secondly methadone programs have been increasing and we are interested to
see that these are operated in a fashion which will not injure the community
and create additional problems.
Haislip, referring once again to tonight's specific proposal. What do you
see are the dangers, first in terms of the individual who's put into that
kind of a program?
Well, as the proposal is
stated there are several dangers we have to consider. First of all, of
course, methadone, itself is a highly addicting drug. In fact, when you
consider that most of the heroin available in cities has been greatly
diluted through the cutting process, the addiction to methadone may be well
in excess of that which is customary on the street. One of the dangers that
we run is making methadone addicts out of people -- particularly young
people — who may be only peripherally involved with experimentation with
narcotic drugs. Second danger, we cut off all possibilities of an early cure
in return of individuals to a drug-free existence unless we assure ourselves
that far less radical and presently accepted techniques have been first used
to see if this can be accomplished.
you touched on just a second ago. What do you see are the potential dangers
in terms of the illicit drug traffic in this country?
Well, there are several. Unless such programs are
accompanied by strong therapeutic efforts to change the addict's entire life
pattern, several things can happen. First, we may only succeed in driving up
the cost of the heroin habit that he currently has because we know that if
he can acquire sufficiently large doses of heroin in the illicit traffic he
can still obtain his euphoria. Secondly, we may drive him into other forms
of drug abuse which are completely unaffected by the methadone — the abuse
of cocaine, meth amphetamine, barbiturates. All of these drugs are
completely without effect. So these are two important reasons.
Finally, Mr. Haislip . . .
Let's go to Mr. Baker now. Mr. Bailey, I want to interrupt and see what Mr.
Baker has waiting on cross-examination.
can get untangled from this snake cord over here, I'll ask you a few
questions. Now, Mr. Haislip, you pointed out several dangers and .one of the
dangers of being on this program is microphone cord. But anyway, you said
that methadone itself is highly addictive. We don't dispute that, but let's
make a distinction, shall vie? You said there's a danger of people becoming
methadone addicts on the street. Now you can shoot methadone up, but we're
advocating a program where you give methadone to people orally in orange
juice which can't be shot up in a stabilizing basis. Now there's no danger
of these people experiencing a euphoria or high from the use of that
methadone in that manner, is there?
would dispute that. I think that has not been proven. I think there is a
question as to just how much euphoria is experienced by these people but
certainly we have people who have worked in this field to tell us that a
good percentage of their patients do manifest the typical euphoria symptoms
and frequently will not. Now the extent of which this is true is
questionable. It's clearly not as true in the case of heroin. But this is
the point you must remember. The addict's primary motivation frequently,
particularly those who have not been through the mill, so to speak, is to
obtain this high to the extent that you do succeed in blocking it by giving
his methadone without any other therapeutic advantages or programs, he will
merely seek that same high in other drugs* or perhaps in acquiring
additional doses of your illicit methadone in the traffic.
Mr. Haislip, you studied Dr. Jaffe's program in Chicago;
you know it well and you know the Dolan-Neiswander program. Isn't it in fact
true that there were very few cases of drug abuse outside methadone, in fact
you have urinalysis as a means of testing whether an addict is using any
other form of drug.
Well, we did look at Dr.
Jaffe's program, and I think he has an excellent program from what we were
able to see. And I certainly want to make that clear. But I wouldn't concede
your point. The indications are that there is a good deal of abuse of other
drugs accompanied with many of these programs. Perhaps, not Dr. Jaffe's but
certainly many of them. In fact if urine surveillance is not done on a very
regular basis and on a surprise basis, you will not be able to pick this
Mr. Haislip, could I ask a question
because I think it is the issue here. I don't think that film shows there's
any dispute between being clean and being on methadone, that's not in
dispute. What's in dispute here it seems to me is fundamentally this. If we
make therapeutic treatment a mandatory part of a program will that decrease
the number of those who will seek rehabilitative help?
Will it decrease the number of those who will seek
rehabilitative help? Well, I find that difficult, if not impossible, to
answer. I don't know of data on that particular thing, but to the extent
that it does, of course, it selects out the most promising candidates and
one way of looking at the matter is that if you have X number of dollars to
spend, you should probably spend it on those who represent the most
promising candidates if you want to make a definite improvement. That's the
way I would analyze your question. I don't have data on the specifics that
All right, Mr. Haislip, thank you
very much for being on "The Advocates." Mr. Bailey, you now have one minute
Mayor White, I think it's
important to understand that I'm not against methadone. I'm especially not
giving methadone to that person for whom it is the last resort — the person
who might die from an overdose of heroin, the person for whom any other
program is a complete failure. But I do urge you, sir, please, if you're
going to establish a program which does issue methadone in the city of
Boston, consider, consider what you've heard from Dr. Deissler and Mr.
Haislip about the necessity of tying in some kind of rehabilitative program
that gives that young addict a chance, at least a chance, to be drug-free
and not maintained for life. And also bear in mind the serious dangers that
both ray witnesses point out to you about the potential illicit drug
traffic, about encouraging all kinds of new experimentation and about
letting people who could go clean live on methadone for the rest of their
Thank you, Mr. Bailey, and now Mr. Baker
you also have one minute.
Mayor White, talking
about encouraging illicit drug traffic and talking about encouraging
youngsters to go into dope is like saying, you're not going to help a man
who's going to get run over by a car because you want to discourage people
from jay walking. We're dealing with a moral crisis in our community that
people are dying from heroin overdoses; they're living wretched lives;
they're preying on citizens in our community, and you have it in your power
to do something about it. Dr. Jaffe has told you how; Mr. Harris has told
you how. It strikes me that the critics of the methadone program remind me
of the fellow who wouldn't throw a life line to a drowning man because he
was depriving him of such a beautiful chance to learn to swim. Thank
Thank you, Mr. Baker. Well, recently "The
Advocates" conducted a national public opinion poll on the question of
providing methadone to heroin addicts on their request. I'm going to show
you the results of that national public opinion poll in just a moment. First
let's get a reaction from our studio audience here in Boston. Just before
the broadcast started, we asked them to vote on this issue. Now no group of
one hundred people can give us a scientific sample of the country but in
selecting this group in our studio, we did try to approximate a broad
cross-section of our population. Before we reveal the results of that first
vote, I'm going to ask our studio audience to vote a second time. Ladies and
gentlemen, you've heard both sides of the argument. You all know the voting
procedure. You know the question. Remember to hold the lever down for a full
five seconds. Are you ready? Please vote now. Five, four, three, two, one.
Let's see now the results of the first
vote that was taken before the broadcast started and there it is. In our
studio audience 51 said, yes, they favor methadone programs; 20 said no, 29
were still undecided. Now those 51 people who originally favored the
proposal, let's see what happened. How many left that position; where did
they go? May we see that please? Ten left. Six of them went to no; 4 went to
not voting. Now the 20 people who opposed the proposal, how many changed
their minds? Nine -- almost half. Seven to yes, and 2 to not voting. And
finally of those 29 who were originally undecided, who went which way? There
it is. Sixteen left — 4 to no and 12 to yes. And here's the final count in
the studio. We have 60 saying, yes, they favor methadone programs despite
the dangers; 21 say, no, 19 still undecided.
let's compare that with the results of the national poll that "The
Advocates" took on this same question. On our national poll we had 46
percent saying yes, provide methadone. 30 percent said, no, don't provide it
and 24 percent registered no opinion. Not a big gap but somewhat less
nationally favoring the program than those who heard Mr. Baker's
Well, ladies and gentlemen, now's the
time for you at home to act. You've heard the cases. You know how the people
in our studio audience feel about this problem. The question is how you feel
about it and what you're going to do about it. Wherever you stand on the
question of providing methadone, to heroin addicts on their request, you as
a citizen can make your position felt and you do it by writing "The
Advocates", Box 1970, Boston 02134. We tabulate your views and make them
known to Mayor White here, make them known to every other big city mayor
throughout the country. If you want to work with organizations dealing with
this problem, let us know and we'll do our very best to put you in touch
with them; and tell us, will you, the station on which you heard this
broadcast? Incidentally while we welcome your comments at any time, as you
know, if you want your vote to count, let us have it within, two weeks of
our broadcast, because that's when our tally is made up. Will you remember
that address? "The Advocates", Box 1970, Boston, 02134. Rolls off the
tongue, doesn't it?
Two weeks ago "The Advocates"
brought you a special program on the Cambodia crisis from our nation's
capitol. Our question was this: "Should Congress resolve that the President
immediately withdraw all troops aid and advisors from Cambodia and commit no
further forces outside Vietnam?" And the largest response to any Advocates
question so far as of Friday, May 22, nearly 16,000 people from throughout
the entire country had mailed us their vote. 57.8 percent said, yes,
withdraw from Cambodia; 41.6 percent said, no. Only 6/10th of one percent
expressed other views.
On March 15th "The
Advocates" argued the proposal: "Should the government pressure people to
use doctors who work in groups on salary?" Our guest that evening was Paul
McCloskey, a Republican congressman from California. He's considered the
question, and he's prepared with his statement.
The public response to this question has been overwhelmingly
favorable, but I'm not yet personally convinced that the government should
require medicare and medicaid patients to go to group clinics. Encourage,
yes. But require, not yet. I hate to see the government require anything of
people until we have exhausted our attempts to reach the same result through
encouragement. I think that the development in use of group practice is
something to be encouraged. The group practice have proven their merit and
the Nixon administration has recently introduced proposals to put an
incentive system of institutional reimbursement and to cause payments to be
perspective rather than retroactive. I think that these legislative
considerations now before the Congress merit your concern, and I hope that
everyone watching this program will take the opportunity to write your views
and your experiences to the Senate Finance Committee and the House Ways and
Means Committee that are now considering this legislation.
Thank you very much, Congressman
McCloskey, for your thoughtful comment. Now let's look ahead to next
There are over one half
million inmates in the nation's prisons. When they are released, more than
half of them will commit another crime. Would retraining outside of prison
work better and cost less? Next week, "The Advocates" argue: "Should
automatic probation replace prison sentences for all those convicted of
Thanks very much, Mayor
White. Thanks very much to our guest advocate William Bailey, to all our
witnesses. Ladies and gentlemen, this is Lisle Baker's last appearance as a
regular advocate. Lisle, from all the staff of "The Advocates" our thanks
for a job very well done. Ladies and gentlemen, I'm Victor Palmieri. Until
next Sunday night, good night.
as a program takes no position on the issues debated tonight. We ask each
advocate to present responsible arguments, not necessarily his personal
views. Our job is to help you understand both sides more clearly.
This program was made possible by grants from the Ford
Foundation and the Corporation for Public Broadcasting.