Nat Hentoff Notes Methadone Success, Less Interested in Seeing Heroin Legalized
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February 17, 1972, Vol. XVII, No. 7
Dealing with heroin now: how to begin
By Nat Hentoff
Before methadone gave significant reason for hope in counteracting heroin addiction, I was very much in favor of legalizing heroin under knowledgeable controls and with real -- not nominal -- supportive services for each person being administered heroin. (For anyone interested, some of the specified proposals are in a book I wrote some years ago, "A Doctor Among the Addicts," published by Rand McNally in hardback and Grove Press in paper.)
I was also -- and continue to be -- in favor of anything that works in getting addicts off heroin or at least out of crime. Not only methadone but also the various drug-free therapeutic communities. There is no one answer for all addicts; and for some, there may be no other way out of the criminality endemic to heroin addiction under present law than in changing the law to allow addicts to obtain heroin legally. Again, with both controls and real services.
My interest in legalizing heroin lapsed during these methadone years as I waited to see how effective that blocking agent would be. In many cases, methadone has enabled people not only to abandon heroin but also its desperate subculture. They get and retain jobs; they raise families; they are as normally distraught as the rest of us. For others, methadone has not worked. In part, because some treatment centers have not adopted the controls and the full range of services urged by Dr. Marie Nyswander and Dr. Vincent Dole, who initiated the methadone approach. And methadone has failed others because they were not "ready" for that way of coping. Some may never be.
Not enough is known yet about the nature of addiction to be definitely certain about when any given addict not in a treatment program will be "ready" for any treatment program, and whether he will remain if he tries one. The only thing that is clear, as has been stated in a May 1971 discussion paper of the Vera Institute of Justice, is "that many of our city's most troubled addicts are not being reached by such programs. They either refuse to voluntarily enter treatment or have dropped out of these programs. A substantial portion of the city's heroin addicts, including some of the most crime-prone, are unlikely to be reached by the simple expansion of existing treatment programs."
That's a sober way to state it. Another way, common to most of us in this city, is to tell each other of the muggings we have experienced and/or of the survival techniques we are continually perfecting, or so we hope. Occasionally, I look at myself and my family with a sudden shock of possibility that we are quite made to live the way we, and other New Yorkers, do. A frequent subject of dinner conversation, with all the children included, is how to walk on the street, what places to avoid, what to do if trapped. It is both astonishing and frightening to recognize the conditions of siege to which we have left the city. The rest stay because they have no choice or because they want to -- notwithstanding the game of chance they play when they leave their apartments. Some don't even have to leave their building to discover that the odds have narrowed down to them.
How long can this "adjustment" continue for those who stay? I don't know, but I don't think Robert Claiborne was being fanciful in his article proposing the legalization of heroin in the December 16 Voice. He fears a time when the majority of the electorate will be so scared and angry that they will support a politician who will try to use Draconian measures on street criminals. At that time, we will have bought our "safety" -- though I think the effect will be reverse -- at the expense of becoming quite literally a police state.
Should such a politician emerge, he is likely to find the majority of the electorate everywhere in the city. John Wicklein, general manager of WRVR, began a February 4 editorial by putting the state of danger in this city in perspective:
"Ninety per cent of all businesses in Central Harlem were robbed in 1970, most of them by narcotics addicts. The same survey that disclosed this fact revealed that thefts to support the narcotic habit that year cost the people of Harlem $1.8 billion. One half of the persons interviewed in the study said they had been criminally assaulted during 1970..."
...One response to that very real concern is that if this large group continues to be addicted, what kind of future do they have now -- individually, and as part of the potential collective strength of their communities?
But the burden of proof must be on any heroin-legalization program to show that it will not produce "zombies" but will instead make it possible for those so treated to choose a way of living that is not solely copping. To choose a way of living that does not make them criminals and that does not make them prisoners (of their habit and more often than not of the state).
The record was broken in New York last year -- 1259 people died of narcotics-related causes. And, James Markham noted in the January 26 Times, "narcotism remains the largest single cause of death for New Yorkers between the ages of 15 and 35."
In "Britain Gives a Fix to Its Addicts" (the National Observer, January 22), New York State Senator Robert Garcia is quoted concerning the legalization of heroin: "I still don't feel that I could advocate such an approach until we've exhausted every other possibility."
But why not at least try a carefully structured and continually re-evaluated experimental project in heroin transition as one possibility? Not as the only "answer," but as a way of trying to find out how to reach those many addicts who so far live only for their habit and whose overwhelming need to feed it transmogrifies them into fearsome hunters, themselves prey to each day's void...
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