A Tale of Two Clauses: Due Process in Racialized Reproductive Freedom

For Women’s History Month, I’m so pleased to celebrate three women who have each, through their original work, taught me important lessons about the history of drug control. This second post in my series on Drugs, Women, and Families summarizes an exceptional research paper written by Lydia Wendel during my seminar in drug law last year. She identified two very different constitutional and legislative histories that defined reproductive freedom: one path for white women and another path for all other, or BIPOC, women. The U.S. Constitution’s “due process of law” clause appears twice, commanding both federal and state governments to provide it to all citizens. Wendel’s remarkable insight into how these words have worked to protect the rights of some women while forsaking others gave me a deeper understanding of this difficult and vital aspect of constitutional law. She arrives at a chilling conclusion: that these two constitutional paths are now converging to the detriment of overall reproductive freedom for all women in the United States.

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Points Interview: Carl Erik Fisher

Today we’re excited to feature a Points Interview with Dr. Carl Erik Fisher, the author of The Urge: Our History of Addiction (Penguin Press, 2022). Carl is an addiction psychiatrist, bioethics scholar, and author. He is an assistant professor of clinical psychiatry at Columbia University, where he studies and teaches law, ethics, and policy relating to psychiatry and neuroscience, especially issues related to substance use disorders and other addictive behaviors. The interview was conducted by Dr David Herzberg, Editor of the Social History of Alcohol & Drugs.

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Some people like to shoot dope: Ideology and pragmatism in the film ‘Methadone: An American Way of Dealing’

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 their opioid use, and yet, like the emperor who wears no clothes, it must publicly masquerade as a “treatment for addiction” so as to not disrupt the War on Drugs ideologies that require firm distinctions between “drug” and “medicine”; “addict” and “non-addict”. It’s no wonder that people end up a little confused.

Methadone: An American Way of Dealing captures these contradictions playing out in real time.

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An American Way of Working

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 shifts for the first time because he feels so low.  We meet many workers who have chosen to stay outside the factory, period, and stay high all the time. They claim they are living a better, more real life than their fathers did, trooping into factories every day with their coveralls and lunchboxes, “sheep” meekly accepting their slaughter.  As the film notes, with its passing shots of street preachers and sex shows, the straight life is studded with its own addictive consolations. Dayton, we are told, has “1000 bars and just one [methadone] clinic.” 

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Methadone: An American Way of Thinking

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 on which it had left the U.S. were gone, replaced by film cores. The leaders (the length of cellulose attached to the beginning or end of a film to assist the projectionist) were in German, not English. To add insult to injury, the package arrived with an exorbitant bill for cash-on-delivery shipping. 

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“I envision the methadone clinic as we now know it disappearing”: The promises and failures of methadone and LAAM

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 of addiction and crime, couldn’t overcome the era’s other issues: deindustrialization, Vietnam, and America’s trends toward atomization and its concomitant political right turn. 

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Telling Methadone Stories: Men in Ties

Time has a way of turning lived experience into memory and from then into stories that seem, by turns, improbable and fantastical (yes, kids, I used a typewriter to prepare my college research papers!). In the improbable category, one might include my attendance at the Yale School of Medicine’s conference marking the centennial of heroin, held in New Haven from September 18-20, 1998. Organized by the late David Musto, billed as a sweeping review of the heroin’s past and present, it lives in my memory as reunion of Nixon administration drug policy alumni. Egil “Bud” Krogh was there, handing out copies of his short volume The Day Elvis Met Nixon, which described in detail the culturally resonant meeting that Krogh helped arrange (a meeting in which the King asked the President for a federal drug enforcement badge). Daniel Patrick Moynihan was there, delivering an opening-night address that embarrassed some of us younger historians in the audience with its confident declaration that no one had heard of a drug problem back in his childhood days. And, of course, the Special Action Office for Drug Abuse Prevention (SAODAP) was well-represented, with both of its Directors—Jerry Jaffe and Bob DuPont—in attendance and giving presentations. In between the addresses and presentations—for which junior folks like myself had been invited to offer commentaries—they told stories, especially methadone stories. 

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Intolerable Normalcies: Multiple American Methadones

“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), where she argued the practice would have a tenuous future as a “chemotherapeutic ‘fix’” for heroin addiction. The latter, she wrote, was an “adaptive response to real and overwhelming social or psychological difficulties that cannot be resolved by a simple technological fix” (3, 152). But methadone was no simple technological fix. Programs developed in a “climate of conflict extending from the level of policy down to the actual operation of individual clinics” (8). The Dayton, Ohio, methadone clinic where James Klein and Julia Reichert shot their film Methadone: An American Way of Dealing is a Black space full of energy and music—even as no-nonsense white nurses refuse to disclose to Black patients the dosage they are serving up in their “free cup of methadone.”

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