Word: doled
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Dates: during 1970-1979
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...increasing controversy. Last week critics of the methadone program got some unexpected support. It came from the same doctors who did more than anyone else to create the massive U.S. methadone program, which is currently treating some 80,000 addicts. In a special report to JAMA, Drs. Vincent P. Dole and Marie Nyswander of Rockefeller University acknowledge that the methadone program, however sound in theory, has failed abysmally in practice...
...Blaming its failure directly on the Government, they complain bitterly of many "politically inspired controls." Relegated to jammed clinics, addicts are often processed on a "take-it-or-leave-it basis"; little or no effort is made to provide the supportive counseling or job help that made the original Dole-Nyswander experiments at Manhattan's Beth Israel Medical Center and Rockefeller University so successful. Even when treatment shows promise of working, Dole and Nyswander say, Government inspectors exert such strong pressure to get addicts off methadone that many are soon back on heroin-or buying black market methadone...
Many addicts themselves are fed up with the programs, Dole and Nyswander contend, largely because of the rigidity of the bureaucratic rules and the indifference and sometimes contempt of clinic staffs. The result: "The great majority of heroin addicts remain on the streets, and the programs have lost their ability to attract them to treatment...
Sound Idea. Dole, a specialist in metabolic medicine, and Nyswander, a psychiatrist, are still convinced that properly supervised methadone treatment is an eminently sound idea. But they admit there has been a "nearly universal reaction against the concept of substituting one [addictive] drug for another." There is further opposition in cities from neighborhood groups complaining that the methadone clinics bring an influx of dangerous addicts. The program has also been tarnished by disclosures that some clinic operators and physicians have collected scandalously high Medicaid fees for doing little more than giving addicts a daily dose of methadone mixed with fruit...
...Dole and Nyswander suggest that the clinics could be salvaged if bureaucratic controls were lifted. But other experts argue that the controls have been far too lax. Dr. Robert L. DuPont, director of the National Institute on Drug Abuse, notes that there were at least 800 methadone-related deaths last year involving "street" methadone-a fact the authors ignored. Thus there may be increasing clamor for other ways of dealing with the nation's estimated half a million heroin addicts. Among them: a new crackdown on dealers and "cold-turkey" detoxification of addicts-a tough but effective tactic (TIME...