In the early 1960s a trio at the Rockefeller Institute started a bold experiment to change the way heroin addiction was treated, and they did so using a drug originally created by “the devil's chemist”
After years of disappointing results in her quest to treat heroin addiction, Marie Nyswander was more than ready to try something new. When she met a prominent doctor at the prestigious Rockefeller Institute, now the Rockefeller University, the two embarked on an experiment that would define both of their careers and revolutionize the treatment of addiction for decades to come. But not everyone was happy about it.
KATIE HAFNER: But his work had grown unfulfilling. He found himself going to the same conferences, meeting the same people over and over, and then there were his patients. In 1982, he told the historian David Courtwright, he’d help them lose weight, but then- KATIE HAFNER: The epidemic was heroin addiction. As we discussed in the last episode, in the late 50s and early 1960s, East Harlem was particularly hard hit by heroin addiction, and the problem was growing.
What if something similar was going on here? Something about the metabolism of a person addicted to drugs that made their bodies crave drugs in a way that other people’s didn’t? The connection was Lew Thomas. Lewis Thomas was the chairman of the New York City Health Department’s Committee on Narcotics. And on that day, Vince was telling Lew about his new interest in addiction, and said, you know, isn’t it a shame there isn’t more good research in the field? And as Vincent tells it, that’s when Lew essentially handed him the keys to the kingdom.
CAROL SUTTON LEWIS: In 1956, a few years before Marie published The Power of Sexual Surrender, she’d published a book about addiction called The Drug Addict as a Patient. In this book, Marie efficiently summarized everything she’d learned about addiction—the effect of drugs on the body, methods for easing withdrawal, the history of criminalization in the United States, and some of the theories of addiction from the day.
EMILY DUFTON: She's been banging her head against the wall for years trying to, you know, help her patients get better and instead they're dying. And so Vincent Dole says, you know, hey, come talk to me. I've got, um, the backing of Rockefeller University with the prestige and, uh, respectability that that offers. And I've got a whole lot of money from the City of New York to try to figure out how to solve addiction.
KATIE HAFNER: Oh, okay. Let me just tell you. A fictionalized Vince features heavily in it. In the book, Vincent Dole becomes “Thurman Cantwell,” a New York physician who recruits “Elizabeth” aka Marie, who is also the Beauty in the book, to help him on his quest to find a treatment for alcoholism. CAROL SUTTON LEWIS: Mm-hmm. So back to the non-fictional account. Marie was officially hired in January 1964. And that same month, Vince brought another member onto the team - a second-year medical resident named Mary Jeanne Kreek.CAROL SUTTON LEWIS: In this oral history interview from 2017, a few years before she died, Mary Jeanne had a habit of acting as both interviewee and interviewer. And after posing this question to herself, she proceeded immediately to answer.
Okay, that’s our research trio – Marie, Vince and Mary Jeanne. As Mary Jeanne explained it, she was the clinician on the team, meaning she did things like observing reactions and monitoring side effects. MARY JEANNE KREEK: Marie and Vince and I used to have these think tanks after talking with patients and we'd hear the story – do you like heroin? Not really. You have to take more and more of it. You get high the highest 10 minutes, 20 minutes at most. Then, you're okay for about an hour or two. If you take too much, you're sleepy, nodding out. And then you go into withdrawal and you have to do this four to six times a day. It's just terrible.
And from that perspective, the abstinence approach to drugs was just never going to work. But then what was the alternative? KATIE HAFNER: As Vince saw it, what compounded the danger was the criminalization, the lengths people were forced to go to get heroin. Add to that the unreliable quality of street drugs. Maybe, if drugs were administered in a safe and legal controlled setting—with careful dosing and without contamination—then those drugs didn’t have to be so dangerous?
KATIE HAFNER: And Carol here, I wanna talk about this whole concept. In fact, David Courtwright wrote a paper on it called “The Prepared Mind.” And that is what we see a lot in science, is it's the prepared mind that leads you to discovery. CAROL SUTTON LEWIS: And the Bureau could be scary. For three decades, it was headed by a man named Harry Anslinger, one of the most powerful men in Washington and a larger than life figure in American history. The way Marie described him, he was like a cartoon villain.
VINCENT DOLE: I asked first of all, uh, that Bronk was president of Rockefeller, whether this would cause him any problems if I got into such a politically controversial field, and I said that this problem is too hot for any doctor or institution of the country to handle so far as I know. And he said, if that's so, he said, then it's our job to do it.
MARIE NYSWANDER: Anyway, brought in two [laughs] quiet and weak—well, not so weak—addicts, put them on narcotics, and I was allowed to put them on any narcotics I wanted, any amount. We just tried to keep them comfortable. MARIE NYSWANDER: The patients were not happy. They were looking at their watches and going in and out of withdrawal, comfortable for maybe an hour. Never got dressed. Never had any goals other than waiting for the next shot. The dosage went up and up, and this was not a program designed to make them high, but simply to keep them comfortable. I could not make them function. There was no way I could make them function.
CAROL SUTTON LEWIS: It had been developed by I.G. Farben, a German company that had been so integral to the Nazi regime, it was sometimes called “the devil’s chemist.” I.G. Farben had used tens of thousands of slave laborers during the war, many from Auschwitz, to work in its factories. It manufactured Zyklon B - the poison used in the gas chambers.
So there was a bit of legal maneuvering, but ultimately the Bureau prevailed and got it classified as a narcotic drug like morphine. KATIE HAFNER: So back in 1964, the Rockefeller team had been trying everything they could think of, and nothing was working. Their patients were getting high doses of opioids, but they were still irritable, distracted, and dissatisfied. And then, the doctors decide to try methadone. Since their patients had been on high doses of other opioids, they put them on equivalent high doses of methadone - presumably to avoid harsh withdrawal symptoms.
MARIE NYSWANDER: I didn’t believe it. I had been around too long and seen too many miracles which turned out not to work. So I think, in a way, Mary Jeanne Kreek, who had no such past failure experiences, noticed and believed it at first. KATIE HAFNER: So at this point, methadone looked promising. But so far, these patients had been living full time in this controlled hospital environment. Yes, this treatment seemed to have changed the patients. But what would happen if they actually went out into the world? There was only one way to find out. But, Marie was nervous.
KATIE HAFNER: But they did come back that first day. And the second, and the day after that. Over and over, the patients came back. One time, they told Marie this story, they told her that, yeah, we saw people buying drugs across the street, but we didn’t feel tempted.
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