He also is project director of the new Physician Leadership on National Drug Policy. The major struggle is between the heroin addict and heroin addiction. To the extent that many have found health and stability through maintenance treatment, we must support their efforts. His attack on methadone patients comes within a year of the landmark National Institute of Health Consensus Conference in which an expert panel affirmed the positive outcomes of this approach to treatment and recommended its expansion. Barry McCaffrey, director of the Office of National Drug Policy, swiftly and correctly countered the mayor with a strong statement in far-reaching support of methadone maintenance treatment.
Campaigns decrying maintenance are nothing new.
Along with the anti-maintenance mentality came vilification of the heroin addict, denunciation of ambulatory treatment, limited access to institutional care, and a designation of abstinence as the only acceptable goal for treatment. Some, like a short-lived one in New York City, were hastily planned and suffered from administrative problems. Others, like the one in Shreveport, La., were effective and were supported not only by the medical profession but also by local politicians and law enforcement officials. But federal authorities at the newly formed Narcotics Bureau were overzealous and successful in their pursuit of these clinics. The last one closed in 1923.