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Offline Anonymous

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Show the man the respect he deserves
« on: June 18, 2009, 01:49:08 AM »
http://psychiatry.ucsd.edu/faculty/ddeitch.html

 
David A. Deitch, Ph.D.
Professor of Clinical Psychiatry
Director, Addiction Training Center
9500 Gilman Drive, La Jolla, CA 92093-0980
Phone #: 858-551-2949
FAX #: 858-534-3877
E-mail: [email protected]
Biography
DAVID A. DEITCH, Ph.D., a Clinical and Social Psychologist, is currently Professor of Clinical Psychiatry at the University of California, San Diego, and Director of the Addiction Training Center. Dr. Deitch has 40 years experience in the development of drug abuse treatment systems for adolescents and adults, nationally and internationally. In the non-profit public health sector, he was Co-Founder of Daytop Village, Inc., and also served as Senior Vice President and Chief Clinical Officer for Phoenix House's Foundation. In the academic sector, he has had faculty appointments at Temple University, the University of Chicago, University of California at San Francisco, as well as serving as Chief of Substance Abuse Services for the University of California, San Francisco. In the government sector, he has served as Coordinator of Curriculum and Faculty for the United Nations East Central European Drug Abuse Treatment Training Project. He continues to consult to a variety of Departments of Corrections and Ministries of Justice and Health, in Latin America, South East and South Asia and Europe. Dr. Deitch served during the Johnson Administration as consultant to the Presidential Commission for the Study of Crime and Juvenile Delinquency, and the National Commission on Marijuana and Drug Abuse. During the Carter Administration, he chaired the White House Task Force on Prevention. He chairs (1993 - current) the Curriculum Development Committee of the National Addiction Technology Transfer Centers (see Technical Assistance Publication Series 21 - The Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice). He further serves as Advisory Board Member for the Association for Medical Education and Research in Substance Abuse - Mentor Project. At UCSD, he serves on various Education Committees (Medical Electives, Allied Health) and is a member of the UCSD Health Sciences Academy of Clinical Scholars. He has numerous publications (and videos) in the field and is currently the Principal Investigator on three Federal grants.
Research Focus
Efforts in this domain have been primarily practice based approaches in therapeutic community treatment of addictions, and other outpatient methodologies. Also, addressed have been issues of addiction and criminality, impact of prison based therapeutic community on inmate behaviors and uniform service quality of life. Another category of study has been the development of specific competencies for treatment of addictive disorders.
Clinical Focus
Contribution to the innovation of therapeutic community treatment for adult and adolescent drug overusers; therapeutic community for spine and head injury as well as t.c. approaches with the aged. The direct teaching and education of professionals and paraprofessionals in the delivery of drug abuse treatment services across a full continuum of models throughout Asia, Europe and the Americas. Finally, direct consultation to individuals and families.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

Offline Anonymous

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Re: Show the man the respect he deserves
« Reply #1 on: June 18, 2009, 02:07:22 AM »
Harry G. Levine    http://www.hereinstead.com/sys-tmpl/htmlpage14/

The following letter is a reply to the long-time editor in chief of the most eminent alcohol and drug abuse journal in the world today. He was putting together a book of the journal's interviews with prominent addiction specialists. The book was to be divided into sections with a brief introduction by an appropriate outside expert. Dr. A (for Anonymous) wanted me to introduce a section called "USA Treatment: Not by Doctors"

He sent me only the last names of two interviewees. I did not immediately recognize either name, but I tracked down one of the printed interviews. The fellow turned out to be a major figure in the Therapeutic Community movement, and I found his views as expressed in the interview appalling. So I wrote back to the good doctor and editor to explain my problem with his assignment.

This was a professional correspondence and until now I have kept my letter private. But I think that drug courts, drug treatment, and therapeutic communities are becoming increasingly important political topics, at least in New York. And since September 11, 2001, it seems important to me to discuss things like this more openly. -- HGL, October 2001



--------------------------------------------------------------------------------




Harry G. Levine

Department of Sociology,
Queens College and the Graduate Center
City University of New York
Flushing, New York 11367
718-997-2800

______________________________________________________________________




January 10, 2001

Dr. A
Editor-in-Chief
(Journal Name Omitted Because It Is Not Relevant)
London, UK.

Dear Dr. A:

You occasionally make seemingly simple requests that, when scrutinized closely, turn out to involve very difficult issues. If I quickly agree to do the task, I immediately find myself in a thicket of sticky, complicated questions, and I'm forced to learn and think about a whole lot of things I had in no intention of getting involved with. However, if I closely scrutinize the proposal before accepting, then I am still confronted with the thicket of complicated questions, and I'm forced to learn and think about a whole lot of things that I had no intention of getting involved with. All as a result of a seemingly simple request.

You asked me to comment on "USA Treatment: Not By Doctors" with two names listed. David Deitch is not on the tip of my tongue, especially in the "Deitch" only version, and I still don't know who "McDermott" is. But your publisher was willing to sell me an electronic copy of Deitch's interview through the web for an absolutely exorbitant sum -- which I was very happy to pay because I wanted to see the mine field you were offering me a chance to run through.

David Deitch, as they say in America, is "a piece of work" -- or to translate into another American slang expression: he is "sumpthin' else." That he is, as you properly understand, an American temperance character is only part of the story. He is a temperance character as pictured by Mark Twain, especially in Huckleberry Finn. He is the con man, chiseler, thief, hypocrite, ne'er do-well and do-gooder, adventurer and jolly companion, all rolled into one. He cheerful embraced shaved heads and busting people as good for them, and he opposed methadone maintenance as close to the devil's work. Then he more or less cheerfully abandoned those views eventually becoming an administrator of, yes, methadone programs.

Dr. Deitch claims to have played an important role in calling the lock-em up and bust-em down approach to curing drug addiction a "therapeutic community." But in his interview Deitch reveals that he is unhappy with the name therapeutic community. He regrets not using the term "humanizing community" to characterize these punitive, moralistic, authoritarian, infantilizing institutions. I believe that earnestly using the opposite term to name something is properly called "Orwellian." Since the fifteenth century, "humanism" has been about respect for human freedom, creativity and autonomy. Most American TCs push pretty much in the opposite direction. And Deitch hasn't a clue to the ironies and contradictions in his ideology.

I've never seen Deitch, but in the late 1980s I did meet George DeLeon (who is a more serious thinker than Deitch). I had an extended conversation with George about what he believed. I was fairly astonished to discover that, deep in his heart, this gentle, nice man passionately believed in keeping drug addicts (but, conveniently, not alcoholics) in what to his dismay I insisted on calling "pink padded prisons."

Unlike the nineteenth century temperance speakers, who just spread the message of their personal reformation, Deitch's project (like Synanon's) has a more punitive and sadistic edge. And this preference became even more pronounced as Deitch became more professionally successful. It does not seem surprising, therefore, that after a while Deitch's work emphasized the institution TCs most resemble: prisons. Especially prisons in "Malaysia, Thailand, Sri Lanka," and "Latin America." It takes someone later than Twain, Graham Greene perhaps, to invent a character who proudly reports in his interview that

"some of the best staff I ever trained were in the Malaysia prison system. They now have four therapeutic communities in Malaysia in the prisons run entirely by uniformed personnel. Thailand has 54 prisons using therapeutic communities."
I'll bet they do. Yet even Deitch doesn't tell us in which Latin American countries he trained prison personnel. Argentina under the Generals? Pinochet's Chile? Cuba? Does anyone doubt that if Kim Il Song invited Deitch to set up "humanizing communities" in the prisons of North Korea, that David would not leap at the chance. He might even get to dig out the old Ché poster that he reminisces about.

East Germany, by the end, was filled with characters like David Deitch, George DeLeon and Mitchell Rosenthal [the director of Phoenix House] -- high status and successful professionals who believed they were "serving the people," doing good for ordinary folks by humiliating them, coercing them, depriving them, punishing them, and lying to them, for their own good.

I know a couple of knowledgeable observers who say that just about the only careers that successful graduates of American drug treatment TCs have is working for a TC. If so, David Deitch is emblematic of that pattern. No matter how many twists and turns his life took, or that the drug-free therapeutic community movement took, Deitch stayed onboard. Maybe he's the most successful TC graduate of all time, the greatest one of all. And now he trains prison personnel in how to reform inmates in countries whose prisons are nightmares, including those of the state of California.

The problem, Dr. A, is that these kinds of comments are not appropriate for your purposes.

The legitimacy of TC's in the U.S. is a big problem, and not to my mind an accomplishment. Most of them probably have made things worse for hard-core drug addicts, for people with drug problems, and even for non-problematic drug users.

I offer one personal anecdote. About a year ago, my then 18 year old son brought home a friend of his to talk with me. Jeffrey smoked marijuana a few times a week, most often perhaps before going home to his often feuding parents. He was a bit goofy but sweet, and my son had worked on an after school project with him for two years and knew him quite well. Jeffrey had never been a great student, but he was doing better academically than ever before. He had a girl friend at another elite school, he'd been accepted at a decent university. He was happy,18, and in his last semester of high school. He and another dopey friend got arrested by undercover police for smoking a joint in Central Park, near their homes. Mayor Giuliani has increased marijuana arrests from about a thousand or so a year to forty thousand a year. Mainly teenagers and young adults get caught, including lots of middle class kids like Jeffrey. What happens? No one knows for sure, but this story may not be that unusual.

When Jeffrey's parents were told to come to the police station and get him out, they became very upset and worried. They sought out a competent professional to examine Jeffery, and were given the name of a top doctor. His name happened to be Dr. "E" (as in Addiction Expert). As you no doubt know, he is a professor at a prominent medical school and a long-time member of the American Society of Addiction Medicine.

Dr. E did not want to see Jeffrey, but only his parents. He listened to them and may have said that Jeffrey was in serious danger. In any event, he firmly told the parents that they and Jeffrey should all go to Phoenix House. When the three of them arrived at Phoenix House, the parents and Jeffrey were separated. The Phoenix House staff told the parents that they had seen many cases like this. They said that Jeffrey was in very serious trouble, he was on the way to becoming a drug addict, his life was in danger. They said that Jeffrey must immediately enter a Phoenix House program, and the parents could attend a group too, so as to better help their son. Jeffrey's parents told him that, given all these professionals' advice and experience, he had no choice: he was to begin treatment at Phoenix House in few days. During that time my son brought Jeffrey to me.

When Jeffrey came to my house a Dutch psychiatrist who specialized in drug cases happened to be there. This good doctor listened to the whole story along with me and was flabbergasted to hear that an eminent physician and medical professor had recommended Phoenix House for someone he=d never met. Jeffrey himself was most upset that almost overnight his parents had become deeply fearful and distrustful of him: they fully accepted the idea that he was in immediate danger of becoming a drug addict and destroying his whole life. He found this prognosis amazing, especially considering that he had never done any other drugs, and he didn't even like alcohol.

I then brought Jeffrey to another drug expert physician who interviewed him at length. He told Jeffrey that, in his opinion, Phoenix House would not be the best place for him, and that if Jeffrey wanted counseling or psychotherapy there were a number of alternatives to consider. The physician also said that, unlike private counseling or psychotherapy, Jeffrey's treatment by Phoenix House for drug abuse might well become part of his permanent medical and health insurance records -- with serious implications for career, reputation, and future health insurance. The physician also said he would say all this to Jeffrey's parents if he wished.

Jeffrey thought it all over that evening, and then bravely told his parents that he did not want to go to Phoenix House, and he wanted to consider other treatments. His parents went ballistic, and fought with each other and him. They then called Dr. E to ask him what to do. Dr. E said that now he did want to see Jeffrey. However, before, going to meet Dr. E, Jeffrey was directed to meet a girl, about his age, who had been in Phoenix House for a couple of years. She told him what a great place it was and how he could meet interesting people there. Jeffrey said she was also pretty good looking.

Jeffrey and his parents then went to Dr. E's office where it was announced that Jeffrey would be interviewed by another doctor -- who just happened to be Dr. E's wife. Jeffrey talked with her for quite a while. Then she came out and reported to the parents and Dr. E that Jeffrey certainly did not need to go to Phoenix house, but instead would be in treatment with ... her.

The story goes on, but that's enough. Now I know the world is full of crazy people, but it is also full of crazy institutions -- and American drug treatment therapeutic communities are disproportionately of that class. In the U.S., TCs have enormous credibility, and prominent addiction physicians work closely with them. It's my sense that the majority of TCs -- or at least the ones like Phoenix house -- probably should be regarded as "treatment" in much the same way that, 200 years ago, Benjamin Rush's ice baths and preference for locking patients in closets were treatment.

Unfortunately, the machine that caught Jeffrey and his family rolls on. Jeffrey's experience has produced no new collective knowledge. He's now far away in college and doing very well -- more sober-minded, in fact, than the heavy-drinking dormitory mates he finds all around him. For understandable reasons he hasn't told many people, and his parents don't want anyone to know what happened. I tried to get a New York Times reporter interested, but unless the family was willing to go on the record there was no story, and no one wants this said about them in the papers.

So this year, when the thousands (perhaps tens of thousands) of New York City high school students, younger perhaps than Jeffrey (17, 16, 15, or 14 years old) get caught smoking marijuana by Mayor Giuliani's police, some of them will get referred to expert physicians who will send them and their families to a TC. There, these mostly innocent (in the fullest sense) people will meet experienced, compassionate professionals and treatment personnel who will say and truly believe that the teenager must, of course, come only here, immediately. And some of those many thousands will enter treatment.

What would David Deitch say about all this? He would likely say what a great place Phoenix House is and that he helped out the young "Mitch" Rosenthal early in his career. He might say that perhaps a few inappropriate referrals are made, but not many, and besides, just smoking marijuana is a danger sign. He might also say that TCs are, after all, very beneficial institutions, even for people without drug problems. For Dr. Deitch, with the right approach, even horrific third world prisons can be "humanizing communities."

Now, who was that other guy you wanted me to comment on? And what can I possibly say about him or Deitch that would be appropriate for your volume? Of course these are all important issues that should be discussed, but not I suspect in the 1200 word introduction to two interviews in a book of interviews.

But I may misunderstand the situation, so please advise.

Cheers,

Harry G. Levine
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Offline Inculcated

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Re: Show the man the respect he deserves
« Reply #2 on: June 18, 2009, 02:58:08 AM »
Oh, Levine although we've never met ...I’m feeling some of that tingly positive transference for you.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

Offline Anonymous

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Re: Show the man the respect he deserves
« Reply #3 on: June 18, 2009, 12:47:01 PM »
He hasn't my respect... not even a little.

As a matter of fact, I will not even waste the time to think of this man.  Besides, what is your point?

Paul
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Offline Ursus

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Re: Show the man the respect he deserves
« Reply #4 on: June 18, 2009, 12:58:03 PM »
Quote
Dr. Deitch has 40 years experience in the development of drug abuse treatment systems for adolescents and adults, nationally and internationally. In the non-profit public health sector, he was Co-Founder of Daytop Village, Inc., and also served as Senior Vice President and Chief Clinical Officer for Phoenix House's Foundation.

Interestingly enough, Deitch's UCSD biography makes no mention of his involvement with Synanon in the early days (I say that tongue in cheek). That was the gateway to his involvement with Daytop and Phoenix House.

Speaking of gateways, I think he was involved with setting Gateway up as well (they are the people that run that Texan SAFPF program). A real mover and shaker in the TC world.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
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Offline Anonymous

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Re: Show the man the respect he deserves
« Reply #5 on: July 28, 2009, 05:59:31 PM »
OP, I assure you, we the majority of Fornits members have every interest in showing this man exactly as much respect as he deserves.

I'll bring the dildos if you have the liquefied feces.
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Offline Inculcated

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Re: David Deitch is a pernicious virus
« Reply #6 on: August 06, 2009, 03:22:12 AM »
Deitch himself reports that his program time was served inside the Narco Farm in Lexington Kentucky. The Narco Farm is notable for being the first attempt at a T.C. in this country and for being located within a prison. It is of notorious repute for researching the treatment of addiction with LSD
(inmates as “voluntary” test subjects) and for being closed in the 80’s due to its controversial research involving providing cocaine and opiates to subjects.
(All of the above information was gleaned from references posted on Fornits under the Narco Farm thread)

Deitch sought his initial “training” at Synnaon with the megalomaniac Charles E. Dederich – (Synanon Founder).
Thus began the long career of David Deitch, the man responsible for the propagation of countless TCs.
*Each of them based on Synanon’s founding principles. These still apply to today’s TCs that treatment should provoke “dissonance,” meaning discord or conflict, to individuals’ self-image so they are no longer comfortable with whom they are.*(That last bit *-*is paraphrased from a source linked on Fornits … somewhere)

The following is excerpted from an expansive report published in fellowship with the World Health Organization 1967:
Synanon
Synanon, an ex-addict community with several facilities in California, has proved to be an effective way of organizing treatment. It has, however, discouraged ex-addicts from leaving Synanon and re-entering the larger community and has zealously maintained its separation from government programmes. Further, Synanon, after a rapid growth between 1958 and 1965 has now apparently stabilized its size at approximately 600 residents. Because of the nature of its programme, it is unlikely to increase significantly in size.
Daytop Lodge
This is an open voluntary treatment programme originally serving drug addicts placed on probation by the local courts of Brooklyn, New York. Technically it is a half-way house, but has a much more active treatment programme headed by an ex-addict, Dave Deitch, trained at Synanon. The lodge is staffed chiefly by ex-addicts; its major features are:
1.   The newly referred addict is made to fight his way in to the programme.
2.   Rigid high standards for behaviour in all areas is expected and enforced, by all patients.
Drug dependence in the U.S.A. 19
1.   The new addict is treated as a helpless child first, but gradually moves from menial to responsible jobs at the Lodge and finally to work outside.
2.   Vigorous, aggressive "gut level" group sessions are held frequently.
3.   More intellectual philosophic seminar sessions are also held. The similarity to Synanon is striking, the major difference being that the former is a purely voluntary private organization, while Daytop Lodge was supported by a National Institute of Mental Health Grant. It was also originally under court sponsorship. The Daytop Lodge programme now receives support from the City of New York and now also accepts voluntary admissions and patients from sources other than the Brooklyn Courts.
United Nations Office on Drugs and Crime UNDOC
http://www.unodc.org/unodc/en/data-and- ... ge003.html

Daytop, founded in New York City by Monsignor William O’Brien, Dan Casriel, M.D.,David Deitch and Judge Alexander Bassin.
More on Daytop’s new image as it slinks away from association with three of its four founders when I can stand sifting through the cluster fuck…
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
“A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

Offline Ursus

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Re: Show the man the respect he deserves
« Reply #7 on: August 06, 2009, 12:12:49 PM »
    The Narcotic Farm
    viewtopic.php?f=22&t=28143[/list]
    « Last Edit: December 31, 1969, 07:00:00 PM by Guest »
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    Offline Inculcated

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    Re: Show the man the respect he deserves
    « Reply #8 on: August 30, 2009, 04:28:30 AM »
    Substance Abuse Research Center Interviews: brief mentions of (Global Pandemic) David Deitch’s early Daytop years
    http://sitemaker.umich.edu/substance.ab ... tMode=list

    Oral History Interviews with Substance Abuse Researchers
    ________________________________________
    There were lots and lots of others.  An amazing group of people.  Amazing group of people.  
     
    Nancy Campbell: Did you ever have the opportunity to demonstrate that to people from the outside?  
     
    FredGlasser: In fact we did have these seminars.  They would invite people to come in and talk to us.  Sometimes it was people like Abe Wikler or Harris Isbell, who were local, but other times it was guest visitors.  One of them was somebody who’d been a patient there before.  He had gone to Synanon on the West Coast and he came to tell us about therapeutic communities. His name was David Deitch.  After I left Lexington, David was then in New York and I went up to visit him at Daytop.  A group of us in Philadelphia sponsored a splinter group from Daytop when Daytop split.  They founded Gaudenzia in Philadelphia, which is still a big thing in Pennsylvania.  David and I became fast friends, and we’ve been in touch really ever since.  I’ve seen him in California and throughout the country at different places.  We keep in touch.  David was a remarkable person and still is.  He was a heroin addict for about 15 years and was really the founding director of Daytop in New York, although there had been several prior directors.  I learned a lot about therapeutic communities from him.
     
     
    Beny Primm:  Matt Wright, who was Jerry’s right-hand guy, was an ex-addict.  He ran Safari House.  Then there was Joey Joya and David Deitch out there with him.   That was it for black guys...  I went out there just at the beginning, just before I went into ARTC.  
     
    I was looking for models to duplicate.  I hadn’t been working in addiction, and these guys had been working in addiction, with addicts.  What did I know about addicts except for when they were on the operating table? At Interfaith Hospital, I was bringing them in, detoxifying them, keeping them for two weeks, and letting them go through therapy.  It was like a revolving door. I did it for about two years or so before I went over to ARTC from ’66, ’67, and ’68.  In ’69 I started ARTC.   But in 1970, ’71, I was at a conference in Washington.  I was in the back of the room because I want to slip out.  I wasn’t going to stay.  Some guy comes in the back of the room and says, Dr. Jaffe is looking for you.  It was a Secret Service guy.  It scared me. He said, Dr. Jaffe wants to see you, so I saw Jerry, who says, I want you to go to Vietnam with me.
     
    Nancy Campbell:  Tell me about your trip to Vietnam.
     
    Beny Primm:  Jerry said, we’re going to go over there because the President wants me to look at the drug problem.  I’d like you to go with me.  I said, I can’t do that, you kidding me?  Go to ‘Nam?  I said, I’m a retired Army officer and I missed combat.  I don’t want to get killed.  He said, you’re not going to get killed.  He talked me into it, so I said okay and went home and told my wife.  She says, Beny, you’re crazy with this drug stuff.  Please don’t do this.  I said, I think I have to do it. She says, I don’t want you to do it.  We’ve got kids, you’ve done your Army time, and now you’re working with these addicts, too.  I’m afraid.  I said, well, don’t be.  I think I’m going to be all right.
     
    They brought me to Washington to orient me to the whole trip.  They brought my wife down to Washington the week before we went.  They’d chosen who was going to accompany us on the trip.  Seth Rosenberg was Jerry’s assistant. Jeffrey Donfeld was on the domestic policy council. Me and Jerry and a couple of bodyguards on the plane.  We took the first free radical assay testing machine, EMIT, over there with us on the plane.  The plane was a very private 747.  My wife was to be on the plane with us, and we were going to drop her off in New York on the tarmac.  This is what happened.  We kept on to Alaska and stopped in Anchorage. They checked people coming back, their belongings, and they had dogs sniff out drugs in their belongings in Anchorage.  We knew what we were going to be facing when we got over there because people were shipping drugs back home in their belongings.  We flew from there to Taiwan, and from there to Hong Kong, and from Hong Kong to Saigon.
     
    We did the whole thing in Vietnam, set up drug testing, called it the Pee House of the Harvest Moon.  We had troughs where the guys would come in and pee, and waited while we observed them and tested their urine.  Up to the rank of major, if they were positive we kept them and sent them to treatment.
     
     
    Beny Primm:  Yeah. We were hobnobbing with the President.  We came back and met at San Clemente with the President.  We’re sitting around the table like this. There I am, a black revolutionary in Harlem, taking over buildings, an ex-paratrooper type, now sitting with the President of the United States and telling him about substance abuse.  He says, you guys got to write a book.  I smoked a pipe then, and I think he got a little bit afraid because he didn’t recognize it was a pipe until I put it on the table.  Then he was more comfortable.  There are pictures of all this, by the way.  I have pictures of all of this stuff.
     
    After that, when we came back, Jerry was the drug czar and he said, Beny, I want you to continue to come down.  I said, Jerry, I’ve got to run my program.  He says, you’ll fly down here every day and fly back to New York and just help set up the office.  And that’s what I did.

    ….Jerry Jaffe :By that time, I had also become familiar with the therapeutic community approach to treatment. I had visited Daytop Village and met the people involved, and I’m pretty sure I had already visited Synanon in Santa Monica.  So now there were three treatment options being tried: methadone, therapeutic communities, and narcotic antagonists

    Nancy Campbell:  What was the inspiration for Tinley Park?  How did it come about?
     
    Jerry Jaffe: Tinley Park came about as a result of several distinct influences coming together at a single point in time. One was my belief that I needed to show that treatment was more cost-effective than arresting and incarcerating drug users. That led me, perhaps inappropriately, to seek to do the most I could with available resources.
     
    The second was the recognition that some of the patients being treated in our ambulatory methadone clinics needed more support than could be provided on an outpatient basis: a place where there was more structure and where in a matter of a few weeks we might be able to influence problems such as excessive drinking or continued heroin use. While our therapeutic community was occasionally willing to refer someone to our methadone programs, they were reluctant to admit anyone to their facility who was unwilling to commit to the longer term treatment the TC espoused.
     ?
    « Last Edit: December 31, 1969, 07:00:00 PM by Guest »
    “A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

    Offline Inculcated

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    Re: Show the man the respect he deserves
    « Reply #9 on: August 30, 2009, 05:14:12 AM »
    Another excerpted Interview: (Deitch is called Brilliant.The rest of the content provides insight into the source and into confrontational tactics being seen as break through treatment)
     
    Herman Joseph interviewee http://sitemaker.umich.edu/substance.ab ... tMode=list
    NC:  Why do you think the TCs were so successful in getting established at that time?
     
    HJ: Mayor Lindsey brought Dr. Efrain Ramirez from Puerto Rico to be the first commissioner for narcotics treatment in the city. Dr. Ramirez was supposed to have developed effective programs in PR using the 12-step therapeutic community approach, but there was no data to substantiate his claims. Ramirez harbored anti-methadone biases and so just encouraged the development of one type of program in the city. Lindsey and other politicians appeared impressed with the goals of the TCs and aggressively supported the modality. The well-meaning and influential Monsignor O’Brien of the Catholic Church developed a famous therapeutic community called Daytop, which was presided over by a brilliant ex-addict, Dave Deitch. The community took in young persons who were experimenting with drugs and others who were addicts. They developed ties to probation and the criminal justice system. They offered educational programs and tried to prepare residents for their lives when they left. However, I never saw their statistics for treating hardcore heroin addicts. Daytop tried to offer quality treatment and appeared to be more open to methadone than the other therapeutic communities. Monsignor O’Brien was a positive force in the city for diverse drug treatment and at that time the TC was the major treatment for addiction.  
     
    A therapeutic community fits right into one’s thinking about denial and honesty. They had 24-hour encounter groups to make the addicts face themselves by breaking down their defenses. In our probation office, we had nuns who were social workers. They were a real asset to the probation office with counseling and referrals on a variety of issues.  Furthermore, methadone in the late 1960s and early 1970s was considered an experimental controversial research medication.  
     
    At that time it was known that Riverside Hospital in NYC and the US Hospital in Lexington, Kentucky, had failed. New York State set up civil commitment for the treatment of addiction.  This program proved to be excessively expensive and addicts who were committed absconded from the program and relapsed at high rates. The next step was to develop community programs, and the TC is an attractive alternative since the TC tries to inculcate certain values that are acceptable to the community and politicians.
    (And continues on the topic mentioning the origins of other TCs)
    Furthermore, the founding directors of the TCs were people of some political clout and social standing. Odyssey House was run by Dr. Judianne Densen-Gerber, who was a wealthy, influential physician whose husband was the medical examiner, Dr. Mike Baden. She was heir to the Gerber food fortune. She was a psychiatrist at that time, connected to Metropolitan/Flower Fifth Avenue Hospital, so she formed a ward in Metropolitan Hospital which turned out to be Odyssey house. Unfortunately, Densen-Gerber and Baden were very hostile to the concept of methadone treatment. Baden started classifying all deaths of patients as “methadone related” irrespective of the cause of death. Phoenix House was formed on a ward at the Morris J. Bernstein Institute of Beth Israel by the patients, and Dr. Trigg supported their endeavors as did Commissioner Ramirez. Later a third generation physician with social and political connections Dr. Mitchell Rosenthal became the medical director of Phoenix House. In the therapeutic community the residents all looked good. They were detoxed, they were full of ambition, and they wanted to take control of their lives. For the few who succeeded, the therapeutic community saved their lives. It was very appealing. They learned how to organize their lives and kept the TC immaculate. If you went to a therapeutic community, you could virtually eat off the floor. However, therapeutic communities did not address the physiological narcotic craving. At the time they considered methadone treatment to be just substituting one addiction or drug for another.
     
    For all their good intentions, therapeutic communities were unable to meet the public health needs of New York City. Heroin addiction continued to spread, death rates and heroin related crime increased. Under pressure from the medical and legal professions, Lindsey saw that another approach was needed and that methadone had to be implemented. The leaders in this fight for methadone in NYC were Dr. Ray Trussell and Dr. Arthur Logan, a leading Black physician who was also Duke Ellington’s physician. Ellington approached Logan about methadone treatment since several of the musicians in his band were addicted to heroin and had entered the methadone program and made successful adjustments. Logan met with them and was impressed. Another leader in the Black community, James Haughton, who organized minority workers to obtain union jobs, was also impressed with methadone when he saw the successful results of some of the members of his organization. Logan and Haughton knew each other. I knew Haughton from my involvement in the school desegregation movement. Haughton knew Annie Stein and Max Wolf who were involved with school integration and the creation of educational parks so he had my phone number and called me at work one afternoon in August. That must have been in the late 1960s or early 1970s. He told me to come to Dr. Logan’s house about a meeting concerning methadone.
    « Last Edit: December 31, 1969, 07:00:00 PM by Guest »
    “A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis

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    Re: David Deitch is a global pandemic
    « Reply #10 on: September 03, 2009, 06:29:24 AM »
    Narcotic Farm the rise and fall of America’s first prison for Drug Addicts

    "Virtually every treatment now offered to those in addiction recovery was once attempted –with both successes and with failures- at the Narcotics Farm.” –The Narcotic Farm/ The Talking cure

    That’s just page #103. The top of this page also mentions Daytop and Synanon, also Synanon modeled "Houses" fostered on the grounds of the Institution.

    The previous page has a paragraph of Deitch with his dissonance waxing fond reminiscence about his treatment at Lexington (in 1951), specifically the weekly sessions of psychotherapy. He really felt understood for the first time ever. Then he relapsed within a day of his release.

    Whatever they did to that man there, I suspect it didn’t help anything...except maybe, wean him from drugs to an issued identity. One he would make a career of, and spend a lifetime inflicting on others.
    « Last Edit: December 31, 1969, 07:00:00 PM by Guest »
    “A person needs a little madness, or else they never dare cut the rope and be free”  Nikos Kazantzakis