THE NARCOTIC FARM

[Inculcated]

http://www.itvs.org/pressroom/press_det ... essId=6621
an ITVS Film Review:
THE NARCOTIC FARM Tells the Fascinating and Untold Story of a Unique Federal Prison and U.S. Public Health Service’s 40 Year-Long Experiment There to Discover a Cure for Drug Addiction

Film by JP Olsen and Luke Walden to premiere on Public Television in November 2008

(San Francisco)—From its opening in 1935, the United States Narcotic Farm in Lexington, Kentucky, epitomized the nation’s ambivalence about how to deal with drug addiction. On one hand, it functioned as a compassionate and humane hospital, an “asylum on the hill” on 1,000 acres of farmland where addicts could recover from their drug habits. On the other hand, it was an imposing federal prison built for the incarceration of drug addicts.

“Narco,” as it was known locally, was a strange anomaly, a co-ed institution where federal convicts did time alongside volunteers who checked themselves in for rehabilitation. Not long after its opening, the institution became the world’s epicenter for drug treatment and addiction research and for forty years it was the gathering place for this country’s growing drug subculture, a rite of passage that initiated famous jazz musicians, drug-abusing MDs, street hustlers, and drugstore cowboys into the new fraternal order of the American junkie.

Although it began as a bold and ambitious public works project, Narco was shut down in the 1970s amid changes in drug policy and scandal over its drug-testing program, where hundreds of federal convicts volunteered as human guinea pigs for pioneering drug experiments and were rewarded with heroin and cocaine for their efforts.

THE NARCOTIC FARM tells the compelling story of the institution’s noble rise and tumultuous fall, and includes rare and unpublished photographs, film stills, newspaper and magazine clippings and government docu¬ments, as well as anecdotes and recollections from the prisoners, doctors and staff who lived and worked there.

A companion book entitled The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts has been published by Abrams. Written by authors and filmmakers JP Olsen and Luke Walden, with drug policy expert Nancy Campbell, the book chronicles the tumultuous years of this controversial institution with interviews, film stills, press clippings and rare and unpublished photographs and documents.

The film will premiere on Public Television across the country in November 2008. For more information and to check local listings, visit http://www.itvs.org.

THE NARCOTIC FARM is a co-production of JP Olsen and Luke Walden and the Independent Television Service, with funding provided by the Corporation for Public Broadcasting.

About the Subjects

Dr. John Ball was staff criminologist with the Addiction Research Center between the years of 1962 to 1968. After leaving Lexington Ball went on to work for the Nixon White House’s “Special Action Office for Drug Abuse Prevention.”

Dr. Nancy Campbell is an associate professor at Rensselaer Polytechnic Institute in Troy, New York. She is the author of two books on addiction: Using Women: Gender, Drug Policy and Social Justice and two books on the Narcotic Farm, Discovering Addiction: The Science and Politics of Substance Abuse Research and is co-author of The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts.

Dr. David Deitch was arrested at the age of 17 for heroin use and sent to the Narcotic Farm. Following a long recovery from drug addiction he would go on to co-found the drug treatment center, Daytop Village. Today he is a Professor of Clinical Psychiatry at the University of California, San Diego.
Dr. Robert DuPont, a psychiatrist, was the drug czar under President Ford and is the former head of the National Institute on Drug Abuse. DuPont is widely credited as one of the first government figures to endorse methadone maintenance as a viable treatment for heroin addiction.

Edward Flowers is a former heroin addict who grew up in the South Bronx and in an orphanage in upstate New York. After nearly a decade in and out of prisons due to crimes committed in the service of getting drugs, he became a drug treatment counselor with Second Genesis near Washington, DC.

Dr. Frederick Glaser came to the Narcotic Farm in 1964 on a two-year psychiatric residency. Like many who began their careers at Lexington, he went on to work in addiction treatment for the remainder of his medical career. Today he is Professor Emeritus of Psychiatry at East Carolina University.

Bernie Kolb volunteered for drug treatment at Lexington in 1964 and stayed for a little under a year. There he worked as an assistant within the Addiction Research Center. A veteran of the Korean War – where he picked up an opiate habit after sustaining a battle injury – Kolb would leave Lexington and become a member of the self-help group “Synanon,” which he credits for his recovery.

Dr. Conan Kornetsky arrived at Lexington in 1948 while seeking a graduate degree in psychology at the University of Kentucky. Over the next four years, Kornetsky would be involved in some of the institution’s most famous drug tests, including ones that would establish barbiturates as highly addictive and dangerous drugs. Today he is a professor of psychiatry and pharmacology at Boston University Medical School.

Robert Maclin was the Narcotic Farm’s agriculture administrator between 1951 until the farm closed in 1968. During those years he raised his family on the grounds. Following that time he worked within the Addiction Research Center until it closed.

Stan Novick spent the better part of three decades in and out of federal, state and local jails and prisons across the country. In the late 1960s, by then in his 40s, he enrolled in a methadone program and, as a successful methadone patient, became a drug counselor with Beth Israel hospital in New York. He died in 2007.

Marjorie Senechal is the oldest daughter of esteemed addiction researcher, Dr. Abe Wikler. As a “Narco Brat,” she, along with her brother and two sisters, grew up on the grounds of the institution, living there between the years of 1940 through 1953. Today she is a professor of mathematics at Smith College in Northampton, Massachusetts.

John Stallone grew up in Brooklyn in the 1940s. He dabbled with heroin as a teenager and by the time he was 18 he was addicted to the drug and began committing crimes to support his habit. He arrived Lexington – in lieu of being sent to Rikers Island – in 1959. For the next several years after his release he continued to use heroin, but kicked the habit after moving to California and joining the self-help group “Synanon,” of which he was a member until the early 1980s. Today he counsels prisoners in California.

The film’s narrator and composer, Wayne Kramer, is a former member of the rock and roll band The MC5. Following the break-up of his band, Kramer fell into drug addiction and was eventually arrested on federal drug charges and sent to Lexington – after it was no longer a treatment hospital – in 1975. Today he lives with his wife in Los Angeles.

The Filmmakers

JP Olsen is a journalist, filmmaker and writer whose work has appeared on PBS, ABC News and The Discovery Channel. He is also the co-author of the photo book The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts, which he co-authored with Luke Walden and Dr. Nancy Campbell. He lives in Brooklyn, New York.

Luke Walden is an editor and cameraman. His previous projects include travelling to Lebanon, Kosovo and Uganda for a film on UN Peacekeepers. He recently re-located from Manhattan to live in Portland, Oregon.

About ITVS

Independent Television Service funds and presents award-winning documentaries and dramas on public television, innovative new media projects on the Web and the Emmy Award-winning weekly series Independent Lens on Tuesday nights at 10 PM on PBS. ITVS is a miracle of public policy created by media activists, citizens and politicians seeking to foster plurality and diversity in public television. ITVS was established by a historic mandate of Congress to champion independently produced programs that take creative risks, spark public dialogue and serve underserved audiences. Since its inception in 1991, ITVS programs have revitalized the relationship between the public and public television, bringing television audiences face-to-face with the lives and concerns of their fellow Americans. For more information about ITVS, visit itvs.org. ITVS is funded by the Corporation for Public Broadcasting, a private corporation funded by the American people.

CONTACT:
Randall Cole, [email protected]
415-356-8383, ext 254

cpb a private corporation funded by the American people

[Inculcated]

http://www.asylumprojects.org/tiki-inde ... otics+Farm
This site tells the story of the Narco Farm…
“In 1974, Narco was closed as a therapeutic center. On Dec. 31, 1976, the last human research subject there was transferred out. In 1984, its addiction research operations were moved to Baltimore. The prison became a Federal Correctional Institution, and then in 1991, changed its name to the Federal Medical Center. Hundreds of acres became Lexington's Masterson Station Park.

Now, 73 years after the complex opened, the drive up the hill is still as long as William Burroughs Jr. described it, and the architecture is still an exemplar of the United States governmental-behemoth style — a Biltmore built of good intentions.”

… and offers a fascinating photo gallery

[Inculcated]

Reaping a Sad Harvest: A "Narcotic Farm" That Tried to Grow Recovery
http://www.scientificamerican.com/artic ... overy-farm
"A federal prison in Kentucky was a temporary home for thousands, including Sonny Rollins, Peter Lorre and William S. Burroughs
 as well as a lab for addiction treatments such as LSD"
By Charles Q. Choi    
(includes slide show)


 government “research center”
http://www.erowid.org/freedom/governmen ... ory1.shtml

http://ajp.psychiatryonline.org/cgi/rep ... 9/1/22.pdf
…and became the first intramural research branch of NIMH,
under the name Addiction Research Center.

[Antigen]

Dr. Robert DuPont, a psychiatrist, was the drug czar under President Ford and is the former head of the National Institute on Drug Abuse. DuPont is widely credited as one of the first government figures to endorse methadone maintenance as a viable treatment for heroin addiction.

Robert DuPont, Richard Nixon's Drug Czar, had overseen funding for an experimental juvenile program to try to turn American kids into the straight laced citizens that he thought they should be. That program was called The Seed and its methods were likened by the US Senate to Communist brainwashing techniques.

Straight, Inc. grew out of The Seed and Robert DuPont became Straight's consultant.

....

Hmm... Robert DuPont, the Seed and a US government-backed mind-control experiment. George Bush, Sr., the CIA, and mind control experiments. Is there a Straight-CIA connection? This brief essay tells the story of the Republican Party connection to the destructive-mind cult known as Straight, Inc.

http://www.thestraights.com/gop.htm

[Ursus]

Robert Dupont apparently appears as a subject in this film on Narco Farm. Did he have any connection to the institution while it was in operation? Or was he merely interviewed for his "expert opinion?"

[Ursus]

From one of Inculcated's links provided above:

-------------- • -------------- • --------------

U.S. Narcotics Farm



History:

For nearly four decades, from the 1930s to the '70s, Lexington was a center for drug research and treatment. It drew addicts talented and desperate, obscure and celebrated, and provided free treatment and more: job training, sports, dental help, music lessons, even manicures. Research done there, much of it conducted with volunteer human subjects, yielded insights into drug addiction that still resonate today.

Jazz greats Chet Baker and Elvin Jones took the Lexington Cure. So did William S. Burroughs and his son, both of whom wrote about it. The father described the grueling detox but opined that the food was excellent. The son wrote about the place's isolation, and the joys of landing an easy job on-site.

A 1930s big government project emblematic of the New Deal, Narco was a joint venture of the Public Health Service and the Bureau of Prisons. The notion that thorny problems are best solved by a centralized bureaucracy is a concept that has seen happier days, but Narco's founders were sure that government, fueled by money and manpower, could change a nation's social landscape — from Lexington and a facility in Fort Worth Texas, that opened in 1938.

Lexington's countryside setting was important because this was a project that idealized rural life, built on a belief that if you turned up hopelessly addicted and worked in the sun, learned wholesome values, got dental care and played golf, maybe you could leave drugs behind. The nation, in the throes of the Depression, was flush with ambition if not cash, and drug addiction was seen as more of a bad habit than a brain-based physiological craving. But the odds of success with treatment at Narco were, it turned out, abysmally bad — as low as 7 percent, according to a 1962 survey.

"She rose proudly. She had spires and Roman cornices and Greek ramparts and punk American Depression symbols of electricity that coursed about the pregnant dirtybrown marble belly, and She pronounced the smug disunity of her period with disordered extensions and low, latched-on excrescences, and windows, windows, thousands and thousands of windows that hadn't been washed in decades, and stared like the cataract eyes of a square caterpillar onto the peacefully curving road that led into the black socket of her navel." — from The Farm by Clarence Cooper Jr., written in 1966

The Lexington Cure drew pop culture portrayals like a July picnic draws flies, but its depiction in the press changed over the decades, from unabashed heroic poses in the 1930s to the lurid tabloid coverage of the '50s. Photos from 1951 feature a patient undergoing withdrawal in the "shooting gallery," male patients lined up for a shot of morphine during detoxification. The caption on a photo of a barefoot teenage girl, face buried in her hands, reads: "Sweating it out after the withdrawal phase, a 17-year-old sits despondently on her bed, fighting the craving. Out of curiosity because others in her crowd took it, she smoked marijuana at 13 for a bang, then took heroin 'for a lift.'"

Heroin's popularity in the era's jazz circles, and the musicians' subsequent trips to Lexington, provided Narco with one of its greatest claims to fame: the Narco jazz band. But no audio of the band — including its 1964 performance on Johnny Carson's late-night television talk show — still exists. The band has a nickname: "the greatest band you never heard." The level of talent that passed through Narco was staggering: from jazz musicians to writers to those whose talents vanished beneath their unconquered addictions.

The Narco Farm was a prison, but it also offered free drug treatment to almost anyone who asked. Once on site, it was difficult to tell who was considered a criminal and who had simply lost their way to heroin — a drug once touted in the same ad with Bayer aspirin as a cure for coughs. All sorts of people checked in to Narco, but patient demographics shifted over the decades. When Narco first opened, its population skewed toward older, white addicts. But in the 1940s, more young addicts and African-Americans were admitted. The Lexington Herald reported in 1955 that most Narco residents were addicted to heroin and the average patient was young and likely to be of African-American or Latino descent.

Starting in 1968, those who qualified could serve six months of civil commitment for drug treatment instead of jail. Lexington became the toast of the civil commitment program.

But by 1972, the idea of a small treatment community that had evolved out of the behemoth Narco had become poisonous. The Lexington Herald reported in the early 1970s allegations that at Matrix House, one of the small communities, "some of the patients were stripped of their clothing and their pubic hair burned off, that some of the male patients' genitals were placed in ice water for long periods of time." Nude rituals and bomb-making were also alleged. By 1973, though, even the center's former boosters had turned against it. Dr. Harold Conrad, chief of the addiction research center at Narco, dismissed the place as being remote and no longer nationally unique.

In 1974, Narco was closed as a therapeutic center. On Dec. 31, 1976, the last human research subject there was transferred out. In 1984, its addiction research operations were moved to Baltimore. The prison became a Federal Correctional Institution, and then in 1991, changed its name to the Federal Medical Center. Hundreds of acres became Lexington's Masterson Station Park.

Now, 73 years after the complex opened, the drive up the hill is still as long as William Burroughs Jr. described it, and the architecture is still an exemplar of the United States governmental-behemoth style — a Biltmore built of good intentions. But it's now in the Lexington suburbs, not in the American countryside.

Even with cyclone fencing that lines the front façade, it still looks like a castle on the hill.


Aerial ca. 1940, photo courtesy UK special collections


Patients working at the farm ca. 1950s, now city owned Masterson Station Park.

[Inculcated]

Robert Dupont apparently appears as a subject in this film on Narco Farm. Did he have any connection to the institution while it was in operation? Or was he merely interviewed for his "expert opinion?"

I’ve not yet had an opportunity to view the Narco Farm documentary. It’s on the list. I do believe that it it’s likely DuPont's interview is for his knowledge of the subject and related research, and that he was probably not directly part of operations there.

In 1971 Dr. Robert L. DuPont was Director, District of Columbia Narcotics Treatment Administration.That same year Dr. William Martin was Chief of the, Addiction Research Center in Lexington, Ky. (Narco Farm).
Both testified before the select committee on crime U.S. House of Representatives [pursuant to H. Res. 115, a resolution creating a select committee to conduct studies and investigations of crime in the United States],regarding narcotics research, rehabilitation, and treatment. http://www.archive.org/stream/narcotics ... t_djvu.txt As did Dr. Daniel H. Casriel, of Daytop notoriety (among others).

Much of the portion of the discussion DuPont (143), Martin (435,439), and Casriel (273) were involved in centered on pharmaceutical treatment options for opiate addictions. Chemical cessation remedies discussed include Methadone, Perse, Cyclazocine and Naloxone.

EXHIBIT NO. 11 (a) THROUGH (e)

DuPont, Dr. Robert L., director. District of Columbia Narcotics Treatment Administration:

(a) Article entitled "Profile of a Heroin Addict" 166

(b) Study entitled "Summary of 6-Month Follow up Study" 178

(c) Brief collection of statistical information entitled "Dr. DuPont's
Numbers 183

(d) An administrative order setting forth guidelines for methadone
Treatment 183

(e) Article entitled "A Study of Narcotics Addicted Offenders at the

D.C. Jail" '_ 195

[Inculcated]

(An odd topic deviation that jumped out at me from the transcripts of the hearings mentioned above)
http://www.archive.org/stream/narcotics ... t_djvu.txt

“The chairman mentioned the possibility of immunizing people
Against drug abuse. I think that this is an area well worth exploring
and, as a matter of fact, my organization is exploring this possibility
at this time. I would like to get the medical practitioners of this
country to be interested in that area of inquiry. If we can deal with
the problem on all of the fronts that we well know, and deal with it.”

(385)
The Chairman. Mr. Brasrco, did you have a question ?

Mr. Brasco. Yes; I did have one last question of Mr. Ingersoll.

As I understood you to say before, Mr. Ingersoll, you and your De-
partment have a division which is doing some research work ; is that
correct ?

Mr. Ingersoll. That is correct,sir.

Mr. Brasco. And I understood you also to say that you are working
on some substance that might possibly be used to immunize people
from the effects of narcotics.

Mr. Ingersoll. We are in a very preliminary stage of investigating
that possibility.

Mr. Brasco. You know, listening to the dialog here, and I think
that yon absolute]v right, in terms of having to attack this on
various levels, but I kind of suspect that the difficulty that we have
here, controlling the supply and the traffic, is only magnified when we
try to get involved in foreign countries.

I am not saying that we shouldn't do that. But it comes to the
question that has always been disturbing me, as to whether or not
we are doing enough in this research area.

Several witnesses have appeared before this committee and have
touched on the research area with methadone, and briefly in terms of
the fact that there may be in the wind some prospects of getting a
longer lasting drug other than methadone.

Now you talk about immunization, and I am wondering, are we
doing anything in this area of research or is this another one of those
late start areas ?

Mr. Ingersoll. I think that is correct ; yes, sir.

Mr. Brasco. A late start area.

Mr. Ingersoll. Yes.

Mr. Brasco. Well, let me ask you this, then. It would seem to me
that one of the things that you are talking about, immunization,
should be the star emphasis of this or any other administration. I
am wondering what your resources are to follow that program that
you speak of.

Mr. Ingersoll. It is not really within our sphere of responsibility to
do it. We are just trying to examine the proposition in a preliminary
way to see whether it has any possible merit.

Mr. Brasco. Well, is anyone else doing it that you know of ?

Mr. Ingersoll. Not to my knowledge.

Mr. Brasco. I am told, by our counsel, that the National Institute of
Mental Health is doing something.

Mr. Ingersoll. I was just told that we are working with one of
their employees — one of their staff people.

Mr. Brasco. Do you have any idea what that budget is, in dollars
and cents ?

Mr. Ingersoll. For this particular project?

Mr. Brasco. Yes.

Mr. Ingersoll. It would be miniscule at this time because again, it
is something we have just started examining in the last month, 2
months.

Now, the other thing I wanted to ask you : Is your agency, the Bu-
reau of Narcotics and Dangerous Drugs, providing any money for a re-
search program into synthetic drugs or into blockage drugs or im-
munizing drugs?

Mr. Ingersoll. Our research authority is restricted by law, and we
are not investing any substantial amount of money in any of those
areas because that is principally the responsibility of the National
Institute of Mental Health.

Chairman Pepper. Are you providing any money for a national
treatment and rehabilitation program ?

Mr. Ingersoll. No, sir. That is completely out of our sphere.

Chairman Pepper. My last question here is this. You have indicated
here today out of your great knowledge that if we are going to mount
a massive assault on heroin in our country, it has got to have many
facets. We have got to carry on an effective and extensive research pro-
gram, an effective and extensive rehabilitation program,
and an extensive law enforcement program, at least those elements must be a part
of any effective all-out fight upon heroin ; must it not ?

Mr. Ingersoll. Yes, sir.

Chairman Pepper. Thank you very much. You are very kind and
very helpful.

Mr. Ingersoll. Thank you very much, Mr. Chairman.

Chairman Pepper. The committee will adjourn until 10 o'clock to-
morrow morning in this room when the first witnesses will be Dr. Ed-
wards and Dr. Gardner.

(Thereupon, at 1 :40 p.m., the committee adjourned, to reconvene
tomorrow, Thursday, June 3, 1971, at 10 a.m.)

Chairman Pepper. The committee will come to order please.

The Select Committee on Crime is today continuing its hearings into
various aspects of the heroin addiction crisis. Yesterday we received
valuable testimony from John Ingersoll, Director of the Federal
Bureau of Narcotics and Dangerous Drugs. What he told us about the
rapidly increasing rate of heroin addiction among soldiers in Vietnam
certainly does not bode well for the future of our country.

In fact, Mr. Ingersoll's testimony on that subject and on the limited
ability of this country to effectively halt heroin struggling makes all
the more important the testimony we are going to receive today. For
today the committee once again turns its attention to the scientific
aspects of fighting drug addiction. Given our ability to halt or
significantly decrease the flow of heroin into our country, as long as it is
cultivated legally elsewhere, we must concentrate our attention and
our resources on seeking new and creative means of curing drug dependence.

Our investigations lead me to believe that the creative genius of our
country can be utilized in order to produce new drugs to combat
heroin addiction. If there is a substantial possibility of developing
more effective and longer lasting blockage drugs or effective nonaddicting antagonistic drugs,
then there seems to be no reason for our Government's failure to expend
 its energies and resources in the development and use of such drugs.
Further, if our scientists can possibly develop a vaccine which could be used to immunize our population
against the euphoria of opiate base drugs, then it is our responsibility
to see that these laudatory projects are properly funded and that
sufficient manpower is committed to the completion of such worthwhile endeavors.
(302)

Any reasonable amount of money, including even hundreds of millions
of dollars, would be a very wise investment if we can find something
that will be an antagonistic, blocking, or immunizing drug.
Chairman Pepper. Does NIMH in your opinion generally
have responsibility in this field as the initiating agency to try and do
something about the drug problem?

Dr. Edwards. I think it has the prime responsibility in the Federal
Establishment for initiating and stimulating research in this area;
yes.

Chairman Pepper. Well, now, has NIMH submitted to the Food
and Drug Administration any drug and asked for your evaluation of
those drugs with respect to the treatment of heroin addiction?

Dr. Edwards. For the specifics I would have to ask Dr. Gardner
to answer.

Dr. Gardner. They submitted applications for investigational new
drug status for not only methadone, but for some other drugs, particularly
those that are being studied in the Lexington Research Center, (403)

and this is only for the investigational phase. Beyond that, of course,
if they are to be marketed, that would become part of the responsibility
of the pharmaceutical industry.

Chairman Pepper. Well, now, Doctor, one of the things that this
committee is very interested in and very concerned about, is trying
to develop a system by which everything that can be done, shall be
done as quickly as it can be done to do something effective…”
Dr. Edwards. It certainly shows some promise, more so than any-
thing we have currently available.

Chairman Pepper. Well, now, if it were to be used — suppose we
were to recommend to the House of Representatives, and the Congress
should adopt a law and adequate funds should be provided to set up a
404

system of treatment and rehabilitation facilities all over this country,
in every community in America where there was a need for it — would
you suggest that such treatment and rehabilitation programs should be
conducted through clinics where there M'Ould be proper supervision
and the like, rather than permit these drugs to be prescribed by in-
dividual practitioners?

Dr. Edwards. I think a drug with the potential danger — and I
will use the words "potential danger" — of methadone, if it is going to
be used on a widescale basis, it has got to be used through institutional-
type clinical settings. I don't think they can be used through individual
practitioners.

Chairman Pepper. And your regulations have been moving rather
in that direction?

Dr. Edwards. Our regulations are definitely moving in that
direction.

Chairman Pepper. The clinic can require the patient or the recipient
of the treatment to be there in person and receive it when they think
it is desirable to do this.

Dr. Edwards. That is right.

Chairman Pepper. And they can give him certain therapeutic and
occupational and other assistance.”

[Inculcated]

http://www.archive.org/stream/narcotics ... t_djvu.txt

(Discussion turns to Narco Farm research)

Mr. Chairman, our overview of the Institute's research program
would not be complete unless I mentioned three additional activities.
First, the Institute's program of supplying standardized pure preparations of drugs of abuse to qualified researchers. Originally this
program focused on distributing LSD to researchers through the joint
FDA-NIMH Psychotomimetic Agents Advisory Committee. With
the increased use of marihuana and related drugs, the program has
extended to include a wider spectrum of drugs, including psilocybin,
radioactively tagged (THC), the active ingredient in marihuana, and most recently heroin for
research purposes.

At present the Institute is not only supplying requests from U.S.
investigators but has established procedures with the Canadian Food
and Drug Directorate and the U.N. Narcotics Laboratory for supplying and distributing these drugs for research in Canada and Western
Europe. Information generated by research performed in foreign
countries should help the U.S. research program. The number of
requests for research drugs has doubled in the past year. Since this
program's inception, 650 requests for research drugs have been filled,
250 of them for marihuana or its derivatives.

Secondly, the Institute is currently presenting a number of educational materials including pamphlets, posters, workbooks, and films
to determine their usefulness in reaching different groups within the
population. Some of the materials and educational materials, which
have previously been developed through the National Clearinghouse
for Drug Abuse Information, have been used in the Institute's training
program. In fiscal year 1970, this program provided 1- and 2-week
courses on drug abuse for over 1,500 professionals, allied health
workers, Government officials, and members of the public

Lastly, I might mention the program being conducted at the Addiction Research Center by Dr. William Martin to developing methods of determining the abuse potential of drugs before they become problems on the street or in the clinic, and to study pharmacological treatments for narcotic addiction. Dr. Martin and his associates are investigating the conditions under which animals will self-administer drugs thus determining the abuse potential of drugs
before they become problems on the street or in the clinic, and to study
pharmacological treatments for narcotic addiction.
Dr. Martin and his associates also are investigating the conditions under which animals will self-administer drugs and are determining to what extent each (435)

drug induces physical and psychological dependence, behavioral
toxicity, and harmful physiological effects. At this point, I would like
to introduce Dr. William Martin, who can tell you in more detail
about these research programs.

I would like to turn to Dr. Martin who will also give an overview
of the research program at the center.

STATEMENT OE DR. WILLIAM R. MARTIN :

Dr. Martin. Thank you, sir. I appreciate this opportunity to appear
before you today, and t would like to read my brief statement.

I am the chief of the NIMH Addiction Research Center. I am a
physician and my particular area of competence is in the area of
clinical and neurosychopharmacology. I have worked the last 13
years on problems related to understanding the process of dependence,
its diagnosis and its treatment.

The Addiction Research Center (ARC) is located in the Clinical
Research Center at Lexington, Ky., and is both a basic and clinical
research unit constituted of 56 employees, which includes six physicians
 and seven professionals at the Ph. D., or master's level, as well
as administrative and supporting staff. The disciplines represented in
the ARC include pharmacology, psychiatry, neuroendocrinology, bio-
chemistry, drug metabolism, neurochemistry, clinical psychology, and
physiological psychology. Our major areas of interest and work have
fallen into two categories: (1) Prevention, and (2) diagnosis and
treatment of addiction.

The major thrust of the prevention programs is to understand the
basic modes of action of the different drugs of abuse and in so doing to
develop methods for the assessment of their abuse potentialty. The
ARC has developed methods for assessing the abuse potentiality of
the narcotic analgesics such as heroin, sedative-hypnotics such as
secobarbital and phentobarbital, amphetamines such as dexedrine and
speed, and LSD-like hallucinogens, and has conducted extensive
clinical studies of the actions of marihuana and the tetrahydrocan-
nabinols. It has for many years provided advice to the National
Research Council and to the World Health Organization concerning
the abuse potentiality of new strong analgesics.

The most important contributions concerning the diagnosis and
treatment of heroin addiction that have been made are, in my opinion,
(1) the demonstration that the chronic administration of morhine
to both human and animals is associated with long-persisting abnormalities following withdrawal and that these physiological abnormalities
are associated with relapse of post addict animals to narcotics and
a])pear to be associated with an over sensitivity to stress; (2) the role
of conditioning in relapse and in drug-seeking behavior has been
explored and in part demonstrated; (3) three narcotic antagonists,
Cyclazocine, naloxone and EN-1639A, which is a drug which is very
Closely related to naloxone structurally, have been studied at the ARC,
and their potential utility for the treatment of narcotic addiction has
been demonstrated and suggested. We believe that the narcotic
antagonists may be of use in extinguishing the protracted abstinence
syndrome, as well as conditioned abstinence and drug-seeking behavior.



436

The first drug that we studied with this end in view was Cyclazocine,
which is a very potent drug, but produces some undesirable side effects
All of which has made it necessary for physicians to be both knowledgeable of its pharmacology and skilled in its use. The second drug that
was studied was naloxone, which proved to be a pure antagonist with-
out undesirable side effects, but which suffered from the disadvantages
that it was short acting and quite ineffective by the oral route. We have
continued to study other narcotic antagonists and have recently investigated EN-1639A, which combines the structural features of both
naloxone and c3^clazocine, and have found that this agent is two to
three times more potent than naloxone and cyclazocine and that it
has a longer duration of action than naloxone. We have further found
that we can, for all intents and purpose, antagonize both the euphorogenic and the dependence-producing effects of large doses of morphine
with an oral dose level of 50 milligrams per day. Thus, we feel that we
have made substantial progress in finding the ideal narcotic antagonist
which meets the criteria of: (1) Being potent, 10-50 milligrams per
day; (2) having a long duration of action; (3) having no side effects,
being a pure antagonist; (4) being orally effective; and (5) being
suitable for depot administration.

Additional efforts need to be undertaken to develop not only longer
acting pure antagonists, but depots which will allow antagonists and
methadone-like drugs to be administered at 2-week to monthly intervals
and which will provide effective levels of the drug for this period of
time. If we can achieve these goals, I believe that certain motivated
addicts can be benefited by this approach. Because the antagonists do
not produce physical dependence and are nontoxic, they may find a
role in the treatment of the juvenile experimenter.

Turning now from the anatgonists to the general problem of drug
dependence, it is my personal, though professional, opinion that
mounting an effort to deal effectively with drug abuse problems
specifically and the problem of psychopathy generally should start
with the assumptions that we do not have an understanding of the
basic psychopathology or pathophysiology of these disease processes
and that we do not have effective and nontoxic therapeutic measures
to deal with all except a small proportion of the patients incapacitated
with this disease process.

It is further my conviction that both the size of the problem and its
impact on society will continue to increase until we find definitive
solutions. The reasons for this conviction are: (1) The number of
abusable drugs will increase because of the growth of the chemical and
pharmaceutical industries, (2) the impact of psychopathic behavior
on society will become less tolerable as our society increases in size
and complexity, and (3) the complexity and stability of our society
lessens the impact of social controls on psychopathic behavior. Be-
cause of the imminence of the problem, I would recommend that the
following steps be taken: (1) Increase our efforts to identify drugs
with an abuse potentiality early and to utilize appropriate control
measures, (2) increase our efforts to understand the psychopathology
and pathophysiology of psychopathy and through this effort to rationally coordinate therapeutic processes, (3) aggressively search for
nontoxic, nonaddicting drugs that may be effective in the treatment
of psychopathy.

Thank you, sir.
(437)

Chairman Pepper. Doctor, I think some of my colleagues will
share my curiosity, and want to know what psychopathy is.

[Inculcated]

"A new deal for the drug addict" : The addiction research center, Lexington, Kentucky
Auteur(s) / Author(s)
CAMPBELL Nancy D. (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Science and Technology Studies at Rensselaer Polytechnic Institute, Troy, New York, ETATS-UNIS
Résumé / Abstract
This article describes the social organization of knowledge production in the formative moments of the substance abuse research enterprise. It describes the institutional arrangements and material conditions of a U.S. Public Health Service laboratory that was housed in a facility run jointly with the federal Bureau of Prisons. The Addiction Research Center (ARC) in Lexington, Kentucky, was dedicated to elucidating the basic underlying mechanisms of drug addiction. The ARC was housed on the rural campus of a prison-hospital called "Narco," one of two "narcotics farms" in Lexington, Kentucky, and Fort Worth, Texas. For its studies on drug effects, the ARC had access to a pool of drug-experienced human subjects drawn from the ranks of convicted felons. Given their unparalleled access to human subjects, the scientists who worked at the ARC made conceptual contributions still acknowledged today. Based on archival work as well as dozens of oral history interviews with individuals who began their research careers at Lexington, the article presents an analytic, intellectual history of the early work of Abraham Wikler, whose lifelong pursuit of the underlying mechanisms of opiate addiction led him to hypothesize the role of conditioning in relapse, as an exemplar of the kind of scientific research that depended on closely listening to and observing "post-addicts," as subject participants were called.
Revue / Journal Title
Journal of the history of the behavioral sciences   ISSN 0022-5061   CODEN JHBSA5  
Source / Source
2006, vol. 42, no2, pp. 135-157 [23 page(s) (article)] (2 p.1/4)http://cat.inist.fr/?aModele=afficheN&cpsidt=17732598

[try another castle]

RMA had a DuPont as a student. I always wondered if it was coincidence, since I could never figure out how they were related. (His mother was the DuPont.) The DuPonts are a huge family, so it's entirely possible there is no correlation.

[Antigen]

Well, now, Doctor, one of the things that this
committee is very interested in and very concerned about, is trying
to develop a system by which everything that can be done, shall be
done as quickly as it can be done to do something effective…

:lala:

[Inculcated]

Some of this lengthy interview is not included in this post. For the full interview and links to a number of very interesting interviews, follow the link below.
Interviewee:  Charles Gorodetzky  
Interviewer(s):  Nancy Campbell
Date:  July 24, 2008  

--------------------------------------------------------------------------------
 
NANCY CAMPBELL: What was your pathway into the field? How did you come to be associated with the incredible enclave that was the Addiction Research Center in Lexington, Kentucky?

CHARLES GORODETZKY: The story actually starts historically for me when I got a phone call from Harris Isbell in October or November of 1962. I was an intern at Boston City Hospital, having graduated from BU medical school. And Harris told me “We’ve got a two-year position down here for medical officer, would you like to come down to Lexington?” Two years earlier, when I was in medical school, they were drafting physicians. It was the time of the Vietnam war. Even if it hadn’t been wartime, I would have preferred something other than the military, and one option was the U.S. Public Health Service. When I was a junior in medical school I applied for a commission in the U.S. Public Health Service. In those days it was a big deal. I went for a personal interview at Brighton Marine Hospital, which was a PHS hospital in Boston. I had to take a written exam to get into the PHS, and I was awarded an inactive commission at a rank equivalent to an Army second lieutenant. Then when I was a senior in medical school, I elected two months of active duty. Barbara and I spent our honeymoon in 1961, the first two months of my senior year in medical school, doing electives on Staten Island, NY. It was a valuable experience, I met some wonderful people at Staten Island, and I was very impressed with the quality of the medical people that I met.

When I was in my internship, I wasn’t sure what residency I might want to pursue—I was interested in radiology, I was interested in internal medicine—but I really wasn’t quite decided on what I wanted to do. I figured I should do my two years of selective service and get them out of the way. I was going to have to do them when I finished my internship, or I would have had to go directly into a residency and apply for a deferment program and eventually have to do two years of selective service. So I said okay, I’ve got this inactive reserve appointment in the US Public Health Service, why don’t I go on active duty for two years. So I applied for a two-year position in the PHS and when they asked me what I wanted to do, my first choice was a research position. I had a strong basic science background coming out of MIT as an undergraduate, and had always liked the idea of basic research but didn’t have any experience. I wanted to get some experience in the field and see if there was something that interested me. My second choice was to go out to the Indian reservation, because one of the guys I worked with in pathology had been on an Indian reservation and told wonderful stories (for example,  that they give you a house, a horse and a rifle and you were on your own to deliver health care). I thought that would be fascinating for a city boy from Boston.

Because I had asked for a research position, I was a candidate for all of those positions that were available. There was one two-year position that had been created at the ARC. I would be the third person to occupy that position, as it had only been created four years earlier.  When Harris Isbell called me and offered me the job, I said, “Where is Lexington, Kentucky? And what is the Addiction Research Center?”  He answered, “Well, there’s a guy that’s just come to teach at BU who you could talk to.” So I went to see Conan Kornetsky, and said “Dr. Kornetsky, what do you think? Should I do this?” And Conan said, “It’s a wonderful place and it’s a unique place; they’re doing the best addiction research in the world there” In fact there were very few places doing addiction research in the 1960s.  He said, “Go down there for two years, you’ll have a wonderful time.” So I went and told Barbara we were going to spend two years in Lexington, and, as I’ve been fond of telling her ever since, I only lied by an order of magnitude. We were there for 21 years. So that was how I got to Lexington. We came to Lexington with no furniture. We rented an apartment, Bill Martin brought over a few lawn chairs, and we lived on those for a couple of weeks until our furniture arrived. That was so typical of Bill, and typical really of the kind of feeling there was in the ARC. It really was one big family.

There was a very close relationship personally and professionally among the folks at ARC. I arrived officially on the first of July, and my first day of work they were renovating the Addiction Research Center, as happened periodically—they’d rip the place out to the walls and rebuild it from the inside. I was involved in a couple of those renovations later on. I learned how to redesign a laboratory. I designed a whole suite of laboratories for my drug metabolism section. But that wasn’t until the next renovation. During this renovation, everybody was moved out of their offices and they were all put up on the third floor where we had the volunteer research ward, and all the desks were crowded side to side in the day room. And they gave me a desk next to Abe Wikler, which is one of my dominant memories—they put me, this kid out of nowhere, next to this giant in the field.

Abe was just a wonderful person, and that was my introduction to Abe. Although Abe and Harris Isbell and Frank Fraser all retired on the day that I arrived, and they have told me many times, the two are totally causally unrelated, I became very good friends with all three of them. Although Frank left to join Eli Lilly, Abe and Harris just went across town. Abe was in the Department of Psychiatry and Harris was chairman of the Department of Medicine at the University of Kentucky. The medical school was new then. I think it had only started in 1959. But neither one of them totally left the ARC at that time, and they still continued ongoing research there. So I was involved in research primarily with Harris. Abe was doing his work on the chronic spinal dog. I was brought in essentially to be a clinical intern, something akin to a postdoctoral fellow in clinical pharmacology; I worked with Harris, who was the one who really introduced me to human research. And I was privileged to be one of the co-authors on the first paper that identified Delta-9-THC as the active ingredient in marijuana. That was a paper where a group of investigators in Germany had isolated and synthesized the cannabinoids from marijuana, and they sent them to Harris for testing. I think I’m the sixth author on the paper, but that was one of the pivotal papers identifying Delta-9-THC. I learned initially how to do clinical research from Harris Isbell.

Bill Martin was the other one that I worked very closely with, because he took over as ARC Director when Harris retired. Although Bill had a lot of basic science interests and continued work on the spinal dog, he was also running the clinical ward. I got involved with him immediately on some testing of narcotic antagonists, and in re-looking at their abuse liability. Frank Fraser had finished most of the work on pentazocine and cyclazocine  was the next in this chemical series. These drugs came to us compliments of Sid Archer and Lou Harris, whom I met in 1965 at the Committee on Problems of Drug Dependence (CPDD) meeting where I gave my first scientific paper. Sid was a pharmaceutical chemist at Sterling Winthrop, and the young pharmacologist who was testing his compounds was Lou Harris. Lou never seems to have changed, he’s always looked like he looks today. We had CPDD meetings in February at that time and we always met on a college campus. There must have been about 150 people at the meeting where I gave my first scientific paper. I roomed with Bill Martin because on a government per diem you couldn’t afford a room by yourself. The meeting was held at Baylor in Houston, and that was when I first met Sid and Lou and became close friends with them over subsequent years.

NC: What was it like working with Bill Martin?

CG: We were a very small staff, especially those of us working in clinical—me, Don Jasinski, Dave Kay. We were small enough that the atmosphere, the outlook, the scientific perspective was really shaped by one person, and that was Bill Martin. Bill Martin was the one that taught us how to do science. He taught us how to do good science, how to do ethical science, how to do very high-quality work. He’s the one that set the standards and set the atmosphere for where we were going. As we grew, we got more and more freedom. He developed us into being more and more independent investigators with our own ideas, and he encouraged us to do that. But he was the one that set the tone from the very beginning, and I think he set the directions of the other units as well. Even with older investigators like the psychology group. Harris Hill was the same era as Isbell and Frank Fraser. Harris Hill was the one who initially developed the Addiction Research Center inventory. Chuck Haertzen came to work with him and I think Conan worked with him initially as well. They brought other people into that group; for example, Bill Jones was an experimental psychologist who became a member of that group. That whole program was shaped by Bill Martin, again, giving people a lot of freedom, keeping them within the general bounds. He’s the one that taught us our management styles. He set the bounds of the field. He’d tell people, “Okay, however you want to work, work within those bounds.” And you can make the bounds wider and wider depending on the independence of the people.

NC: I’ve heard characterizations of him as a bit more authoritarian.

CG: Bill was authoritarian, but I think more in form than in actuality. I think Bill felt that we needed discipline, and he imposed that discipline. You always wondered when he was criticizing you and trying to bring you along, make you think, make you do things well, and you wondered, what was he going to say to outside people about you? When he got outside, he was all praise. He thought incredibly highly of his staff, and the staff stuck with him. In later years, I think we all became very good friends. Bill was my scientific mentor, in a million different ways. Abe Wikler was as well, but in a less hands-on way.  Bill was the one who actually finally signed off on my PhD dissertation. He was authoritarian, and I think at times we felt that he was being too authoritarian. He was not, in fact. He was trying to make us think, trying to make us develop. As we look back on it, just as you look back on any disciplinary parent, you know it really did you some good. He was really a very warm person, but he felt very strongly about his scientific position and his responsibility for spending government money well and carrying out programs well. He felt a deep responsibility for the people he was training. If he felt you were worthwhile training, and you wanted to stay and he wanted you to stay, I think he took that very seriously. He used to make me jump through a lot of hoops.

NC: When you spoke earlier about what was going on at Lexington as “good science,” I wondered what you meant by that. You mentioned that Bill Martin taught you to be good and ethical scientists at the ARC. What did that mean for those of you who were there?

CG: It had to do with a whole approach. It has to do with asking good questions, questions that are answerable, questions that are amenable to experimental verification or at least experimental exploration. Then once you had asked those questions, you have to go about them in the right way and execute experiments precisely. Then you need the subsequent integration of that knowledge in a way that makes sense, thinking through your data, looking at your data, drawing appropriate conclusions from your data, publishing papers. These are the kinds of things that one learns as one begins to progress in science.
NC: So Bill Martin was somehow able to give a lot of structure but also a lot of freedom within it. What directions did you take personally?

CG: After my two years in that post-doc position, I decided I needed some additional training if I was going to stay in the field. I had become interested in drug abuse or at least in pharmacology. I decided I either needed to go back for residency or to graduate school. Being academic by nature, I decided to go back to graduate school. The University of Kentucky was right across town and had a pharmacology program. I became the first graduate student in the program, because the school at that time was only about five years old. So I went across town to become a graduate student. I managed to convince the government that it was in its best interest to send me to graduate school, so I actually went back as a commissioned officer in the USPHS. There was one professor who for years never forgave me because as an assistant professor he was making less money than I was as a graduate student. Of course, I already had an MD, but that was beside the point.

I was working in opiates, and had been involved with Bill during the early experiments with nalorphine and cyclazocine, during which he really developed the concept of multiple opiate receptors. Bill Martin was one of the originators of that idea. Although he didn’t do the molecular work to identify the receptors, Bill’s concept was there. He was talking about a nalorphine and a morphine receptor, and he published that work in Pharmacologic Reviews in 1967 or 1968. I built my dissertation around looking at the opiate receptor hypothesis. I wanted to look at various models and determine whether the interaction of morphine and nalorphine using them alone and together best supported a two-receptor hypothesis or a one-receptor hypothesis. That was where my dissertation was going. I learned a lot about science and a lot about opiates, but I never did get definitive data. I wanted to do five models, but wound up inventing one model. Five models would have taken me probably twenty years. As it was I didn’t get my PhD dissertation written until 1975. I got my degree, and Bill Martin was my final dissertation advisor. One of my fond stories about Bill was when I was a graduate student—of course I had to take all these graduate courses, and Bill was on the graduate faculty and I took one course with him. And in my entire graduate school career, that was the only ‘B’ I got. When I asked him about it, he said, “It’s good for the soul, nobody’s perfect.” He was our taskmaster, keeping my nose to the grindstone and making me get out those pages and go over them with him and making sure my scientific arguments were sound. It was in retrospect a great learning experience, as graduate school is meant to be.

NC: Would you describe yourself as moving toward neuropharmacology after you finished graduate school?

 Clinical research was in a relatively early era even in the early 1960s. We were still developing appropriate design of experiments with appropriate controls, with appropriate ethical concerns, what was ethical to do and what was not ethical to do, and how you do it. We were very sensitive to those issues. We were very sensitive to the issues of coercion and seduction because we were working with prisoners. We thought about those things and we talked about them and began to develop the concepts;  and that was part of good science, too. It was a vital part of good clinical science. Certainly, that was not happening in isolation from the rest of the scientific community. Those concepts were developing throughout the scientific community, as people began to do better and better clinical trials and better and better clinical research. I think where we began to get a bad rap – if indeed we did – and even that may be putting it too strongly – was when the ARC was redesigned when it moved up to Baltimore. It wasn’t that we were doing bad science but that the questions we were asking weren’t basic enough. There was a practical side to our questions. They were practical kinds of questions and a lot of our program in Lexington was oriented towards answering those practical questions. From my perspective, developing adequate questionnaires and validating them for evaluating subjective effects of drugs in humans was a pretty legitimate enterprise. From the NIH campus folks’ perspective, they were working at a different level. They wanted to know what was happening at the molecular level, that was their orientation. So I don’t think it was so much that we were accused of doing bad science but that we were accused of not going deep enough into mechanisms and molecular biology.

NC: Wasn’t molecular biology just coming on at that point?

CG: Yes, but a lot of the work at NIH  (although certainly not all) had always been more at a basic level rather than the clinical level. It was more from the perspective of “Let’s learn about the brain, let’s learn about how the brain works and then once we know that, we’ll be more able to explain how disease occurs in that brain.”. Now, there was obviously disease-oriented research at NIH – there was wonderful clinical research there. But the orientation always seemed to be much more basic, much more oriented to the lab.
We were much more practical in our outlook. But from those studies done at Lexington a lot of very basic concepts emerged. I think that somehow people lost that connection  - that out of human studies in the abuse liability of nalorphine or cyclazocine arose the ideas of the multiple opiate receptors. It wasn’t from working in a test tube that that concept first arose. It was out of detailed and accurate observation of human subjects. That was another thing that we were taught to do. That was another part of the science we were taught to do – we were taught to talk to our subjects, to observe our subjects.

NC: Do you think that people are not being taught that now?

CG:  I think they are, but a lot of it, fortunately, has become ingrained into the appropriate methodologies for doing these kinds of studies. So a lot of it has been codified. I think it’s being taught in relation to whatever they are doing, although I sometimes find scientists not paying the kind of attention to their data that I was taught to pay. It’s so easy these days to plug data into a computer and press a button and get a result and not have any idea what happened to the numbers. I found it so instructive to have to write my own programs for doing analysis of variance because I had to know exactly what happened to the numbers. I had to realize that when that number changes, the implications of that in the statistical variation are the following. . . . I didn’t learn it to the same degree as Don, who is a real expert in biostatistics.  I had a much simpler level of knowledge in that area. The kind of things I learned was how to look at your data, learn what you’re doing with the numbers, not just plug them in and press a button. There are people doing superb science who have a very good feel for their data. Graduate students in the neurosciences these days are learning those details, I have no doubt about it.

NC:  How did you learn biostatistics, how did you learn to write those programs?

CG: By the seat of the pants. Some of it was formal but a lot of it was learning from Don, learning from Bill Martin, learning by doing, learning by having to do them, learning by going to the book and finding out how to do them. When we first started doing statistical analysis, we had these big mechanical calculators that just ground away.

NC: What technology did you have available at the ARC?

CG: Technology initially was very creative. It was probably appropriately state-of-the-art for the time. A lot of the work that was done out in the animal lab was invented in Lexington. It was handmade in the physics lab. A physicist named Harold Flannery would design what was needed. I was told by Abe Wikler that the first EEG machine west of the Alleghenies was built at the Addiction Research Center. But a lot of that instrumentation was handmade. When I came to ARC computing and electronics was still in its infancy. As that grew, we grew with it and we acquired the technology that was appropriate. When I was doing drug metabolism work, we were on the cutting edge of analytical chemical technology. We had a mass spectrometer. We had a lot of gas chromatography. A lot of instrumentation was automated. It wasn’t automated to the degree that it is now because now everything is computerized. When we finally closed Lexington in 1984, we had computer capabilities dedicated to particular kinds of experiments. For example, we had Dave Kay’s dedicated sleep lab. A lot of experiments we did in the animal labs were automated. A lot of our equipment was computerized. We didn’t have PCs in the early 1980s. We had the generation before that—we had highly programmable calculators that were essentially very early computers. I think that was pretty much state of the art at the time. I learned how to do bio-assay statistics, which are fairly complex, on a programmable calculator. It used to take me a whole day to do what you now could do in about thirty seconds by pushing a button. I learned those from Bill Martin and Don Jasinski.

We learned by doing. We learned in informal as well as formal ways. I had a wonderful association when I was doing my graduate work with a statistician by the name of Bill Thompson at the University of Kentucky. I started at the University of Kentucky in 1965. I subsequently brought him to the ARC and he worked there for many years. He was the in-house consultant. He knew enough biology that he understood the biological processes and I knew enough math to talk to him. That was when I started learning computers and doing Fortran programming with decks of cards on an IBM computer that would fill up this room. That was how we did non-linear curve fitting. So we had a lot of expert support and we did use the University of Kentucky in a collaborative sense. I maintained adjunct faculty status the whole time I was at Lexington and for about ten years beyond that I would come back every year and lecture on biostatistics for medical students. I tried to get medical students to understand what a T test was, what it meant by plus or minus standard error, what does that kind of information mean? We took it as far as simple analysis of variance.  

NC: When you were at the ARC, did you feel like you were a well-supported part of science, on the cutting-edge of this science, despite being off in the middle of nowhere?
CG: Yes, we were always very well supported. Part of it was because I think we had a very practical goal in much of our research: what was the relative abuse liability of a particular drug? Our support was all intramural, Bill Martin was a wonderful advocate, and Harris Isbell before him was a wonderful advocate, so they were able to get programmatic intramural monies. That was how we existed. There were higher budgets and lower budgets, and you obviously had a budget, but I felt we were very, very well-supported. The biggest problems came in hiring freezes, when the government said we couldn’t hire.  For a while I actually held a grant with Abe Wikler that we used mainly for hiring people through the university. But they worked full-time at the ARC. That was all acknowledged—there wasn’t anything crooked about it, but it was an unusual mechanism for an intramural program. So it was a really neat place. Everybody did care for each other, we did bring people in; I don’t remember anybody ever being excluded, even if behaviorally they were a little “far out”. And we had some far-out folks.

NC: Did you think of yourselves as government or public or academia or industry?

CG: We thought of ourselves as NIH, as government-academia. We probably thought of ourselves as more a high-level academic center. We had a lot of close relationships with industry, probably closer than any of the other NIH laboratories.

NC: What was the nature of those relationships and how did they change over time?

CG: The nature of the relationships were that Lexington was the only place that did human abuse liability studies, and any company that was bringing a drug on the market that had potential abuse liability essentially came to Lexington to get it tested. We maintained a great deal of independence in those studies. We never accepted money for them, it was done from a perspective of public health. Doing those studies was one of Don’s main jobs. They were always done as academic studies. They were not done only to get the abuse liability data but also to develop knowledge. The knowledge that developed out of those - naloxone, naltrexone, cyclazocine, the whole concept of partial agonists – all arose from those kinds of experiments. All of that came through Lexington. Although we had good relationships with the industry who came to us to get that data, we were the ones who designed the experiments. We were the ones who determined what was going to be studied and how it was going to be studied, and we wrote them up independently. Then that data became available to the industry to make their case for what was going to be the abuse liability of their compounds and their clinical utility. Questions such as: How will naloxone be used? How will naltrexone be used?

NC: Did that kind of relationship work for both parties?

CG: Yes, I think it worked very well. We were very jealous of our independence and we were very cognizant of not compromising that independence in our interactions with industry. We knew the kinds of data they wanted to get. We thought that was important data for the public health, so we did experiments under government auspices to gather that kind of data. But we also designed the experiments to gather information that we thought would be more broadly useful, like therapeutic information and  basic mechanisms (for example, defining partial agonist or how these drugs interact). We developed some wonderful relationships with industry scientists. They would come and visit us and on rare occasions we would visit them. More often they came to us. They would bring compounds. Everything was done under legal auspices. FDA required them to have INDs, all kinds of qualifications and licenses.

NC: Did you have much of a relationship with the FDA?

CG: Our relationship with FDA was really one of a sister agency. When we sat on their committees we sat as independent scientists. That was a little bone of contention with NIDA, because NIDA always we felt we were there as the Institute’s representatives. But we really felt we were there as experts in this area. That’s really the way we acted on those committees, Bill Martin, Don, I and others. We were always invited to sit on those committees as experts in the area just like all of the nongovernmental experts who sat on those committees. That was how we conducted ourselves. Again, we built a lot of close personal relationships with FDA people. We worked closely with them but it was mainly as a sister agency. We had official relationships with them and then relationships with them as individual scientists.  

NC: Were there changes in those relationships over time?

CG: The relationships began to change when NIDA was formed. When those relationships began we were in the Division of Narcotic Addiction and Drug Abuse in NIMH.  When NIDA formed as an independent institute, as one of the three institutes of ADAMHA, it became more organized and bureaucratic and the relationships became more complex. But I never felt that the relationships I had with FDA were changed because of NIDA’s existence. We continued to have those relationships with industry people while we remained in Lexington. The bureaucracy became more complex for them but we were able to maintain scientifically cooperative relationships during that time. My relationships with industry people were not quite as close as those of Don because he was running the clinical ward. I also had relationships with the technology industry making instrumentation for urine screening like the folks at SYVA, who made the EMIT system. My relationships to the folks that were making the technology for urine screening were very similar to the kinds of relationships we had with the pharmaceutical industry. Even though I was doing work that they would be able to use, I was doing it with no payment and always from the perspective of increasing the science base that would allow clinicians to appropriately use the kind of methodology they were developing. Again I always designed my own experiments; they never dictated the kinds of experiments they wanted me to do. All those things were reviewed by our committees so there were all kinds of checks and balances internally. That was the area that I did the most original work in - urine screening methodology, developing the basic concepts of urine screening—sensitivity, specificity, and validity.

NC: What drew you in that direction? Why were you working on that?

CG: We were trying to put some kind of conceptual framework around urine screening methodology. It was an area that interested me. It was an outgrowth of drug metabolism. Because what we were trying to add was the human element to it. It’s one thing to say “I can find morphine in the urine,” it’s another thing to determine what that means in terms of when the subject took his last shot of heroin, how much he took, and how long ago? And it was those kinds of parameters that we were exploring.

 NC: Were you encouraged to go in that direction? Was that a direction someone wanted you to go in for governmental purposes?

CG: No, it was a direction I found myself. I was the one that sought it out. It started with my interest in drug metabolism and then grew into the specific program-oriented piece of drug metabolism, which was detecting drugs of abuse in the urine. We were interested in specificity, sensitivity, and the parameter that we added that people had not considered,  validity. That’s the ability to detect drugs after human drug consumption. We wanted not just to detect drugs in the urine, but to know how the results related to people taking drugs. And we tried to produce a lot of that kind of data.

NC: Did you think about commercial applications of urine testing at the time? Were you thinking about what drug testing might become as an industry?

CG: No, not too much. To some degree I did. I became involved peripherally as new technologies began to develop, like the EMIT [Enzyme Multiplied Immunoassay Testing] system. Those people would contact me to do some human testing for them. So we would run experiments and look at a variety of technologies and methodologies and compare them. I did a lot of the original human work on the EMIT system. Not the chemical work, but work on validity. We were also doing much more formal drug metabolism in those days. We brought in Ed Cone in about 1970. Ed was in my section, and, in fact, when I became Associate Director of Lexington in the early ‘80s, I turned my section over to him. He became the section head, which continued into Baltimore. Ed came in as a chemist, which he is, and then turned his interest to drug metabolism.

NC: With your urine screening work or abuse liability studies, was there concern about what we would call conflict of interest?

CG:  There was recognition of that potential. Very much so. We were very careful to be aware of potential conflict of interest. I remember when Frank Fraser went to work for Eli Lilly, Bill Martin wouldn’t even let Frank buy him a cup of coffee at a Federation meeting. We were all cognizant of that and I don’t think we were ever accused of conflict of interest. Everything we were doing was published in the open literature. It was all studies designed by us, and all went through our review process internally, our own institutional review board.

 I’m probably very similar to a lot of individuals who spent time at Lexington. We came away with very, very positive feelings about what went on there. There may have been individual conflicts, you may have thought that Bill Martin was too directive. But when you look back on your experience, almost all of us have real positive feelings about what was going on and many times some nostalgia about how nice it was that we didn’t have to worry about a lot of the things we have to worry about now (for example, all the administrative-bureaucratic structures we have to contend with). We were just as ethical and just as concerned with the same kinds of issues as we are today, but it didn’t have all the bureaucratic paraphernalia surrounding it. It was much simpler, so I think we look back on it with some nostalgia on the freedom that we were given to do good science relatively unencumbered. A lot of that I attribute to the way Bill Martin ran the ARC. He took care of all the bureaucratic stuff for us. He argued with headquarters about budgets and he’d leave us alone to do science. At the time we probably didn’t appreciate it as much as we should have.

NC: Do you recall genetics or heredity ever discussed at the ARC?

CG: It certainly came up but we didn’t ever have an experimental approach to it. We discussed some of it from the sociology side – who are the subgroups and why do they get involved? Why do people get involved with drugs? Who are the people who get involved? It arose from the sociological side, from population thinking rather than from neurobiological thinking.

 

NC: Did you have to defend the kind of science you did in order to justify budgets?

 

CG: We had less of that to worry about in the 1960s and ‘70s at Lexington. Bill Martin was fighting those battles. We certainly had to justify what we were doing – it had to be legitimate. It was mainly to Bill that we had to justify what we were doing. Later on we had to do more justification and we had to do things like grants. We were certainly under scientific review. We started having review committees that gave us good critiques and changed some of the directions we were going. That increased over time. Early on it was just Bill Martin that we had to satisfy. It had to make scientific sense.

 

NC: What do you think were the most significant findings that came out of Lexington?

 

CG: If you go back to the very earliest days of the Himmelsbach laboratory that led to the ARC, I think the whole description of the opioid abstinence syndrome, the fact that there was such a thing came out of those earliest studies. Similarly, the studies of Harris Isbell in the 1950s that described the alcohol withdrawal syndrome, that that’s what the d.t.s were, that they were indeed withdrawal, and extended that immediately to sedative-hypnotics. I think basically that Abe Wikler’s work that developed the concepts of learning and conditioned abstinence was seminal as well. I think that the concept of multiple opioid receptors, which emerged primarily from Bill Martin’s work, was a key concept. By that time there were a whole lot more people working in the field so it’s hard to give priority. I think that Bill Martin deserves a great deal of credit for the whole concept of opioid receptors; but he was not working on molecular systems or binding systems. He was working from acute observations of human and animal pharmacology and a way to explain what he was seeing. I think the emergence of narcotic antagonists – their use, their pharmacology – again evolved out of a lot of the work in Lexington. I don’t know whether my work on urine screening methodology would even fit in the top group. I think it was a contribution to understanding of drug metabolism but it was not necessarily a conceptual breakthrough. I think if I had to distinguish it, it would be putting a conceptual framework around urine screening. I wouldn’t put it in the top five of things that came out of Lexington.

 

Another big contribution was the development of methodology for evaluating human pharmacology, subjective effects in humans. I’d put the ARC Inventory in there, and a whole host of methodology that Harris Isbell, Abe Wikler, Frank Fraser, Don, I, and Bill Martin developed around evaluating drugs in man. They’re still basically similar to the ones in use today.  A lot of that work was initially done in Lexington.  I think people are vaguely aware that methodology involving abuse liability of opiates came out of Lexington. But I don’t think young people are aware of that – it’s been so suppressed.

 

NC: What do you think was responsible for the amnesia or suppression of Lexington?

 

CG: I think it’s because the field has just grown so rapidly and because of the move from Lexington to Baltimore, the elimination of the hospital as a narcotics hospital. Part of that came from the fact that throughout the country from the Thirties on to the Seventies, junkies all knew there was a Lexington. It was part of the culture that if you were a junkie, you got sent to Lexington. If you were an addict, that’s where you wound up. It was celebrated in the movies. Everybody knew Lexington. Since we left there in 1984 and the hospital became a federal prison, that whole cultural consciousness has disappeared. Honestly, I think that Alan Leshner’s conscious effort to rebuild the ARC as the intramural research program along the model of the intramural NIH research laboratories on campus contributed to that as well. I don’t necessarily fault him for that, I think he was good for the ARC, I think he was good for the development of that intramural program to a new level of sophistication. But he could have done it without totally suppressing the memory and the historical context of what was done importantly at Lexington. Methadone as a treatment modality, not as a maintenance modality but as a withdrawal modality, that all came out of Lexington. I think that those are the things that contributed along with the fact that science has grown rapidly. Neuroscience has grown rapidly, interest in substance abuse has grown very rapidly. When I came to Lexington in 1963, I think that laboratory was the only one anywhere in the world that was doing any extensive work studying addiction. That changed in the ensuing decade. I think that the discovery of opiate receptors generated tremendous pharmacological interest. As the field has grown in beneficial directions it has become very strong especially on the academic side.

 

I think the folks that come into the clinical side, that begin to do clinical research on substance abuse, tend to learn about Lexington. The academic folks are doing much more sophisticated things than we ever did in Lexington.

 

NC: What accounts for the incredible proliferation and explosion of the field? The discovery of the opiate receptors or something more?

 

CG: Part of it also grew from the clinical side and I trace that to Vietnam. There was such tremendous social concern about addicts coming back from Vietnam, about people coming back with exposure to very high-grade heroin. There was tremendous concern that there was going to be a huge problem in this country. That spurred a lot of research and funding of clinical programs. Then the clinical programs considered what was the basis of what we’re doing here for treatment. We obviously needed more basic research on treatment modalities. That kept working back to the question of what is an appropriate  treatment modality.  What are you trying to do at the biochemical level? At the receptor level? All of that began to blossom in the context of the increased general funding for science and the increased emphasis on neuroscience. The tremendous strides in neuroscience have all led to this increase. And then, of course, the increased publicity about the cocaine epidemic led to increased concerns, and an increase in the availability of funds increased the interest of the academic community in developing grants to explore basic mechanisms.

 

NC: Do you think the academic community began to do more basic research?

CG: Yes, I think they did. To state it another way, I think the basic scientists in academia became more interested in the field. One big factor had to be the availability of funds. NIDA had money so they tilted their science towards substance abuse. And, of course, it then became very basic. There’s a lot of basics to learn about the brain, a lot of things about drug receptors. When you start thinking about endogenous compounds like the enkephalins and endorphins that actually interact with the receptors that we thought were interacting only with exogenously administered compounds, that was one of the great conceptual breakthroughs. That came from Hans Kosterlitz, I think, the conceptualization that said: Why do humans have receptors in their brains for a substance that comes from the opium poppy? That doesn’t make any sense.

The conceptual breakthrough was that there’s got to be an endogenous compound that’s also meeting that receptor. I think that conceptual breakthrough has had tremendous implications for the field, because then you’re looking for endogenous everything. There are a whole host of endogenous compounds. There were then a whole group of people who concentrated on this area of opiate receptors – for example, Sol Snyder, Avram Goldstein, and many others. There were a number of centers that were working simultaneously in the same area. The science was ripe for people to begin thinking at the molecular level, for isolating receptors; there developed the ability to do cloning and get purified receptors, the analytical capabilities to look at three-dimensional structures. All of those things coming together at the same time spurred a lot of superb thinkers to begin to work at these levels. Certainly Sol Snyder was one of them, but his initial interest was not in substance abuse but in neurochemistry. But it all came together, and he was instrumental in it.

NC: How did those of you who were at Lexington at that point feel about this other world?

CG: It’s interesting. I think that we were working primarily at much grosser levels. A lot of us were interested in humans and we were looking at substance abuse in the phenomenologic areas. So we looked skeptically, critically; but I think it soon became very apparent that this was all complementary, that what was being studied by Hans Kosterlitz in the brain was very much related to the people that we were seeing on the wards of the ARC. So I think it became apparent to us that this was a very complementary part of the science, that we were all doing the same thing at a variety of levels. We began to develop a little bit of capability in that area at Lexington. Not a great deal, but a little, and that was an area we obviously needed to do a great deal more on. We brought Tsung-ping Su into my laboratory. He started doing a lot of work on binding. So it began to evolve but nowhere to the point that it should have. That was something Alan Leshner stimulated after the ARC moved to Baltimore. It was obviously an area in which we had to grow and should have grown. By that time we were already caught up in the renovation and relocation of the ARC. We were obviously not in a growth phase but in more of a hold-the-line phase. We were not looking to hire new people in Lexington and build new laboratories because we were going to be moving.

NC: When did the redefinition of addiction as a chronic, relapsing brain disease come about in your view? When did that begin to be a way of thinking about it?
CG: I was introduced to that notion when I got to Lexington in 1963. The folks at Lexington were biologists. Abe Wikler was a psychiatrist, but Abe was a biological psychiatrist. Abe Wikler was the kind of guy who, when confronted with the id and the ego, would say, Show me where it is in the brain. What’s its chemistry? Where is it located? Those are the kinds of questions that Abe would ask. That was the way all of us at Lexington got interested in this. We always thought of this as an illness. The concept came as no surprise to any of us. I had always thought of drug abuse as a chronic relapsing illness. That was the way everybody thought about it. We used to argue about the great recidivism rates at Lexington and the terminology that we used was that this was a chronic, relapsing illness. This was not an infection that you cure overnight and it’s gone. The longer you can keep people in remission, the more good you’re doing. The fact that some of them relapse is to be expected of a chronic, relapsing illness. That kind of conceptualization was present at Lexington – at least at the ARC – from the very beginning.

NC: Would you say that view was less prevalent on the clinical side of Lexington?

CG: Maybe less so among the psychiatrists at the hospital, although there was a moderate amount of interaction. We were in the same facility, but there was a physical separation. We had to keep the research ward separate from the prison and volunteer population. But we mixed and occasionally held joint seminars. We had some joint committees across the whole institution, like the Equal Employment Opportunity Committee. I was on the EEO Committee for years. That was a hospital committee and I was the ARC representative. A lot of the folks who came to Lexington as psychiatric residents, who came to the hospital as residents, were very much research oriented – people like George Vaillant, who is still up at Harvard. Herb Kleber, Everitt Ellenwood. These guys were interested in research from the start and there was a lot of interaction with those folks, more on an individual basis than on an institutional level. On a social basis, many of us were commissioned officers in the Public Health Service, so we mixed at that level as well. Jerry Jaffe was part of that group before I got there. We didn’t overlap, but Jerry had a lot of close interaction with Abe Wikler and Bill Martin at the ARC.

NC: Was there conflict between different models or definitions of addiction at Lexington?

CG: There was, but there was not really much conflict within the ARC because we were all pretty much in a biological state of mind. People in the hospital were, too, but not totally, and there was the more sociological perspective and the perspective that this was a psychological problem. There were even some volitional ideas, the idea that people used drugs because they wanted to and they didn’t need it if they were just strong enough. There was some of that attitude around, but probably more with the general public than with the institution. The treatment modalities in the hospital in those days were still psychiatrically oriented, although I think they still saw it as an illness, as a psychiatric illness.

NC: What do you remember about the daily routine of the institution?

CG: The patients lived in a population and they were assigned to four industries. There was the printing industry, there was the farm for a while, the woodworking industry, the maintenance and laundry, and clothing. This was all regulated by the Bureau of Prisons and they got a certain amount of good time and a small amount of money which they could spend in the commissary. Their routine involved going to their jobs, participating in group therapy and some individual therapy sessions. Some of them worked in the dental clinic. We used to go there for dental care. The dentists were commissioned PHS officers, but a lot of the dental assistants were addicts who were in treatment, patients. The barbers were patients. They cut hair for staff. Families used to bring their kids in. The staff numbered in the hundreds. The ARC at its max got to about 100 to 110. We were about 20 to 25 professional staff, doctoral-level staff. Those peak years were sometime in the late 1970s.

Our interaction with the hospital patients was mainly through the recruitment of them as research subjects. The prisoners who were participating in our research, if they were on a single-dose study, as I recall, they would come in the night before. We had a ward, which was 15 to 20 beds. They would be examined, whatever the protocol called for. They would participate in the study the next day and I think usually they were dismissed back into population later that day. If they were intoxicated, obviously, they would be kept overnight again. During that day they participated in whatever was being done in the study. Mostly it was observation but there might be questionnaires, vital signs, cardiograms or other instrumental measures. They had a day room where they could watch TV, play checkers or chess, that kind of thing, a fairly comfortable room. There were 10 to 12 people at a time. They could stay in their rooms or come out. The rooms were all single bedrooms. There was a full staff – nurses, attendants, orderlies – there all the time.

Then there were a group of patients who would live on the ward for a period of months; they were patients who were undergoing chronic testing, where they would be experimentally administered maybe morphine, maybe a new drug to see if when it was discontinued, it would result in abstinence. There were formal methodologies, substitution experiments, precipitation experiments. Those patients, again, would live on the ward and they would have access to the day room. They were fed there. We did have an exercise facility, a weight room, and a small, fenced in yard where they could do things like lawn bowling. We had a bocce court outdoors. That was all, of course, under supervision. I believe that we had that during the time that we were using prisoners from the hospital. When we stopped being able to recruit from the hospital in 1968 when the civil commitment regs came in (nobody was committed for more than six months), we went out to the federal prisons and recruited addicts. I made some of those trips to Atlanta Penitentiary. We came out here to Kansas to visit Leavenworth. Actually, that was the first time I was ever in Kansas City, where I now live. We recruited some of those prisoners to come to live at the ARC, usually for about two years. We maintained a prison within a prison. We maintained a separate ward with as many as a hundred beds, and those were patients living in our population. They were then kept separate from the hospital population and they would volunteer to come from that population to the research ward, either for single dose studies or they would live on the research ward if they were in chronic studies.

NC: Was it viewed as desirable to be on the research ward?

CG:   I think it probably was. I think it was viewed as desirable by at least some addicts to come to Lexington, for example, if they were serving 20 years in Atlanta. Partly because it gave them some variety. If they were sitting in Atlanta doing 20 years, they could at least get on the bus and come to Lexington for two years. The life in Lexington was different from the life in Atlanta, not necessarily any better or any worse, just different. Some of them honestly had some altruistic desire, they thought they were doing some good, and some of them honestly were coming to the program because they thought they were going to get drugs. And some of them did. Not all of them – we had placebo controls in our studies, too.

NC: Did they know the study design?

CG: Yes, these were done under double-blind conditions. You tell patients what the possibilities were. And the days for the researchers depended on what you were doing at the time. You’d work in your laboratory. We used to make rounds on the ward if you had patients there. You were responsible for your patients if they were your experiments.

NC: Tell me how the research subjects were housed at the ARC.

CG: The research subjects were always housed separately in those days. When I came in ‘63, we were still getting all our research subjects from the hospital. At that time the hospital took both prisoners and volunteers, and about half the population at any one time were prisoners and half were volunteers. The prisoners could be sentenced to Lexington to serve their entire sentence, and some of them were serving 15-20 years.

NC: Was sentence length an issue for you at the ARC?

CG: Yes, and it all culminated in 1968 after the passage of that Narcotic Addict Rehabilitation Act, the civil commitment act. In fact that was when they stopped sentencing people for long terms to Lexington. They’d sentence people for just six months. Part of our research protocol was that we would not treat people within six months of release with experimental drugs. They had to be drug-free for six months before release. So we couldn’t use people unless they had long sentences.

NC: What else do you remember about the protocol?

CG: It was probably very similar to the one that we used when we went out to recruit prisoners from prisons to come live at the ARC. We didn’t do that in the early days, but after 1968 we did. When I first got there, we were just going across the hall. There was a group of prisoner volunteers who lived in our unit up in the research ward, and they were the ones who were getting experimental administration of chronic morphine—the direct dependence studies. And they would get experimental drugs as well. They lived on the ward. But patients participating in single-dose studies, where they only get dosed once a week, were only staying in the research ward overnight. Then they’d go back to the prison population. Part of the protocol at that time—and I don’t know whether I’ve got this documented anywhere or not, it may even be in some of the early minutes of the CPDD—was that they had to have documented episodes of recidivism. We weren’t taking first-timers. I think they had to have two documented episodes of recidivism. We didn’t experimentally administer any drugs within six months of release. I’m not sure what the other specific criteria were. I think they had to have had a history of use of the type of drug we were looking at; so, for example,  if you were going to administer hallucinogens, you wouldn’t administer them to somebody who didn’t have a history of hallucinogen use. And the same principle was applied to hypnotics, opiates, cocaine, etc.

NC: Were there any health-related criteria?

CG: Yes. One of my duties as a two-year medical officer was to do the pre-study history and physical. They had to be in good health and have all this documented history. They had to have no clinically significant deviations in their clinical lab values. Pretty much the kind of criteria you use in any volunteer research.

NC: Was there anything like an institutional review board?

CG: Yes, but it wasn’t called that. We may have called it an ethics committee, but I can’t remember what we called it because my mind’s just crowded with the terms we use today. But it was constructive. The major difference from today’s IRB is that there were a lot of internal people on it. We had external people as well, we had people from the University of Kentucky, we had a clergyman on it, we very frequently had a patient advocate like a nurse, who was not part of our staff. But the majority of it was internal staff. We did all the same kinds of reviews as are done today, but it didn’t have all the formalities that you have now within clinical research. We didn’t have the formalities of special reporting of serious adverse events and that kind of safety issue. We  didn’t have the volume of formal rules we have today.

NC: Did you explain the purpose of the research to the participants?

CG: Yes, we did informed consent that the volunteers signed. And they did it for each study. They could turn down a study. Even after the days when they were our in-patient population, they could turn down a study.

NC: Would it be fair to say that the ethical climate was really different then?

CG: It was.

NC: How would you characterize the differences?

CG: I cannot think of any time at ARC when the ethics of informed consent in research were not impressed on me. I think there was every bit as much concern as today for the rights of people, the rights of privacy, the dictum of do-no-harm, the dictum of doing beneficial research that was well-constructed, the issue of risk versus benefits. Those issues were all there. The difference was probably people’s sensitivity and concern for the so-called “special population.” The special at-risk population. We always felt we had to walk a tightrope between coercion and seduction. Those were the things that I was taught. You can’t coerce people into research—it has to be free informed consent. I think we went out of our way to get free informed consent. Of course, we were getting informed consent from prisoners, and that’s where the ethical climate was different. Because as it developed after 1977, by definition it was agreed that a prisoner could not give free informed consent, because they were in prison.

I thought that was a very narrow point of view. I thought they did give free informed consent. I think we went out of our way to make sure that they could give their consent freely. Now obviously they were gaining benefits from us. It wasn’t treatment benefits. We never stated this in any way as being a therapeutic benefit. But these people were serving long sentences, they liked to have the variety, and some of them I honestly believe were altruistic. I believe that some of them really felt for the first time in their lives, where they had never done much good, that they could actually do something that was a benefit to others. And the other thing we could not do is try to seduce them into research. Seduction had the very practical operational definition of not being able to offer them money or extra time off their sentences. What we were able to offer was exactly the same as they could earn by working in prison industry. We could not offer them anything more. Now they did get more personal attention obviously, there were people paying attention to them all the time. They probably got somewhat better medical care when they were with us, because we were concerned with doing frequent physicals and keeping track of vital signs and all the things you would do especially in a chronic study. Those were never offered to them in that way, it was never presented to them in that way. So I think really the difference in ethical climate was mainly looking at these special populations.

 
The National Commission came to see us. I remember when they set up that commission in the mid-70s. Joe Brady, I remember, was the member who came down to see us, and I would subsequently get to know Joe very well. The conclusion of that commission was that what we were doing at the ARC was really state-of-the-art in terms of ethical considerations. They still banned federal prisoner research in ‘76, and they still gave Harris Isbell a hard time. But they were more upset with Harris, I think, for the things that occurred in the ‘50s than the things that occurred in the ‘60s and ‘70s. By the 70s Harris was already out of the ARC.

NC: How did Harris Isbell respond to being called to testify in the congressional hearings of the 1970s?

CG: I think that he felt that he was doing what was appropriate for the time. He was doing work for the Department of Defense in the ‘50s, I believe. I think he had some DOD money and I think he did some work with hallucinogens. I was involved in LSD studies with Harris in 1963. We were looking at a chemical analog of LSD and at morning glory seeds. We were still doing hallucinogen research, but it was not under the auspices of the DOD, it was not for defense purposes.


NC: Did it make a difference for your science that you were in such close proximity to your subjects? Did you gain anything from observing or interacting with them?

CG: I think we gained a great deal. Certainly in terms of our own personal growth and knowledge of the field, and knowledge of addicts, it was extremely valuable. One of the most striking examples of where that was important was in Abe Wikler’s observations that led to his experimental work, and subsequently to Chuck O’Brien’s experimental work in conditioned abstinence and the whole role of learning. Abe always used to say he got that first hint from talking to addicts. They said, “You know, Doc, I’ve been in this hospital for five years, I go back to my community, I don’t shoot drugs; but as soon as I’m in that environment, I start feeling abstinent.” And that’s where that whole idea originated for Abe. Then he went back and demonstrated in animals that you can condition abstinence.  And Chuck went back and demonstrated experimentally in humans, that you could condition abstinence. Yes, I think it was very valuable and I think it was valuable for the addicts as well. They came in close contact on a continual basis with a whole group of caring professionals.

NC: What do you think they made of you? What did they make of this research enterprise?

CG: Some of them really understood what we were doing and why, and I think had a good appreciation for what we were doing. We always debated about doing follow-up afterwards, but we weren’t able to follow these people back into their home communities. We didn’t have the resources to do that. All of us thought it would have been valuable to do it. Anecdotally, when we talked to these people again when we met them years later, we got the clear impression that they had benefited from their participation in research. But as far as statistics, we never had any formal studies.

NC: So in what situations would you encounter them later?

CG: We would encounter them if they came back into the hospital. That’s mainly where we would see them. I don’t think we encountered them in any other venue. Although some staff who went back to academic positions in New York or elsewhere might easily have met these same people again.

NC: Clearly there came to be a more sociological emphasis at some point. Was there conflict or cooperation between the more psychoanalytically inclined? Was there conflict between biological psychiatrists and sociologists and the more clinical folks?

CG: Not within the ARC, but there was within the field. There had been a large sociology unit in the hospital that was mainly involved with social work. A good friend of ours still, Bill Padberg was a social worker who worked there when we came in ’62. He’s now a Professor at the University of St. Louis. Obviously a sociology research group was missing at the ARC. I’m not sure when Jack O’Donnell came over, but Bill Martin established a sociology program and brought some of the research-oriented sociologists from the hospital to the Addiction Research Center. Jack O’Donnell ran that unit and John Ball was part of it. That was one of the beauties of the ARC, I felt—that interdisciplinary research was so easy to do. It was an interdisciplinary group from the word “Go.” We always felt that the whole problem of drug abuse, the whole concept was a multidisciplinary issue. It took in everything from sociology to molecules. And I think Harris felt that and certainly Bill felt that we should span the entire gamut.  My own feeling was that it was the ideal bridge between pharmacology, basic science, and medicine, which was one of the things that attracted me to the field.

 Bill Martin worked on the spinal dog. I was doing animal drug metabolism work as well as human drug metabolism. The people who were in biochemistry always had human interests. The whole orientation of the ARC was that way. We had weekly seminars that were just wonderful, because you’d get questions from all ends. You might present a clinical study and you get questions from the biochemists. And they come in the next week and present a biochemistry seminar, and we’d be speculating about, well, how does that apply to what we saw up in the ward this morning? It was a wonderful interdisciplinary group.

 NC: Can you describe a typical day in the life of a researcher at the ARC?

CG: My laboratory was located on the first floor of the wing. We had a series of laboratories and my office was up there. I would come into the office and if I had an experiment ongoing on a ward, I would go upstairs and make my rounds and talk to my patients, make sure everybody was okay. If we were doing urine collections, which we frequently were, I would make sure they were being collected appropriately. Then I might go do some lab work once I made sure everything was going OK, touch base with the technicians, make sure I knew what today’s experiments were going to be. I did a lot of my own technical work, we all did in the laboratory. I had chemical technicians. I’d probably check in with the other scientists, see what they were doing, see if there was anything that had to be attended to. Then I might work on writing papers, I might read papers, I might work in the laboratory. Usually we’d get together for lunch, go over to the cafeteria in the main hospital or sometimes we brought our own lunches and ate together. Sometimes we ate outsi

[Inculcated]

Interviewee:  John C.  Ball  
Interviewer(s):  Nancy Campbell
Date:  August 21, 2008  

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 NANCY CAMPBELL: I’d like to begin by establishing your pathway into the sociology of drug abuse.


JOHN BALL: Jack O’Donnell and I had a chance to set up the Social Science Section in Lexington, Kentucky, in 1962. He was a student of mine, a Ph.D. candidate at the University of Kentucky, and I was his adviser. That’s how it all started. When word came through to him about the establishment of a Social Science Section at the Addiction Research Center, that’s when he invited me to come and jointly get involved with him in establishing this section. We hired the people and drew up the plans. It was a wonderful experience because we had no worries about money, and we had complete free rein to develop a research program with no strictures from Washington or anyplace else. So that’s what we did. I think the whole program, which lasted for some dozen years, was very successful in that we scoped out the whole epidemiology of drug abuse in the United States.

NC: Can you tell me whether you thought of yourself as doing epidemiology in the very beginning?

JB: I was a criminologist and we were looking at criminal behavior and epidemiology of the drug addict. We were interested in the question of how people got started on heroin. Not much was known about that. We got involved in that right away and found that it was a juvenile, gang-related activity. Our emphasis was on research. One of the best parts of the program that we developed was to track or computerize the medical records of all of the patients who had ever been at Lexington or Fort Worth. We are talking about getting information on roughly 100,000 patients. It became a fantastic database.

NC: You had been trained in a doctoral program in criminology at Vanderbilt University. How well did the program at Vanderbilt prepare you for what became your field?

JB: Very well. The Ph.D. program at Vanderbilt was empirically oriented. We were interested in studying people and issues. We had a theory course on Talcott Parsons that was pretty much a waste of time. Other than that we were dealing with social problems. The program was very strong on methodology. That’s what helped a great deal at Lexington.

NC: Did it feel like you were inventing a methodology for studying drug abuse from the ground up?

JB: That’s right. If you’re doing that, you need a team, you need stability, and you need resources. We had those.

NC: Prior to that time, had you had any contact with drug addicts?

JB: Not that I recall. I had contact with delinquents when I was growing up on the west side of Manhattan. I was held up by black gangs and white gangs. I left Manhattan to go into the Army, where I was an auto mechanic and a soldier. What was really important for me in the field was my dissertation, which was on juvenile delinquency. It involved actually going to a reformatory for boys in Nashville and doing interviews, and then going to a public school for a control group. That got me involved in that field. The other thing was the opportunity when I was a professor at the University of Kentucky to go to “Narco,” where there was going to be full-time research with a staff of a dozen people and to be able to develop a research program in an area where there really wasn’t much known at the time.

NC: How would you characterize the state of knowledge at the time you entered the field?

JB: It was meager. I later did a study of all drug treatment programs in the state of Pennsylvania, and the officials at the time didn’t have any idea even how many programs they had in the state.

NC: Can you tell me what the basic questions were that motivated you when starting up the Social Science Section at the ARC, which was then under the direction of Harris Isbell?

JB: We were looking at the overall status of drug addiction in the United States. I started out going to Synanon, visiting almost all of the existing programs that were of any note, to see what was going on. That was the first six months. Jack O’Donnell had been in the field for a long time. He was Chief of Social Services at the narcotics hospital. He was older than I was at the time. He had undertaken a follow-up study of addicts in Kentucky who had been at the hospital, so he had developed a follow-up procedure. He was still working on that when I started in 1962.

Of course, being in a hospital with a thousand addicts is a tremendous advantage in terms of research. You’re not isolated from the problem, you’re right in the middle of the problem. The advantages of that were many. We published a whole series of papers on various topics. Here are two examples. Once we got the database going, we noticed we had almost a thousand Chinese patients. So I wondered, what are these Chinese patients like?

NC: Did that study come out of the fact that you had built the admissions database?

JB: That’s correct.

NC: What kind of computer technology were you using at the time?

JB:  It was a counter-sorter and a 650. It was the beginning of the computer age, but it worked. It had the advantage that you got very close to the data. With this database we could sort all kinds of topics.

For the Chinese study, we had a Chinese physician, M.P. Lau, who was doing his psychiatric residency at the hospital, who did the interviews. I got a hold of him and said, why don’t we take a look at this. We could pull the hospital records on these patients, and issue instructions so that if any new Chinese patients come in, they could be sent up so we could interview them.

For another study, Emily Cottrell, one of the assistants, was compiling data to see how many admissions these patients had to Lexington or Fort Worth. I can still remember walking by as this was printing out, and noticing that we had patients who had 25 or more admissions. This was serendipity. When I saw that, I said, we’ve got to study this right away because we need to know who these patients are. I had two hypotheses. One is, they’ve been here so many times, they are at death’s door. And the other is the opposite, that these patients have gotten so much treatment that they’re in pretty good shape. So, when any of these patients—and there were 30 or 40 in this group—turned up, we interviewed them.

The one who was the winner, Sam, had 43 admissions and he was readmitted. I went down to interview him upon admission, and he said, who are you? Because I was a new guy, and it was his hospital, he’d been there so many times. I explained to him what we were doing, and what social science was. Nobody understood social science, so we talked about that and we talked about his life. We had quite a bit of information about him from hospital records. The fact was that all these guys who kept coming back were called by the staff “winders.” This was because they were winding in and out of the hospital over the years. Then the administration said, we want to de-emphasize the winders, and they passed regulations to discourage it. But Sammy got arrested in New York on a federal offense and was sent to Danbury Prison. The MOC of the Lexington Hospital sent a letter up to Danbury requesting his transfer to Lexington because we had a “considerable investment” in this patient. This emphasizes the close relationship we had with addicts. You get to know these patients because you’re living with them over a considerable period of time.

NC: Would it be fair to characterize a lot of the studies at Lexington as arising out of serendipity?

JB: Yes, you couldn’t plan a lot of this. You need to get the database together and look at it. Another study we did was one of the patients who had died in the hospital. We were curious because one of the methods of discharge was death. So we wondered about the 385 patients who died in the hospital. What did they die from? You couldn’t plan those things until you had the database. That was a key element. We started in 1962, but it took three years before we really had the database in place. We also went to Fort Worth to get their admissions data.

NC: Did the other scientists at the ARC see the value of what you were doing?

JB: I think it varied. Harris Isbell had a more positive view of it than some of the others who were bench scientists and didn’t really believe in social science. He was one of the best bosses I ever had. He said he wanted us to develop the program and do whatever needed to be done. He supported us for three years in the development of the database. He had to have a lot of faith in what we were doing.

NC: Harris Isbell retired in 1963, and then Bill Martin came in as director. Did you feel a change?

JB: Yes, there was less support for social science research. Jack O’Donnell had completed his Kentucky study, and he had great difficulty getting clearance to have it published. I actually left Lexington because they were starting to interfere with my publications. All these papers had to get clearance. When you work for the government, you have to go through a process and that can get delayed. It’s not like being in the university, where it’s my paper and I send it off to a journal.

NC: Did you also have trouble getting approval for studies?

JB: No. Of course, we had protocols, but everything was approved within the ARC. I don’t recall any problems getting approval for what we wanted to do.

NC: Do you recall any research happening at Fort Worth during the period when you were at Lexington?

JB: The main research program – the ARC – was at Lexington. Fred Maddux was productive down at Fort Worth and we had some cooperation. The thing is, if you’re living in this environment over a period of years, it’s quite different from being at a university, where your specialty is largely an academic affair with various grants. We at Lexington were living this world of addiction.

NC: What was a typical day like there?

JB: There would be travel. I did some testifying in court cases that involved the constitutionality of drug abuse laws. It was a perfect environment for research, but it was also a prison-like environment. Going into the hospital, everyone had to punch in and punch out on the time clock. So it depended on what stage of a research project you were in as to what your day was like. At first we were developing plans for a social science research program and hiring staff. Later on it was pretty much like it would be at any institution, where you were reviewing data and writing results up for publication.

NC: Why did you go to Synanon?

JB: They had an established drug treatment program there, and we wanted to learn everything we could learn about drug treatment in the United States. Synanon was one of the earliest programs. What was most interesting from my perspective was the answer I got when I asked how many patients they had. “We don’t know.” Well, you just told me that you had an admission card that was filled out on everyone, and there’s a box of them sitting there. How many cards are in that box? Can I go over and count them? “No.” Institutions don’t like to be studied in that way.

NC: Did you find any of that attitude at Lexington when you talked to clinicians, or people who were working on the clinical side? Was there a schism between the research side and the clinical side?

JB: No. We were separate and we had different tasks to do. The hospital-prison was very work-oriented. We were not sitting around faculty clubs or coming in every other day. We were working every day, so we had daily contact with the patients. There wasn’t any political orientation anywhere in the whole place. That happened at the end when they got involved in prisoners’ rights and closed the ARC down, that wasn’t there at the beginning. All that politics came later and ended the research.

NC: You did an incredible variety of studies while at Lexington. One of the very earliest studies you did described two different patterns of drug use, one involving marijuana and heroin use, and the other not. Could you tell me a little bit about how you came to do that study?

JB: We started by looking at the data geographically by states. Where are the patients using marijuana? We started seeing a pattern that marijuana was in half the country but not the other half. I want to emphasize that we could respond rapidly to research opportunities. When I saw that print out, I could start the project the next day. I didn’t have to go through various clearances and delays.

NC: Can you tell me what you would see on a print out?

JB: One of the initial problems is how much data to computerize. We made the right decision. I made the decision that one card for each admission of each patient. That card held relatively little data—date of admission, type of admission, date of discharge, type of discharge, date of birth, name, sex, race, where the person was from, the number of admissions. It was quite a bit of work to keep updating the cards when someone came in. Then we had a system, 03, 06, to tell that was the third admission out of six admissions. The cards had the date of every admission and discharge since 1935. This was a way of processing an overview and then you could go into detail. You had the person’s name and his hospital number. That would be on the card. Then you could go to Medical Records and pull the records. A minimum of data gave you the overview, but then you could go look at their full file. If we had tried to collect more data initially, it would have been much less successful. You would have gotten swamped with the data.

NC: Did the study you did on primary methadone addiction at Lexington and Fort Worth also come out of the database?

JB: Yes. One of the basic questions was how many discrete patients had been admitted to the hospital. The administrators could tell you how many admissions there were to the hospital, but they couldn’t tell you how many different patients had been admitted. Because admissions were only admissions. This was one of the first things that hit me. So I had to devise a away to track that. With the database you could identify very quickly, say, the first hundred patients who had been admitted to Lexington. Or the most recent ones.

I recall another study of San Francisco hippies. We interviewed them in a more qualitative way. I published a few papers about hippie-type patients and their lives. We looked at a lot of different things because we were trying to get a handle on the whole drug abuse situation and how it had changed across the United States. The database facilitated lots of different types of studies and I worked with it the entire time I was there.  

NC: Can you give me a sense of what attitudes about methadone were like at the ARC when you were there?

JB: It was pretty early with respect to methadone, and I don’t recall anything specific. We were interested in everything going on in the field. We were keeping up with what was going on in New York to the extent possible. But our objective was to publish papers and get the knowledge out.

NC: What do you recall about your Puerto Rico follow-up study?

JB: That started when I first got there. In 1962 I went down to Puerto Rico. I’ve got to give Jack O’Donnell tremendous credit here and elsewhere. He had done the Kentucky follow-up study and that was a model for me to follow in the Puerto Rican study, which was based on his procedures and methodology. So I traveled down to Puerto Rico in 1962 to interview addicts in Puerto Rico. The original idea of that study was naïve in a sense. That is, you think, what happens to the patients when they leave the Lexington hospital? You think you are going to be interviewing them about what happened at Lexington. But what happens is that their stay at the Lexington hospital is only one part of their life—they may have been in prison, or at Fort Worth, or anywhere else. When you interview them five years after they left Lexington, and you’re looking at their whole life history and their incarceration history, and you ask, Well, what about Lexington? Lexington is just one line in their whole life history.

NC: Who were the people you were interviewing from Puerto Rico? Had they been in New York City before going to Lexington?

JB: Yes, they were all from Puerto Rico. They were not from New York City. They all came directly from Puerto Rico. We even had a few upper-class addicts because voluntary admissions to Lexington were confidential. We had governor’s daughters and people like that. What made the follow-up study possible was that you had a definite sample of people who had been at Lexington, with names and addresses, a definite goal, and a clear methodology and research design. You were looking for these former patients particularly to find out if they were still addicted, what had happened to them since they left the hospital. It was all naïve in the sense that you thought that the hospital was the most important thing that had happened in their lives, and really it was just one episode. But the study findings based on personal interviews gained more substantive data on their life histories.

NC: You mentioned class differences. Didn’t you occasionally have upper-class individuals from the United States at Lexington?

JB: Yes. One of the things we found right away with the database was that we had had 400 physician addicts at Lexington. That was a fairly homogeneous population in many ways as all had been through medical school. Later on, they were getting addicted to pure drugs while they were physicians. They were solitary addicts, not groups. They didn’t start the same way and it was a whole different pattern of addiction.

NC: Who else was in the Social Science Section at the time?

JB: Carl Chambers was there, and a guy named William Bates. We had probably half a dozen Ph.D.s who came and went. We had a lot of support staff, secretaries and assistants. And we could call on the hospital to help us. For example we could send word down if we wanted to interview patients. The hospital was very cooperative. The ARC and the hospital had a good relationship. I think we were all trying to advance knowledge about addiction, so we were all working together.

NC: Do you think that changed later after the reorganization around the Narcotic Addict Rehabilitation Act of 1966, which created the Clinical Research Center? Was the Social Science Section transferred out of the ARC and into the CRC while you were still there?

JB: All of that occurred about the time I was leaving. It started downhill pretty quickly. I can’t give you much firsthand knowledge about what went on, but I visited once, and discipline had management had broken down. They were into all kinds of questionable enterprises based on therapeutic communities.

NC: Would you say that tensions between the ARC and the CRC had increased?

JB: Yes, but I wasn’t there, so I can’t really say. I left for Philadelphia in the summer of 1968. I went to the Department of Psychiatry at Temple Medical School. Fred Glaser was there. He had been at Lexington, so we were friends and we wanted to pursue research in the community. Fred brought me up and Bruce Sloan was chairman of psychiatry. It was a completely different world. When I arrived, Bruce said, Not much goes on around here in the summer. Why don’t you go down to the shore for a couple of months and come back in September? He had lots of money and he was trying to fill slots.

NC: Was there interest in the topic of drug abuse and addiction among academic psychiatrists?

JB: Not at all. It was at a minimum. They were just starting to be interested. They liked the idea of having someone who had been at Lexington. After I was there just a couple days, a psychiatrist called me and said he had  a heroin addict and he wanted to know what to do. This was on the telephone in the evening. It quickly became apparent that he hadn’t talked to the patient at all, so I said, “Doctor, a good start would be to interview the patient.” He never talked to me after that.

NC: Would it be fair to characterize the state of knowledge among clinicians as pretty low at that time?

JB: Yes.

NC: What other observations did you have as you made that transition, which was made at a time when the field was going through what I’ve called a “knowledge explosion.” You could no longer say that all drug abuse research was at Lexington.

JB: That’s right. I started to plan a center for drug abuse research, to build a little Addiction Research Center in Philadelphia. Following the usual pattern, we said, Let’s see what’s going on in this state. So we planned a statewide study of drug treatment programs. From an epidemiological viewpoint, treatment was a good place to start because the addicts are in the treatment programs. It’s one way to get an overview of what’s going on. We got funding from the state to visit all of the drug treatment programs in Pennsylvania. This was not complicated research. We basically wanted to know where the programs were and how many patients and staff they had. Of course, we found that sometimes there was supposed to be a program in this city, and when we got there, it was just a storefront that hadn’t been open in recent memory. We ran into that kind of situation more than once.  

NC: Do you recall a site visit to a program called Teen Challenge?

JB: Yes, very well. We looked at different types of programs and Teen Challenge was one of the more established and larger programs. They had a pretty organized drug-free program. It wasn’t a methadone program. What was interesting for me was that my colleagues were pretty prejudicial against it to start with because it was religiously oriented. I thought we should look at the programs impartially. My philosophy was that drug addiction is such a serious problem that you should throw everything you’ve got at it, including the kitchen sink, and find out what works. Let’s not pre-judge the programs, let’s see what they are doing.

NC: What were they doing at Teen Challenge?

JB: It was a therapeutic community with religious instruction. Very similar to what other therapeutic communities were doing, except most of those tend to have a liberal or even radical ideology. This was more religiously oriented in a social work way. They were trying to get kids out of the drug abuse culture, and it was, I thought, a reasonable modality of treatment.

NC: Did it remind you in any way of Lexington? Wasn’t Teen Challenge on a farm in Pennsylvania?

JB: No, Lexington was a massive prison environment with bars. I recently when down there and drove up thinking I was going to park in front of the main building. A guard came up right away and said, You can’t park here. At one point, I put my hand on his window, and he said, Get your hand off my window. You can’t touch my vehicle. So this is a federal prison. Lexington wasn’t that way when I was there. Lexington was considered to be a country club by the voluntary patients. They could come down for a couple weeks and check out any time they wanted, and go back home.

NC: What did you find out by visiting the treatment programs in Pennsylvania?

JB: We found out that it was a mess. There wasn’t any overall knowledge of what was going on in the different programs. This was the very beginning. Shortly thereafter, they began to get more administration involved and now it’s a whole different ballgame. Because we only made one trip to the programs, it was a preliminary look at what was going on. In many cases the data from the programs was so inadequate that you couldn’t even find out how many patients there were and where they were. At other programs, it was different. For example, the Veterans’ Administration programs had a lot of data.

NC: When did you develop an interest in international drug treatment programs?

JB: That was about the same time. I visited a lot of countries all over the world.

NC: Were you more or less doing what you had done in Pennsylvania, visiting treatment programs and trying to determine what the outcomes were?

JB: Yes, except that it was different because we were dealing with countries, so that if you went to Hong Kong and talked to the commissioner of prisons, he would have a lot of information for the whole country. We compiled a lot of data from 25 different countries. There wasn’t a lot of interest in that publication. I tried to pursue it farther but that didn’t work out.

NC: Tell me a little about the year you spent in Washington, DC, with the White House Special Action Office for Drug Abuse Prevention.

JB: That was pretty exciting. Jerry Jaffe, Ray Glasscote, Jim Sussex, Leon Brill, and I had, before SAODAP, been funded by the American Psychiatric Association to look at the better drug treatment programs. The five of us had a year to visit these programs, and Ray wrote it up as a book. So Jerry and I had this joint experience together, and that led to him asking me to come down to SAODAP. I was there for a year on a leave of absence from Temple Medical School. That gave me security because it’s a tough world at the Executive Office of the White House. People come and go.

I have to preface everything by saying that I can’t write or talk much about my experiences there because it would be unseemly and it would be misinterpreted in a political sense. In order to make it creditable, you have to name names, which I can’t do. I was in charge of research and evaluation.

NC: What can you say about your experiences at SAODAP? Was your goal to get treatment evaluation programs up and running?

JB: When I got to SAODAP, I realized right away that I wasn’t going to be able to do any research. It wasn’t like the ARC. It was a case of my role being to facilitate or promote research on a larger scale, so I had money and power to get national surveys going and facilitate a major advance in number and quality of treatment programs. That’s what we were working on, so I was most interested in promoting the research part of it. We had a lot of contracts and grants out there that I had to superintend in a new field with new, inexperienced people. That was quite a challenge.

NC: That year was when Jaffe’s resignation went into effect, so half of that year you worked under Robert DuPont.

JB: That’s correct. I was fortunate to have both Jerry Jaffe and Bob DuPont as directors. Both were interested in promoting research and evaluation. Both of them gave me great support. The thing that was fantastic was the power that you had to get a million dollar grant going in a week. All the rules and regulations that apply to the federal agencies don’t apply to the Executive Office of the President because if the president needs to get quick information, they have to be able to move rapidly. The pace of work there was unlike any other I have encountered. The problems and the pressure never ended. It was all fascinating, but you couldn’t keep that up very long.

NC: What did you do once your year was up, and you went back to Philadelphia? You seem to have gotten more interested in methadone maintenance programs.

JB: Yes, methadone was coming on then. I got involved in seeing Vincent Dole at Rockefeller. He was running a tight research program, a clinical program that was more like the ARC. He knew exactly what he was doing. It wasn’t like many methadone programs are today, where a physician comes in four hours a week and signs charts and never sees any patients and there’s meager medical supervision. Vincent Dole was an extraordinarily competent researcher.

When I did my study of methadone programs, I wanted to look at the better programs in Baltimore, Philadelphia, and New York City. The methodology that made sense was to look at the best programs and see what they are like. If the best programs are not having much effect, there’s no need to even look at the others.

NC: By the time you were back in Philadelphia, NIDA had emerged. What was your relationship with NIDA like? Were you active in review sections?

JB: Yes, I was on study sections but I wasn’t as much of a politician as I might have been in terms of NIDA. I was very fortunate in that I have pretty much been able to do what I thought should be done for my whole career. Once you’re into grantsmanship, you spend half your time preparing and worrying about grants, and I wasn’t interested in doing that. You think about what grants will get a high priority and will be funded. For the most part, I didn’t have to do that anywhere.

NC: In terms of social science research, did you have any difficulty convincing people at NIDA of its importance? Did you have to promote social science research at all?

JB: Yes. I think that we had the Social Science Section, which was established in 1962 and closed down in 1974. Nothing really like it has been established since. In many ways NIDA was able to build on the different parts of the ARC and build a large organization that could further and advance knowledge in the field. You can see that in the national surveys of the mid-1970s when NIDA was getting up and going. During my year at SAODAP, we were planning the National Household Survey and the Vietnam study.

NC: After you left Temple, you returned to the ARC, which had moved from Lexington to Baltimore. What did you accomplish there?

JB: I moved to NIDA’s Baltimore facility because I had finished my study evaluating methadone programs. One of the problems with complex research (and a bench project is not the same) is that the analysis of the data can take years, particularly if you want to write a book about it. Jerry Jaffe was in charge of the ARC in Baltimore. My grant had run out and I had published a few papers, but I wanted to write a book about the complete study. Jerry invited me to finish it at the ARC.

NC: Can you capture the differences between what the ARC was like in Lexington, and what it was like in Baltimore?

JB: The big difference was that when it was in Lexington, it was in a complex of buildings where there were a thousand addicts who had a drug history, extensive medical records, and specialized knowledge. In Baltimore, it was a small facility with just a few addicts there for particular studies. They didn’t spend the night there in most cases, so it was a whole different environment. The staff was different. In Lexington we had Wikler, Isbell, Fraser, Martin, and O’Donnell. It was a unique situation.


http://sitemaker.umich.edu/substance.ab ... tMode=list

[Inculcated]

Reading  Narcotic Farm the rise and fall of America’s first prison for Drug Addicts

I was surprised to read on p. 103 that five separate “Houses” of Therapeutic Communities were fostered on the grounds of the Institution.(Exelsior, Numen, Ascension, YOUnity and Matrix) Of these, Matrix was the only coed house. The authors state that “there was no staff and little over site”, and they (Matrix House) were allowed to recruit members from outside of the prison community (called squares). John Wildes a former heroin addict and one time inhabitant of the Institution was hired by the government to run this facility.

The next paragraph goes on to detail the mixed reviews of those who remember Matrix House and that it was based on the Synanon Game.
 “The program centered on a confrontational style group therapy called The Game…The Game encouraged members to single out, attack and ridicule…”
The Game sometimes went on for hours at a time. Although physical violence or threats of violence were not allowed, few other boundaries were observed. Screaming, crying and hugging were embraced as therapeutic”. –The Narcotic Farm/ The Talking cure

“But lines of what constituted treatment and what constituted cruelty were blurred as the group leader John Wildes, became increasingly abusive.
In 1972 amidst allegations of torture and weapons possession, five Matrix House members were arrested. Wildes was later imprisoned for possessing firearms on federal property.” –The Narcotic Farm/ The Talking cure

"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