from Smoke and Mirrors, by Dan Baum
("Egil Krogh: deputy to the White House domestic policy advisor John Ehrlichman.
Jeffrey Donfeld: Egil Krogh's deputy in charge of drug-abuse policy.
Jerome Jaffe: director of Illinois's methadone-treatment program, appointed the first drug czar by President Nixon
Robert DuPont: psychiatrist who created the D.C. Narcotics Treatment Administration; later White House drug czar and then director of the National Institute on Drug Abuse")
[1970] [pp 42-44]
Look at this, Jeff Donfeld said to his boss, Egil Krogh.
Rough crime figures were in for the District of Columbia. In the five months since Bob DuPont had been treating addicts with methadone, the monthly number of street crimes was noticeably reduced. Krogh and Donfeld were amazed; they'd hoped for results, but this was awesomely quick.
Krogh and Donfeld started talking about doing nationally what DuPont was doing in D.C. -- reducing crime by treating addicts instead of simply locking them up. Go look at the best drug-treatment clinics in the country, Krogh told his young assistant. See what works.
In 1970, there weren't many such clinics, and the one Donfeld liked best was the state of Illinois's, which used methadone in ministering to the state's 6,000 known addicts. The psychiatrist running the Illinois program was a short, wry, Jewish liberal Democrat named Jerome Jaffe.
After touring Jaffe's clinic, Donfeld asked him to assemble a team of experts outside government and prepare a report on what could be done about addiction in the United States if there was, say, $50 million to spend. Donfeld placed three conditions on Jaffe: the report could not exceed 100 pages, it had to be finished in six weeks, and if it leaked to the press it would be useless. This was, Jaffe thought, an extraordinary request. He didn't have a clue what the White House was up to.
Furthermore, it put him in a tough spot; Jaffe wasn't sure he could find any "experts" who would give the Nixon administration the time of day. The drug treatment field was dominated by liberal Democrats bound by a common loathing of Richard Nixon. Nobody in the field had forgotten that barely a year ago, Nixon had angered the health professions by giving the attorney general the power to schedule drugs.
Jaffe also though Donfeld was leaning too hard on the drugs-and-crime link. In his own experience, heroin addicts made most of the money they needed for a fix by selling heroin to other addicts, not burglarizing homes or mugging people. Most of those who were crooks were crooks before they were addicts. Also, Jaffe had met productive working people who were heroin addicts -- musicians, butchers, you name it. The assumption that drug addiction was responsible for rising crime made him uneasy.
But he understood that the drug-crime link was a political tool that wasn't going to be buried by sober talk about statistics. Besides, Jaffe reasoned, clearly some addicts do commit some crimes. The link wasn't entirely spurious, he told himself, just overstated.
And fifty million pre-inflation dollars was a lot of money.
So Jaffe began asking around, avoiding the doctors who were too rabidly anti-Nixon, and in a couple of weeks had an informal group put together that was beginning to jot down ideas.
What Jaffe didn't know was that Donfeld was simultaneously commissioning a second report from experts inside government. The rank-and-file staff at HEW, the National Institutes of Health, and the Food and Drug Administration were mostly civil-service holdovers from eight years of Democratic rule. They disliked the Nixon administration, and the feeling was mutual. Their recommendations exactly what Donfeld expected; they came straight out of the "root causes" philosophy of Ramsey Clark and the Great Society. The gist of them was that heroin addiction is a symptom of society's failures -- racism, alienation, and lack of opportunity. If government wanted seriously to address addiction, the "in-house" report said, it would pour money into housing, jobs, youth -- the whole dreary laundry list of expensive liberal solutions that the Republican Party disdained. If the government insisted on Band-Aids in the meantime, the in-house crew said, psychiatry was useful for treating addicts, and civil commitment had its place. Therapeutic communities weren't so hot, they said, and the worst idea of all, they said, was methadone -- a simplistic "magic bullet" that treated individual addicts as patients with no consideration of social context. The in-house team specifically recommended against a "massive methadone maintenance program": it simply wouldn't work.
Jaffe saw his marching orders differently from the government team. Donfeld had made it amply clear that the administration's antidrug priorities did not include providing "health care for the long-haired anti-establishment types who did not want to go to regular medical clinics." No, Donfeld said, the goal was simply to reduce crime by addicts. Willing to believe the worst about Nixon and his men, Jaffe assumed they wanted a recommendation of massive "civil commitment" of addicts, a solution Jaffe wanted no part of. Instead, he and his group focused on the estimated 30,000 addicts in the country who had applied for treatment but couldn't get it for lack of slots, and who were presumably tempted to mug old ladies for a fix. Yes, heroin addiction was a complex problem, Jaffe's report said, but methadone was the one type of therapy that demonstrably reduced crime by addicts. It should be made available to all who want it.
As Jaffe's group was coming to this conclusion, Donfeld hectored them with critical questions. Jaffe didn't know why. He didn't know his research was in competition with that of the government's own social scientists. He didn't know that Donfeld was shuttling between the two groups. He didn't know Donfeld's criticism was intended to make the Jaffe report as strong as possible. Jaffe believed he was forcing treatment down the throat of a punishment-oriented administration. He didn't know his finished report was exactly what Donfeld and Krogh wanted.
Methadone had dual attractions for Donfeld and Krogh. It was an inexpensive way to reduce street crime by drug addicts , which was Krogh's primary concern. But Donfeld and Krogh were not political naifs; they knew, as the HEW bureaucrats did, that methadone was a way to discredit calls for massive social spending on the "root causes" of crime. A methadone program would define addiction as a disease suffered by individuals, not a social pathology. Furthermore, adoption of such a program would cut all those hostile social-service bureaucrats off at the knees. As an added bonus, methadone would put a humane face on Nixon's Drug War, deflecting criticism that his only answer to the drug problem was more law enforcement.
Jaffe didn't know all that. He got a nice note from Richard Nixon thanking him for his work, and that, he figured, was that.
