Contested Spaces, Stigmatized Treatment: Methadone In 1970s New York, Boston, And New Orleans

In the 1960s, a heroin epidemic devastated communities, families, and individuals across the United States. In 1965, the federal government legalized methadone maintenance treatment, which used daily doses of the long-acting synthetic opiate methadone hydrochloride to treat opioid addiction. In 1972, the Food and Drug Administration established unprecedented control over the distribution and use of methadone, creating a carceral regulatory system that continues to prioritize surveillance and punishment over humane treatment. Through an analysis of three methadone clinics established in New York City, Boston, and New Orleans in the late 1960s to early 1970s, this thesis addresses the ways in which divergent communities—from white neighborhood groups and Black Power activists to unionized hospital employees and physicians—fiercely organized against the presence of methadone clinics on city blocks. The three cases move from larger to smaller scales (from neighborhood clinic to hospital clinic to private practice) highlighting how community pushback shifted across a variety of medical and urban settings. Using newspapers, letters of correspondence, medical journals, and first-person interviews, this thesis reveals how methadone served as a manifestation of white structural violence, an obstacle to gentrification, and a threat to “ethical” medical practice, all at the same time. Due to protests and invasive federal audits, many methadone clinics were forced to close, relocate, or temporarily occupy makeshift structures not fit for the treatment of patients, demonstrating how attitudes about addiction were reflected in physical space. This thesis will also highlight the physician-activists who directed these clinics, often risking their careers and medical licenses to put their patients first