“Chemistry is the new hope”: Therapeutic Communities and Methadone Maintenance, 1965-71

Historians generally agree that the “classic era” of narcotics control, a period of punitive drug policies and limited treatment options, came to an end in the early 1960s along with, among other things, the emergence of methadone maintenance treatment for heroin addiction. But methadone was not the only treatment model competing to replace the punitive system; throughout the 1960s therapeutic communities also competed for funding and political legitimacy. A close examination of the debate between promoters of these different approaches complicates the progressive narrative of addiction policy moving seamlessly from punitive and conservative to sympathetic and liberal approaches. A compromised treatment infrastructure that combined methadone, therapeutic communities, and criminal justice approaches to addiction, ultimately emerged from the conflict – a compromise that retained key elements of the carceral approach while minimizing the boldest challenges to it, thus laying the groundwork for the drug wars that followed.