United States: The methadone clinic system needs abolition, not a tepid reform bill

By Helen Redmond / Filter Magazine

Peter Vanderkloot’s groundbreaking article—Methadone: Medicine, Harm Reduction or Social Control—hit me hard. As a social worker, I helped people who used heroin get into methadone programs. His insightful analysis and refreshingly angry takedown of the United States methadone clinic system explained both negative interactions I’d had with clinic staff and traumatic incidents that clients shared with me. I go back and review the article often.

Vanderkloot describes in precise detail how clinic regulations disrupt and damage patients’ lives. He shows how a medication that embodies harm reduction is held hostage by a system of harm production. He knows what he’s talking about. For years, he’s stood in line waiting to be called to the plexiglass window by a nurse who pushes a plastic cup filled with red liquid through a chuckhole.

Then he drops this time bomb: “The methadone clinic system is a weapon of the drug warriors, and as long as it exists it will be used to control, degrade and injure.” Vanderkloot argues for the destruction of the clinic system and for methadone prescription parity.

His article was published back in 2001.

But a current federal bill fails to recognize and seize this chance.

Twenty-one years and a pandemic later, abolishing the clinic system and establishing the right of patients to do something as ordinary as pick up a methadone prescription at CVS or Walgreens is a real possibility.

But a current federal bill fails to recognize and seize this chance. On May 18, it was announced that methadone provisions of the Opioid Treatment Access Act of 2022 (HR6279), proposed by Rep. Donald Norcross (D-NJ), were being folded into another bill—the Restoring Hope for Mental Health and Well-Being Act (HR7666), sponsored by Rep. Frank Pallone Jr. (D-NJ). The provisions are woefully inadequate in eliminating methadone restrictions to address the overdose crisis.