In Memoriam: Methadone Pioneer Vincent P. Dole

(This memorial piece for a great pioneer in addiction treatment was written and distributed by his friend and colleague, Dr. Robert Newman.)

Dr. Vincent Dole (an internist) and his late wife, Marie Nyswander, MD (a psychiatrist), began their collaborative research with methadone with a handful of long-term heroin-dependent individuals in 1964. They did so in the face of overt threats of harsh criminal and civil action by federal narcotics agents. Their courageous, pioneering work demonstrated that methadone maintenance is a medical treatment of unparalleled effectiveness -- a superlative description that is as applicable today as it was four decades ago. As a result, well over three-quarters of a million people throughout the world are able to lead healthy, productive, self-fulfilling lives - over 200,000 in the United States, an estimated 530,000 in Western Europe, and many tens of thousands more in Eastern Europe, Middle East, Central Asia, Far East, Australia and New Zealand.

After the remarkable transformation they observed in their first few patients, Dr. Dole and Dr. Nyswander went on to provide direct supervision of the first methadone maintenance treatment program at Beth Israel Medical Center in New York. In so doing they demonstrated that it was possible to replicate on a large scale the therapeutic success they achieved in the small, controlled, research environment of the Rockefeller Institute (now Rockefeller University). Dr. Dole was also responsible in the early 1970s for convincing the New York City Department of Corrections (at the time headed by Commissioner Ben Malcolm) that detoxification of heroin-dependent inmates in the city's main detention facility at Rikers Island was imperative to save lives and lessen suffering (there had been a wave of suicides at the time that had been attributed to severe opiate withdrawal). The detoxification program continues to this day, and has become a model for enlightened corrections officials in other countries.

Dr. Dole and Dr. Nyswander's contributions, however, transcend the life-saving clinical impact on patients and the enormous associated benefits to the community as a whole. They had prescience to hypothesize, years before the discovery of the morphine-like endorphine system in the human body, that addiction is a metabolic disorder, a disease, and one that can and must be treated like any other chronic illness. What was at the time brilliant insight on their part is today almost universally accepted by scientists and clinicians alike, and remains the foundation upon which all rational policies and practices in the field rest.

In his mid-80s Dr. Dole traveled to Hamburg to be present at the naming ceremony of the Marie Nyswander Street; in less than ten years Germany moved from methadone being illegal to having over 60,000 patients in treatment! His efforts during recent years were devoted to fighting the stigma that, tragically, remains so widespread against the illness of addiction, the patients and the treatment.