with excerpts from Fighting Drug Abuse with Acupuncture
by Ellinor R. Mitchell
NADA, the organization, and the NADA 5-point protocol directly attribute one place and time as their origin. The birthplace of acudetox was originally known as the Acupuncture Clinic, Substance Abuse Division of the Department of Psychiatry of Lincoln Hospital; later known as Lincoln Detox; and currently known as Lincoln Recovery.
Lincoln Recovery was established in 1970 in response to community needs, and was created via community activism. Initially, methadone was used to detox clients from heroin.By 1974 acupuncture had been introduced and became an integral service in the clinic.The program was created in the community-based self-help model, as a result of a community activist response to the growing drug problem and lack of services available. A small contingent of professional medical staff was supplemented by many neighborhood volunteers in a collective and non-hierarchical model.
The circumstances which necessitated the program also shaped its design and growth. Those same grassroots strategies pervaded the spread of the acudetox culture with the development of the organization, NADA, and the proliferation of NADA-styled treatment programs across the country and around the world.
To understand the birth of Lincoln Recovery and the development of acupuncture in its use, it is important to review the times in which it came into being. In 1970 New York City, an addicted person could wait a year to receive a slot in a treatment program. Those familiar with addiction understand that many negative things can happen to an individual, their family members and to the societal context where they live, use and support their habits. It was not uncommon for an addicted person to die from drug-related causes before their opportunity for treatment arose.
Also in 1970, a common strategy for dealing with the lack of responsiveness of municipal government was the practice of civil demonstrations. The often powerless in our society took to sit-ins and other disruptive demonstrations to force action from the leaders. In November of that year a confluence of activist groups created the United Bronx Drug Fighters, and demanded the creation of a drug-detoxification center at the local Bronx public hospital. At the time, Lincoln Hospital had no drug treatment program.
Community activists had a large hand in making the program happen, and therefore felt they had a stake in administering the program. Within the cultural context there was a demand for neighborhoods to develop their own programs and treat their own ills. The Young Lords, a radical Puerto Rican group and the Black Panthers, a militant black group were both part of the community forces that came together to provide social services to their communities. These programs included not only addictions treatment, but also generalized health clinics, breakfast programs for disadvantaged children and other social services. The influence of these counter-culture groups was definitely felt within the structure and function of Lincoln Recovery. The groups provided political education classes and instructions on how to navigate the often red-tape ridden social services provided by local government, as well as security for the addiction treatment clinic.
Lincoln Recovery was initially an outpatient detoxification program, using methadone.It was the first of its kind.Prior to this, there were outpatient methadone maintenance programs, but none were detox programs.The idea was generated from the experience of one man, Butch Ford, who had been detoxing people with methadone in the basement of his Bronx home.Based on Butch’s experience and his success in detoxing a number of people in the neighborhood, it was decided that when the community came together to create a program that it would follow his methods.
According to NADA founder and long-time director of the Lincoln Recovery Program, Michael O. Smith MD, DAc, “we had gotten a lot of doctors at Lincoln to be willing to double up in their dorm rooms so that we could really run a detox unit at Lincoln…
“When the day came, at noon we just walked in and took the elevator and went up to the sixth floor… Later in the day there was a symbolic arrest of a few people in the program. That lasted a few hours.
“Over that weekend there was a discussion with then chairman of psychiatry, Gabe Koz, and some of us who were involved. And they said, ‘Well, Monday morning we’re going to do an outpatient methadone detox program.’
“There were about 200 people waiting in line the next day…..we asked people waiting in line if they could help read and write, and do some of the paperwork.”
The current staff design was born out of that need, from day one, of a support staff system that combined the knowledge and experience of former clients to augment the small clinical staff.
“We had a huge volunteer group,” Smith said, “and we started in the auditorium of Lincoln Hospital. We were an innovative program from the beginning. We were the only outpatient detox program. And we immediately served a lot of patients in the hospital. Nursing people, a lot of people were very sympathetic, because this was a service-oriented thing.”
The addition of acupuncture to program services began sometime in either late 1973 or early 1974. Many of the staff had concerns about the use of addictive drugs to treat substance abuse. When Dr. Wen, in Hong Kong, published results of success with heroin addicts using acupuncture, the staff at Lincoln became interested in the method.
Not only the staff, but also the clients were interested in natural methods, and demanding non-pharmaceutical resources. A long-time staffer at the program noted, “It was the clients that wanted something else besides methadone. We had old methadone users—I’m talking 30, 35, 40 years, which is old in addiction – and they wanted another method of detox, because they didn’t like the methadone. They were really dead set on us finding another method for them to detox and stay clean. That’s how we really got into acupuncture.”
The staff sought acupuncturists who would come to Lincoln and demonstrate.Many donated their time to the pioneer program.They started with the protocol used at Kwong Wah Hospital, which was to needle the Lung point on the ear and add electrical stimulation.The effect lasted for about 6 hours.Eventually the electrical-stimulator broke.The staff discovered, much to their surprise, that the non-electro potentiated treatment had a more prolonged effect.
This development had a major effect on the proliferation of the acupuncture treatment. Using plain needling (without stimulation) was a more flexible and less expensive process. It was easier to learn and more easily replicated as the protocol was modeled in other treatment programs. The eastern philosophy of less is more was proven to be true.
Once the effectiveness of the acupuncture was established, many of the Lincoln staff, including Dr. Smith, went on to study acupuncture.Over time, and with much experimentation of various ear and body points, the current 5-point NADA protocol was developed.
The early emphasis on grassroots involvement that created Lincoln Recovery has always flavored the means with which the NADA protocol has spread. Many of the initial program founders and workers have passed, or their radical and anti-establishment methods caught up with them. Among those important program generators are Jose Aponte, Matulu Shakur, and Richard Taft MD.
The story of Dr. Richard Taft’s death, probable murder, soon after the launch of Lincoln’s acupuncture program is one illustration of the tenacity of the program.
Dr. Taft was found dead in the storage closet of the auditorium at Lincoln Recovery, where much of the program activity took place.There was an apparent attempt to make his death look like a drug overdose, potentially harming the program’s reputation.However, those familiar with drug effects could easily tell that this was not the case.
He was found lying on his side, in an unnatural position, as though his body had been fit into a small space after death. His long sleeve shirt and jean jacket were buttoned at the cuff (which could not have happened in the event of a heroin overdose). There was drug paraphernalia near him, but no matches, no cooker or keys to the room (which was always kept locked) and both doors were ajar. His wallet and money were found on his body. The coroners report found no needle marks and no heroin in his urine. However heroin was found in his tissues. His body had a large bruise and indentations in the back of the head, as well as scratches on his wrists. He was not addicted to heroin, nor was he suicidal. A fresh needle mark should have been very easily found.
Two months prior to his death, Dr. Taft had received death threats, had begun carrying a weapon for protection, and he had noted to colleagues that he was in fear for his life. On the day of his death he was scheduled to meet a high ranking Washington official regarding funding for the Lincoln Detox Acupuncture Program. The Washington officials did arrive at Lincoln later that same day. However, the moment they entered Lincoln Recovery a bomb threat was telephoned in to the hospital. The hospital newsletter carried an accounting of the entire questionable incident along with the following eulogy:
“In Memory of Richard Taft
“Richard Taft, a man, a doctor and above all, a revolutionary.As a man he supported the right and fought the wrong.
“For over four years he served in the South Bronx community.He served for one year as medical doctor in the People’s Program, Lincoln Detox.He was instrumental in training paramedics and researching acupuncture as the non-chemical treatment from narcotic withdrawal.It is perhaps this involvement that led to his death.
“He dedicated his life to help people fight their addiction problems with his medical and acupuncture knowledge.It was this dedication that made him continue his work even under the threat of death, even after being shot at.STOP THE DRUG PLAGUE!”
Dr. Smith noted that after Richard’s death many at Lincoln thought the program would be shut down. That reality failed to materialize. This left Smith, who had been providing medical services in the basement floor of the building, to take on the role of director of the program.
Characteristic of the service orientation of the program, even as Dr. Taft’s body was found and police arrived to investigate, the auditorium filled with clients and treatment continued without missing a step.
However controversy continued to follow the program. In the late 1970’s it became a target, as did many social programs, of political attack. The fact that security for the treatment center was run by radical ethnic groups was used against the program. On the Monday after Thanksgiving in 1978 the hospital chained the doors to the program and did not let anyone associated with the program, including staff, enter the building. The programs records and equipment were inaccessible. The staff thought that the end had finally come.
However, there was another location nearby, a former Public Health Station, which was sometimes used for program services. Staff picked up and moved down the street and around the corner to the current location for Lincoln Recovery. It was expected that they would be followed and shut down again, but that never happened.
One staff member noted, “We couldn’t bring methadone over here because this building is not good on security. We had to quit giving out methadone. Then we had to really get into acupuncture full-time. We were getting away from methadone, anyway, because it was a drug, and we were against drugs.”
The relocation of the program was not an easy transition. The place was a “dump”. At times they worked with umbrellas over their heads. There was no heat in the building. The staff performed housekeeping services because the hospital did not provide them. They also did outreach to the community by providing mobile units that would set up in specified areas within the neighborhood to provide additional services.
Anyone visiting Lincoln Recovery today may notice the modest surroundings and an environment that continues to speak to the community’s ownership of the program. For an addict this is important. The treatment center must be the place that they are most comfortable returning to, even when they feel their worst. Clients are naturally encouraged to seek treatment in times of trouble because the treatment center fits who they are and reflects the local culture.
The grassroots efforts by the founders of the People’s Program at Lincoln and their desire to create a program that was built for the community by the community has withstood the test of time and proliferated across the globe. The intention to provide accessible methods of serving an urban community developed into a model of treatment that fits current customs, but harkens back to the “barefoot doctor” tradition of acupuncture as healthcare for the masses in rural China. The cultural consequence of 20th century radicalism resulted in NADA’s emphasis on barrier-free, drug-free access to care.