As I left my doctor’s office a few weeks ago, I walked past a handful of strung-out looking men huddled around a younger guy who was decidedly better dressed than they were. My mind immediately processed all the figures, but took a minute to do the math. The picture sharpened significantly when the dealer palmed a bill from one of his customers and handed the buyer something in return.
I’ve lived in some fairly bombed out neighborhoods in my time and listened to enough Clipse mixtapes to know the routine. As I walked away, I decided that the extra mental beat wasn’t the result of my naivete, but the details running the interference. It was 11 a.m. on a bright West Village Friday in August and we were on a fairly major street. I’m at best ambivalent about post-Giuliani New York, but something still didn’t seem quite right.
It turns out the large medical building where my doctor keeps his practice also houses a methadone clinic. Our dealer wasn’t necessarily out to terrorize the otherwise Sesame Street vibe of the block. He was just practicing that most basic principle of retail: location, location, location.
His business acumen got me thinking about the efficacy of methadone treatment. I’m not an addiction specialist and my knowledge of such maintenance programs is largely based on its more infamous pop culture references. The scene in “24 Hour Party People” in which Shaun Ryder desperately tries to lick the stuff off an airport floor comes to mind. It was enlightening, then, to find this in a 12-year-old Times piece on this very subject:
“Successful methadone users are invisible” said Dr. Edwin A. Salsitz, director of the methadone medical maintenance program at Beth Israel Medical Center in New York City. ”Methadone is always judged by the failures.”
A source in a similar, but much newer article in the National Journal this April put the three-month follow through on methadone at 75 percent. Of course, the latest news is that monitored heroin use might be even more effective. Given the current state of the healthcare debate that’s probably a push.
