Honorary Patients

Drs. Vincent Dole and Marie Nyswander

Dr. Vincent Dole began his research career as a metabolic scientist with a speciality in obesity. He developed the first liquid dietary supplement and his work helped to change the public’s view that obese individuals get fat because they eat too much. He discovered that obese individuals metabolize food quite differently. He also came to realize that his obese patients were remarkably reminiscent of a narcotics addict’s craving for narcotics and so he decided to embark on a new area of research to study narcotic addiction.

Marie Nyswander was a psychiatrist, she was commissioned as a lieutenant in the navy during WW2 and assigned to the Public Health Service. Here she was sent to the hospital in Lexington, Kentucky that treated addiction. Upon leaving the Public Health Service she came to New York and continued to treat addicts, mostly free of charge out of her store front in “The Barrio”.

In the early 1960’s Dr. Dole embarked on his plan to study narcotic addiction. He found very little was known about the addict with the exception of one book written by Dr. Marie Nyswander called “The Addict as a Patient”. When Dr. Dole asked her to visit him to discuss the research he was considering Dr. Nyswander was beginning to realize that her efforts did not accomplish much and that perhaps maintaining addicts on narcotics might be the best solution. Of course Dr. Nyswander joined Dr. Dole’s research project which was the beginning of methadone treatment. (They would also fall in love and marry.) Dr. Dole brought the science to the project and Dr. Nyswander contributed the philosophy.

The two made a significant contributions to the field of addiction medicine which did not exist when they began their research project. These include: (1) developing the first effective treatment for opiate dependence, (2) bringing the treatment of addiction back to the medical profession, (3) postulating that addiction was a metabolic disease which led to the discovery of opiate receptors and endorphins (the first study looking for opiate receptors was done in Dr. Dole’s laboratory), (4) developing the first prison detoxification program, and also (5) developing urine screening for drugs (some call the test “The Dole Test”).

In the early Dole-Nyswander Program about half of the staff were patients that helped to significantly shape the philosophy of the early program. This was during a time when addicts were treated with disdain and some would say not much different than today. However, Drs. Dole and Nyswander thought of the patients that they treated as their peers, they brought the science and their patients brought their knowledge about addicts which together created an effective program.

The many contributions that they made to methadone treatment is not why NAMA is recognizing them. NAMA thinks that Drs. Dole and Nyswander are special and deserving of the title “Honorary Patient” because they cared about patients.

Dr. Herman Joseph

Dr. Herman Joseph came to methadone treatment as a probation officer working for the city of New York. In the early 1960s he read in the newspaper about two doctors who were starting a research project to treat addiction. Contrary to the common criminal justice belief of the day (and one could say today) Dr. Joseph had come to the conclusion that his probationers were not “weak-willed” and that they needed help. So he called the doctors and spoke with Dr. Nyswander who asked him to come to Rockefeller University to talk. After meeting Drs. Dole and Nyswander he was asked to work on the project as a statistician which he also had a background in. Thus began Dr. Joseph’s career as a research scientist.

Dr. Joseph has made significant contributions to methadone treatment including helping to expand methadone treatment, developing the first clinics to treat patients on parole and probation, developing the first in prison methadone program, developing the first office-based treatment program, starting an international conference to bring together pain management and addiction specialists, he is co-author on several books including “Addicts Who Survived” and written perhaps the most thorough work on stigma and methadone treatment.

However the title of “Honorary Patient” is not given to Dr. Joseph for the long list of contributions he has made to methadone treatment. Dr. Joseph’s first concern has always been for the patient and he has spent the last thrity-five years trying to right the things that he saw as wrong. We at NAMA think he is special and one of those extrodinary individuals who cares about patients.

Dr. J.T. Payte

Dr. Payte opened one of the first methadone programs outside of New York City, Drug Dependence Associates in San Antonio, Texas. This program has been for many years a model for quality methadone treatment. He has been one of the few clinicians working in the field who actually included medical care and sees his patients.

In the 1980s he embarked on a Mission to change the anti-methadone attitude of the American Society of Addiction Medicine (ASAM) and in this capacity developed the primary course that is used to train physicians in methadone treatment today. This has had a significant impact on the way the medical profession thinks about methadone and addiction treatment.

Dr. Payte has been quite vocal about methadone programs that treat patients with disdain. The program in San Antonio speaks volumns about Dr. Payte’s attitude towards patients – they are his friends. One of his patients once said that for the first few months he was in treatment he thought Dr. Payte was another patient because he was always out in the waiting room drinking coffee and talking with the patients.

Dr. Payte has made some important contributions to methadone treatment but this title is not for that. We at NAMA think Dr. Payte is another special person because he cares about patients.