Nancy Campbell on The Narcotic Farm

type of drugs. Hello, Psychoactive listeners. So today we're gonna delve into some history on a remarkable place called the Narcotic Farm. The Narcotic Farm that was in Lexington, Kentucky, created nineteen thirties as a place to sort of simultaneously punish and treat drug addicts. Now, my guest, who is this an extraordinary academic is Nancy Campbell. She's a professor at Rensselaer Polytechnic Institute, which is outside Albany, New York.

She's been a leading drug scholar for many years. She's an historian of science and technology who's focused on legal and illegal drugs and on harm reduction. She's written two books on gender and addiction, but she's done also two books that are relevant to the subject at hand. One is a book she wrote some years ago called Discovering Addiction, about the science and politics of substance abuse research, and the other one is the book called The Narcotic Farm,

the rise and fall of America's first prison for drug addicts. So, Nancy, thank you so much for joining me on Psychoactive. I'm

delighted to be here. Ethan. Well, you know, I should also tell our audience that you and I have, you know, cross paths a few times over the years, but our principal intersection was just a few months ago in June of this year, when we both attended the conference of an organization called Alcohol and Drug Historians Society a d h S, which was a place where I met all sorts of interesting people I want to have as guests on Psychoactive, and you're the first one from that conference

I've invited, to be honest, So thank you so much for doing this with me. So let's just jump into this thing. I mean, obviously, this history about the creation of a sort of narcotic farm, a kind of cross between a prison and a treatment program that was set up in Lexington by the US government in the nineteen thirties. At what brought you to be interested in this place? Well, so, I wrote a dissertation in the nineteen nineties about US drug policy in the nineteen In the nineteen fifties, there

were a bunch of hearings. They're called the Daniel Hearings, and they were televised and they were held in seven cities around the country, and there were a lot of witnesses which testified in these hearings, and the New York hearings. Um New York City hearings involved these doctors and researchers, scientists, and what struck me about them was that they were all from Lexington, Kentucky, and they all sounded a little bit like drug policy reformers sound today. They saw drug

users as human beings. They definitely did not think that incarceration or criminalization was the way to go, and they argued with the police and the law enforcement and the federal apparatus because they thought that drug addiction should be placed under the banner of medicine and that it was a health problem. And that sounds very familiar to our

ears and so I got curious about them. I thought, you know, what did they put in the water in Lexington, Kentucky that would lead this group of researchers and doctors and people who treated people who were drug addicts and they called them addicts in those days, to make that argument.

And that turned out to be a harder question to answer than I realized, and also easier because they were all at the U S Narcotic Farm in Lexington, Kentucky, and they were all federal employees of the Public Health Service, the US Public Health Service, and they were there to kind of try to discover what they could about this this disease, and they thought of it as a chronic relapsing disease. And so they were an interesting group, and I tracked them from the mid nineties um into the

early two thousands. I didn't have an opportunity to really track them down. And then in the early two thousand's, I thought it's time to try to figure out what this American institution was before everything about it really disappeared. I see, now we should explain to our audience, you know, when these institutions emerged. I mean, I will talk basically about the one in Lexington, which was the key one, but there was another one in Fort Worth which did

not have a whole research program attached to it. But when we think about the emergence of these things, when Congress authorizes them in the nineteen thirties and when they're created in nineteen thirties, let's set the context for this, because I think you know, some of the our audience will know that you go back to nineteenth century and drugs like morphine and cocaine were legal, legally available, widely prescribed, could be gotten over the counter, ordered by mail order.

They were recommended for, you know, all sorts of aches and pains. And then you see in the early twentieth century, late nine or early twenties century, kind of growing backlash, growing concerns. Heroin had been invented in eight initially a cost suppression. People begin to realize it's it's dangerous. People can begin to realize the dangers of cocaine, and so you get the nineteen fourteen Harrison Narcotic Act, which begins

to change the whole perspective of US drug policy. So if you could take us a little bit through that history from around fourteen, the Harrison Narcotic Act and the Supreme Court, and how we land up in a much more punitive situation within a decade or so. Yeah, it's actually a really interesting history and relevant to today's discussions.

So the Harrison Act was a tax act, and it was not at all clear to anyone how exactly that was going to influence the practice of medicine, which had veered away from using the opiates and over prescribing the opiates um in the early twentieth century. So heroin, for instance, in the US was never indiscriminately available. It might be prescribed, but it was never really used medically, and so that,

uh was an interesting thing. In nineteen fourteen, um the Harrison Act, there weren't that many people who were that concerned really honestly about the problems of opiate addiction. However, once the Act went into effect, there were a lot of people who were using medically using morphine, and that meant that there were suddenly a lot of people who

were basically trying to get off morphine. And so we started in the US morphine maintenance clinics, and the morphine maintenance clinics went into effect towards the end of the of the teens of the nineteen tens, there was a lot of backlash to these morphine maintenance clinics, and they were in cities like Shreveport, Louisiana, or Jacksonville, Florida. The New York City clinic they were shut down in the

early nineteen twenties. So by nineteen twenty one two they were mainly shut down for a variety of reasons, but mainly having to do with prosecution of the Harrison Act, because physicians began to be prosecuted, so that meant that physicians began to be scared. So these clinics that had popped over the years, were they actual see maintenance clinics

or are they more detox clinics designed to get people off. No, they were they were maintenance clinics, but they functioned as detox clinics eventually, and they were shut down rapidly, so there was no real attention to the patient at that point and just doing detox. Even the ones saying we're going to give you declining doses to get you off morphine,

even those ones start getting shut down by the authorities. Yes, so in this era, it's the Treasury Department which enforced prohibition they inforced, you know, they're they're doing the work rather than the Federal Bureau of Narcotics doesn't really start up until nineteen and so you have this period of time when it's really very unclear whether physicians are gonna It becomes clear to physicians that they are in danger of prosecution if they continue to maintain their patients on morphine,

and so they basically eradicate the practice of morphine inuntenance and they switch a lot of people onto barbiturates, onto other sedatives, other drugs, and they basically create a kind of criminalization that gets heightened towards the end of the twenties. And in the end of the twenties and the late twenties. You remember nineteen twenty nine. Everyone knows that's the year

of the Great Depression. But in early nineteen the US Congress, prior to the Great Depression beginning, they legislate the building of these narcotic farms. Because by that time there is overcrowding in prisons. About a third of the people who are in US federal prisons are drug users, and they decide that they don't want prisons containing drug users, and they decide to essentially divert them too large federal narcotic farms. And so in the twenties and thirties, right there is

an attempt, a real attempt to find a cure. The idea is science can find a cure for drug addiction, and if we can only give our researchers are scientists, enough support, then we will be able to cure what is clearly too many a disease, and they call it a disease throughout that period. So the U s Narcotic Farm is authorized to be built by the US Congress in the early early in the year of nine. So I recently came across a new book by a fellow named Kenny Anderson, who I know from the world of

sort of harm reduction advocacy around alcohol. But he has a new little book called From Inebriate Asylums to Narcotic Farms, and one thing he does is also placed the narcotic farm approach in this tradition of inebriate asylums of sending you know, people who are addicted to alcohol in a severe way to these asylums for some sort of quote unquote treatment and for segregating them from the general population. And I was curious. I mean, I didn't see much

about this in the Narcotic Farm book. But do you see this as part of the broader kind of you know, zeitgeist of what's going on and the way people are thinking about addiction or in fact, is the narcotic and alcohol things so separate that you would say that they don't really overlap in any way. No, I I would say they do overlap, and that move from an asylum. Right. The thing about the asylums was that people of all

kinds were in those, right. They might be alcoholics, they might be people who have co occurring mental health disorders with alcoholism or without, with drug addiction or without, and so you might have people who have no co occurring disorders but who are drug users also would sometimes be placed in those settings, and states, you know, did different

things with them, but they definitely lumped everybody together. The Narcotic Farm was an attempt to separate out people whose sole problem was drug addiction narcotic addiction, and narcotics was a catchall term at that time that did refer to both opiates and cocaine, which is a little bit hard for us to understand because they are drugs that do very different things have very different effects. However, it was basically um what became the illicit market after the Harrison

Narcotic Act. And so the narcotic farms did not accept alcoholics and did not even like to accept barbiturate users, although they did and they did study and try to figure out how to respond to barbiturates um withdrawal because that can cause seizures and death. They were primarily made for the opioid user, and at that time that meant

heroin and that meant morphine. Now many many morphine users and heroin users would also use kane, but they did not regard it as their primary drug of choice, shall we say, And so that and other drugs were also very little represented in the narcotic farm. So cannabis, for instance, although that was studied slightly and people did refer to it, it was not thought of as an addictive substance in anything like the same way. These were really made for

opiate users, you know, the opium problem. They're solving the opium problem. So the US Congress is solving the opium problem by building these farms. These large and they were they were a thousand acres and they were large buildings, large farms, sort of congregate care for people who have opium problems, and the idea was six months of essentially

drying out and you'd be good. But the narcotic farms were also they were very interesting as instance, just to be clear here you say the narcotic farms, we were basically talking about two. Write the Lexington, the most famous one has opened up in ninety five and that has a major research part that we'll talk about later in our discussion. And then Fort Worth, Texas, which is the second one, opened up a few years later. And I think it's important, you know, for our listeners to know

that when Lexington's launched, it's a big deal. None of the stuff we're talking about was secret. I mean, when Lexington gets opened, the surgeon generals there, the governor of Kentucky's there, there's national media that's describing the narcotic farm is everything from quote unquote a new deal for the drug addict to quote unquote a million dollar flop house for junkies. So I interrupted you there and saying, so why was it called a farm? Yeah, so that it's

it's pretty interesting. It was an actual farm. They sought for at arable land, and so there were there were contests across the country for first of all, where would these things be cited. And remember this is the depression, and so cities and municipalities would compete to get federal jobs, and there were also competitions for what they would be named. And this was really thought of as an alternative to prison.

This was thought of as a new deal for the drug addict, and that is how it was represented in things like editorial cartoons and so. The U S Narcotic Farm, and in its early days it was called that. But after a while people began to realize that there's a sort of joke in that, and that is that what are they doing growing narcotics there? You know, poppies or

marijuana or whatever it might be. Um And so they gradually kind of moved away from using the term farm, but the farm was already within the lore of the drug using population. And in when the farm opens to great fanfare, I mean, this was the US Congress's answer to the opium problem. Is this massive, beautiful, very large structure. It's still there today. It's just a prison, but it's jointly run right by both the Bureau Prisons and the Public Health Division in the US government. Right, it's a

joint enterprise of the two. So there's both the punishment side and there's the kind of rehab research. I kind of merged together in a kind of awkward sort of way, right, Yeah, And it's awkward in many ways because you can volunteer to go there. You can go up to the gates of the narcotic Farm and say, I'm a drug addict.

I have papers from my doctor. And before the World War Two, most of the people who went to the narcotic farm, so a third of them are volunteering in that manner where they're just showing up seeking treatment and getting it um largely for free. If they could pay, they were asked to pay. But it was a place where you might go if you were a drug user and you know, the snow is starting to fly in New York City and you don't really have a place

to live. What we would call today a homeless or unhoused population often spent their winters at the narcotic Farm. But but I mean, you can think about it quite remarkable because here we have a place that's a prison, yet basically a third of the inmates are people who come knocked me at the door and say let me in.

I mean, there are no other prisons that I'm aware of like that, right, And actually the other prisons right, Most of the people who went to Lexington had been incarcerated in prisons and jails and other places that were not devoted to UH curing the drug addict. And so they thought of Lexington the Narcotic Farm as a country club, and in fact it became known very much as a country club prison there. It is in the South, but it's not racially segregated, and it's not gender segregated after nine.

So it's a strange institution. It's awkward in every way. So for the entire forty years that the Narcotic Farm operated UH ten at any given time. This is true of men as well as women. Were professionals, largely positions, largely people who had access to opiates or put their wives on them. And so you have a nurses and you know many many professionals who had greater access to opioids became habituated to them and ended up going to

the narcotic Farm. UM. So it was a bizarre institution when you really think about it because it is so mixed. So in talking about the general population and we're talking about you know, they treated over a hundred thousand people in the time that they were operating. But you you really do see a kind of change in the pattern of who goes to the narcotic farm that reflects the changes in the pattern of who uses opioids. We'll be talking more after we hear this add you said it

was regarded as something of a country club prisoner. They had all sorts of recreational facilities. They had all sorts of you know, nice ways of treating people, whether people got manicures and haircuts, there were social events, but you had gymnasiums, you had a golf course. I think you had a tennis court. Yeah, it's it's pretty interesting when when we looked at it um and I think Luke Walden and JP Olsen and I as we were trying to interpret these photographs that we were seeing in the

archives and that we were trying to understand. Right, you see all kinds of recreational There was a bowling alley. They're bowling alleys in the narcotic farm. There's the second largest auditorium in the entire state of Kentucky for jazz concerts. And I'm sure there was some resent s mint, but it really looks like an American small town. You can see the mentality, right, it's kind of a city on a hill. This rolling hills of Kentucky, bluegrass. This is

thoroughbred country, right, And they are farming. Everyone is, you know, they're they're harvesting vegetables, they're cutting the hay, they raise the pork. Products that are consumed at that facility are raised at that facility. They have all kinds of activities and they log the amount of time that UM their patient inmates spend at recreation, right, so they thousands of hours each year are recorded of people who are bowling

or playing ping pong, or UM playing softball. There's a women's softball team, there's you know, there's there's there's every kind of recreation that they could a mad and how to fit in there. And that's because they are convinced very early on that UM, if people had better things

to do with their time, they wouldn't use drugs. So the idea there is you find alternative reinforcers, activities that compel people, that make people feel part of something larger a community, whether it's basket weaving or whether it's um. You know, they had these outdoor concerts in the middle of the courtyard, and you know, they really tried to make sure that people were busy all the time. They had jobs. Everybody had a job, so you had to work and you had to play, and you had to sleep,

and you had to eat. And that normalization project, and it really was it was like, we're going to take this institution and we're going to make an American small town, and we are going to um indicate to people how they could fit into that small town. You know. So it's a very interesting model and it's one that we to this day right have this idea that if we could provide alternative reinforcers, then people wouldn't use drugs and they wouldn't go back to using drugs. That turned out

not to work. It turns out that the recidivism rates are off the charts. So it seems so that within the Arconic farm, does is it creates this place for people to chill out, gain some skills. Nobody's overdosing or dying there, right, And in fact, one of the elements I'm curious about is what was if two thirds of the people there have been sentenced under the federal drug laws, but one third are people who have showed up voluntarily, what was the dynamic like between the ones who are

there voluntarily and the ones who were not. Yeah, there was very little differentiation between We call them the balls, and many of the balls will repeat customers um. In fact, they were called winders because they would wind in and wind doubt and then they would wind back. The one that we found who was there the most was there forty four times and on his forty fifth time. After that he didn't didn't return. But many people were there,

maybe nine ten. I mean, we know to this day right that that treatment often doesn't work the first time, and that people do have to try multiple modalities. And one of the things that they tried to do with the narcotic Farm was they tried to provide under one roof UM multiple modalities of treatment. So they tried a lot of different things. The other thing that they really believed, in addition to the alternative reinforcers I either play the

recreational opportunities UM. Everyone had a job and were they were trained for these jobs, and these jobs ranged from auto mechanics two woodworking to working of course in the cooking um and clean up in the kitchen. But they also included skills training, so for instance, photography and dark room work or printing or other kinds of highly skilled activities where you really could imagine people getting jobs afterwards.

Were sewing, tailoring, various kinds of things of this kind, and these were at that time in these were progressive elements of prison reform. The Federal Eureau of Prisons came into being in nineteen thirty and it came into um being at a time when people were really thinking about, um, is it possible to make people who are incarcerated gain new skills or take on new responsibilities. And with that, in fact, UM you know, helped them in their lives

after they left these institutions. And so that vocational training, vocational skills. Aspect of the narcotic farm UM which included agricultural labor, they had cows, and so there are lots and lots of stories about these city boys UM finding themselves out milking cows early in the morning and splashing around in the manure. Right hard hard to see how learning how to milk a cow isn't help you when

you go back to New York City after that. But you know, you talked also in the book about how after World War Two there's a change in the attic population. It's less about older guys, and now you have the first youth heroin epidemic, and you have the children of immigrants, you know, Italian and Jewish and Irish, and you have Puerto Ricans and and Blacks. And that results in the

fifties in Congress enacting really incredibly draconian laws. And we sometimes think about the laws today, but in nineteen fifties six, in Narcotic Act that Congress passes after you know, one of the more more recent drug scares back then, has a five year minimum sentence for first time possession and a death penalty for dealers. So how does all this

effect what's going on at the narcotic Farm. Yeah, so it's pretty interesting because the hearing that got me interested in the narcotic Farm was part of the lead up to that nineteen fifty six Act, and the people at the Narcotic Farm opposed the ninety Act, and that was partly because there were mandatory minimum sentences that were leveled initially in nineteen fifty one in the Bogs Act, and that was very much responsive to concerns about juvenile delinquency.

These populations of largely young men, but young women as well, and I write about that in some of my other work. There was a famous study called the Road to H. H was the slang term for heroin at the time. So the Road to H was done at New York University and it um looks at this population and what's happening is that this younger, more racialized, more ethnicized population is starting to show up at the narcotic farm right around nineteen fifty one. So during the World War two,

UM you've probably all heard at opioids were stockpiled. They were not just stockpiled at Fort Knox, although they were stockpiled there, but at stockpiles around the country for UM efforts during the war. One of the major purchasers of opioids is actually the US military, major users because UM codeine, cough suppression, other uses of morphine. Also, of course, during wartime, you need more morphine to be available for people who

are injured UM in in the war. So you have Korea, you have lots of people who begin to get UM experience with the opioids, and you have after World War Two a kind of flushing out of those stockpiles, so that suddenly you find heroin in the streets again. You also have the nineteen forty on you have the US Mexico border. UM, A lot of opioids are coming into

the country either well through through Mexico. Were guardless of whether they are UM produced in Mexico or whether they're produced in UM through the Asian routes, they're coming in that way. And then you also have of course other routes coming in from to the east coast. The Daniel hearings that led to that nineteen s act were about the border. And so you see, the nineteen fifties is

a period of increasing criminalization, increasing buy in. So even though UM many people the doctor's lawyers, you know, people who had experience with UH drug addiction, like social workers, argued against criminalization, UH, they lost. They lost that fight.

So in fact, in the nineteen fifties, this is back to my dissertation topic, UM, there was a wonderful American Medical Association American Bar Association effort called drug addiction crime or Disease, and there were a significant opponent of people who were saying, this is a disease and it should be treated as a disease. And of course that fit very well with the narcotic farm because they had always seen it as a disease and they in fact talked

about it as a chronic relapsing condition. And the fifties is so interesting. It's so interesting because you have a culture Heroin using jazz culture. I can't I can't kind of convey how important Heroin was to the jazz culture. Um In ninety seven, a guy named Charles Winnick in New York City interviewed three hundred and fifty seven Heroin

using jazz musicians. So this was definitely you know, I mean like that that's a very specialized population and to be able to find three hundred and fifty seven of them for your study is kind of surprising. But in many ways, Lexington became this kind of mecca of this cultural center really for this population, and the nineteen fifties

was it's heyday. And so across the nineteen fifties you begin to see a huge population shift really as a narcotic farm, so you have many more let's just focus on this jas saying because I'll tell you that for

a long time. I mean, if if somebody mentioned the Narcotic Farm to me twenty years ago, the first thing that I would think of, Oh yeah, that was the federal narcotic prison where you had all the jazz, famous jazz players, and I mean, just for our listeners, if you know anything about jazz, it had Check Baker was there, Sonny Rollins, who's still playing and is widely regarded as maybe second only to John Coltrane, is the greatest of

all saxophonists. Had Elvin Jones, Jackie McLean, Sonny State who I used to go see in the Upper West Side years ago, Joe Guy. So I mean, it really was an exceptional story. And then I think this is incident that you mentioned the book in nineteen sixty four. We're an orchestra made up of the jazz as players who

are at Lexington performed on Johnny Carson's Tonight Show. Now unfortunately the tapes no longer exist, but I mean, I guess it was described as the greatest band you've never heard, So I mean, probably no other federal prison can claim that sort of link with great, you know, great artists. In America, Well, no other prison except perhaps Fort Worth, so the Fort Worth Narcotic Farm. They also had jazz

greats and also celebrities. So that was the other thing about Lexington is that there was a celebrity culture UM. And so you might have actors, people you you would know, and the whole population would get very excited about oh, somebody's being admitted. UM. And you could also go here those concerts. They had practice rooms. They also bought musical instruments for the patient inmates, so a lot of people who never played together outside would play together at Lexington UM.

And there were a lot of jazz fans, right, There were a lot of people who went to jazz clubs who also used heroine and who um had this lifestyle. UM. That kind of became part of the place to the point where many many people remember the music above everything else about Lexington. Well, that was certainly my case until

I read your book. You know. So what happens is from the thirties and through into the fifties and early sixties, there's still the basic model, which is engaged people in agricultural work and have them fresh hair and have tremendous recreational facilities and vocational training and hope that all of this stuff works out that people won't recidivate, which turns

out to be false. Although you know, as we also know with drug addiction, that even when most of the people who volunteered to go to the Narcotic Farm, they weren't exactly looking to get clean to get off drugs. They were mostly looking to kind of chill out for a while when they were burning out on the life on the streets. So it did add some value in

that sense. But then there's a moment, I think in the sixties where people begin to give up on the whole agriculture as treatment modeled, and where the Narcotic Farm shifts and it begins to embrace some of these therapeutic community approaches that were happening outside. And maybe there's some things that are initially ground in alcoholics anonymous programs like day Top and the one Synanon which became quite notorious.

But say a little more about that transition that happens in the sixties in the last ten years of the life of the Narcotic Farm. Yeah, so the food at Lexington, like the music was legendary, so people actually liked the food. It was good food, and it was grown there. It was fresh um. It was not like other institutional food. And this was kind of well well known, well documented.

And then in the nineties sixties there begins to be prison reform that says you can't make people work, and so you can't make people work in the same way, which means you can't really run an agricultural enterprise. Because the agricultural enterprise, although it was headed by um, a staff member, it was really entirely patient in my labor.

This was also true in the kitchen. And so what happens is there begin to be shifts in the nineteen sixties, partly as a result of that changing pattern of race and ethnicity that began in the nine fifties, and there's

also federal prison reform that changes things. In addition, there's a shift away from psychotherapy individual or group uh that had been in its heyday in the fifties, towards these more affordable kind of alcoholics anonymous style, narcotics, anonymous style and counter groups and things like that that make more

sense with a large population than individual psychotherapy. That's be difficult to achieve, and nobody really embraced it um in the patient inmate population, because most people, as you said, weren't going there to get off drugs. They were going there to reduce the cost of their habit There were also, i would say hardening attitudes among the staff um, partly because the idealism of the early days didn't outlast the

post war wave that idealism. People begin to see right that people are coming back, that it's kind of a revolving door, and everyone who's kind of in charge begins to realize that we are not having the impact or effect that we wish we would had. And actually, even from the nineteen forties, there were concerns about after care.

The people who ran the narcotic farm believed that there should be after care, that there should be follow up, that people shouldn't just like leave the institution and just go back to their neighborhoods. There began to be, in fact,

a scientific um investigation of relapse. What was it and why was it that people could be on the train or the bus back to their neighborhoods where they had used and they would feel like they were going into withdrawal again, even if they had been cleaned for months, And so what was that phenomenon. They begin to kind

of get really curious about that. Now. The therapeutic communities are actually many of them started by people who were at the narcotic farm and then left the narcotic farm were critical of the model of abstinence only and they basically said, this needs to be a much more confrontational

version of abstinence only. So therapeutic communities or tcs UH sent and On being the largest and most notorious, and day Top Village following on were much more you know that their therapies were things like the hot seat where you had just sit there and just take or or dunce caps. So they really used humiliation and what I would call coercion UH to get people to stop using drugs. And they used the power of a community, a larger

group of people to try to keep people. You know, they would have them do very menial work, unpaid, you know, toothbrushing, the grout in the showers or on the stairways. Very humiliating things were done in the that movement, and that was even tried. The administrators at Lexington gave over a building where the women used to be housed. They were now housed in the main part of the facility. In a separate wing, they gave over a building to a

therapeutic community called Matrix House. To see, right, if they could perhaps um be more successful in terms of more effective at treatment, um if they used these more confrontational techniques. Let's take a break here and go to an ad purely by coincidence, this past weekend, I was hanging out with a friend of mine, Howard Josepher, at his summer

home on Fire Island in New York. And Howard is somebody who was one of the founders of Phoenix House, and then he started a remarkable harm reduction program in New York called Exponents. But he back in the sixties landed up at Lexington And I asked him what did he remember about being at Lexington in the mid sixties, And what he remembered was those confrontational therapeutic sorts of programs. You know, he was among the number of people whom that who sort of was drawn to that model at

least initially about challenging people. But his one recollection was that confrontation know, you know, therapeutic programs at Lexington at

that time. It's such an interesting paradox isn't it. So one of the things about the narcotic farm is that they would give wings two therapeutic communities, often configured around racial or ethnic identity, and they would allow them to choose their name Newman House or Unity spelled with a y o u uh, and both men and women uh could try to do this kind of thing within the institution.

In the nineteen sixties and seventies, Actually, in the late nineteen sixties there were really big changes in the federal prison system, and there were big changes in nineteen sixty six that affected the institution in ways that allowed for more of this sort of thing. In nineteen sixty six, the Narcotic Addict Rehabilitation Act was passed and NARA, it was called the Narcotic Addict Rehabilitation Act, was a federal

act that essentially changed the way treatment was done. So if you think about what is a treatment infrastructure, well, for from until nineteen sixty six, it's these two massive narcotic farms. It's centralized, it's federal, it's one east of the Mississippi and one west of the Mississippi River. And after nineteen sixty six, that legislation essentially says you have to get treatment in your home community. So every state, every town, every city is supposed to have drug treatment. Well,

how are you going to do that? Right? Maybe? Okay, So you have federal contractors who set out to make sure that everywhere that a person who is a drug user comes from has drug treatment. And so treatment essentially devolves to the states. Away from the federal They use the narcotic farm essentially to uh, you go there for six months only and then you are discharged to your home community. And so that's why they're experimenting with these other kinds of forms of treatment, because who is going

to provide all that treatment? Well, who comes forward is the salvation army, these new therapeutic communities, right, Alcoholics anonymous, narcotics anonymous UM. And they are provided federal money to start up treatment in Philadelphia or in um, you know, small towns in say Pennsylvania. Right, So you have a decentralization of the whole treatment infrastructure to the states and then to the cities where people who are having drug

problems are coming from. That changes everything at the narcotic farm. Now, there's also something else emerging at that time, right, which is that when people were initially admitted to Lexington or four works, right, one of the first things that would happen is they would be detoxed from their morphine or heroin addiction, typically with I think, you know, declining doses of morphine until they just stopped, and then after you know,

last I thought it was morphine tight, and then methodon after. But what happens in the sixties is Vincent Dola Marine Nice wandering their research suggesting that methodon should be used not just for detox but for maintenance purposes. So you have sort of simultaneous with the growth of the therapeutic community model, also the beginnings of methodon maintenance programs beginning

to open up in communities around the country. Yeah, and method on maintenance is, like all the old morphine maintenance pretty contested, and it's very much contested by the Federal Bureau of Narcotics Bureau of Narcotics and Dangerous Drugs d E a drug enforcement agency administration. So you have methodon maintenance is a pilot program. It's experimental well into the seventies um, and it is contained within a methodone clinic system.

It's not generalized to medicine more generally, and so methodon maintenance is does become available in some of these destination cities Detroit, New York certainly, so you see a rapid scaling up of availability of methodone in certain places and complete non availability in other places. The Narcotic Farm is interesting in terms of they were anti maintenance in certain ways because they felt that, um, you could overdose on methodone.

Methodone was very little different in their minds from morphine or even heroin, and so they had fights actually with Vincent Dole and Marie nice Wander. Nice Wander herself had been at the Narcotic Farm. They had one of the first psychiatric residency programs in the country at the Narcotic Farm, and so she had been there and she had observed and she did not feel very positive about the program at Lexington. Vincent Dole had a very different theory of addiction.

He had a theory um that addiction was a metabolic disease, and that was in some ways a very different kind of theory than a theory of a neurochemical kind of disease that the people at the Narcotic Farm were functioning with. Between the Narcotic Addict Rehabilitation Act and METHODO maintenance. It is very clear in the early seventies that the narcotic farms are becoming what we might call white elephants, right.

They are out of step with the times. They are carceerole environments, and it's evolving towards something really different as a result of of the Narcotic adict Rehabilitation Act, because the states are beginning to come on and say, all right, let's see what works, and let's start up treatment in our states and in our cities and in our towns. That makes sense for the people who come from this area. But let's turn now to the Addiction Research Center. It

became known as Addiction Research Center. I mean, my understanding was you had leading researchers and scientists, They had already made population of drug addicts who were right there, and that for decades they conducted thousands of studies, published over five articles and leading scientific journals. You know, really had

all sorts of sort of breakthroughs and understanding addictions. So just tell us more about that Addiction Research Center and what was so special about it and what it really added to our broader knowledge historically about drug use and drug addiction. Sure, um, the Addiction Research Center is the name that was given to the laboratory that congress Man dated UM be in the U. S. Narcotic Farm, you know,

back when the farm begins. UM, when it opens in n U S. Congress has great faith that science is going to be able to find a cure for drug addiction. And they really believe that UM nine. They really believe that they mandate that there be a scientific effort, and that effort UM is going to begin actually before the

narcotic Farm opens. The person who's going to become the director of that laboratory based effort, Clifton Himmel's block, is doing research at Fort Leavenworth, which is the largest prison in the country at that time, and he's doing research on that population of people who are drug users who find themselves in federal prison. And he's also doing research at cancer hospitals, and he's trying to figure out what is drug addiction scientifically? What is it? UM? How does

it work? UM? Why does it happen with opioids and nothing else? Right? Why do these and he draws out these UM charts and he finds out that this is a very predictable situation. Right, you have a very predictable lead up too tolerance, and then you have if you withdraw, then a subject will go into withdrawal and there will be a very predictable pattern of symptoms and of physiological responses to that withdrawal. And so he invents this thing

called the morphine abstinence syndrome. You know what happens when somebody is addicted and you take away that substance. What do they do? And um, he begins to study it in very small groups of people. Six is the usual size from well into the post war period. You have very small subject populations. And he believes subjects should know what they're getting into, that they should sign consent forms, and that um, they should understand, you know, what's going on.

And so he says, you can only do these studies on people who are seasoned morphine or heroin users who do not want to be cured. Right, So these are people who say that they are never going to stop using, that they will use, um, you know, as soon as they get out of the institution. No one who hopes for a cure is supposed to be accepted into these studies.

So the laboratory is a pretty interesting place because at that time You have to imagine, we know nothing scientifically about this condition, and we don't even know really what kind of condition it is. We have to define it, we have to chart it out, etcetera. And in addition to that, our subjects no more about the condition. Then the researchers do. They don't know anything about this condition. Who knows? Drug users know and they are the experts

in this area, and so they talk to them. They have a specific ward set aside that's called the research ward, and um they stay in that ward during the time that they're participating in these studies. They are never allowed back in the general population when they are participating in these studies. So from nineteen thirty five to nineteen sixty two, there is no requirement in the US for clinical trials

prior to a drug going onto the market. But the pharmaceutical companies who are putting these drugs on the market do want human testing. They do want to know if their drugs work, if they're dangerous, etcetera. And so what

they do is they evolve a system. This laboratory of the Narcotic Farm works very closely with a committee of the National Academies of Science and the National Research Council because during that the war there was a lot of interest and was it possible to do something with the morphine molecule, to dissect it, to get rid of the addictive potential, and to heighten the painkilling effect and the beneficial effects of morphine and get rid of all of

the bad effects, the the addictive effects. This turns out to be a quest that we are still engaged in. It is a tough nut to crack scientifically, but that laboratory was always in conversation with other laboratories that we're doing this at the chemical bench and in UH animal pharmacology at the University of Michigan, you have essentially Lexington. That laboratory becomes a node in a network of three laboratories that are looking at the molecular level, the animal

pharmacology and the human or clinical pharmacology. So the laboratory at Lexington is called the Addiction Research Center. After nineteen when it is joined, it becomes one of two working laboratories of the National Institute of Mental Health. So and I m H comes into being in and that laboratory, along with one in Washington, d C, is joined together. The idea is still being UH find a cure. But if you can't find a cure, then now we have a new goal. Find a way to change the morphine

molecule so that it won't be addictive. And in meanwhile, all these other drugs are being produced by the pharmaceutical company and all those ones need to be tested for

their potential for addiction another. Right, So you basically have a population at Lexington of people both inmates about both those who are incarcerated as well as those who are volunteers who are basically volunteering for these programs to say, test these drugs on me and use me as a guinea pig um And by the way, and it returned. What did they get in return for participant in the studies? Well, so the question of compensation was always a big one

at Lexington. And that's partly because when you take a prisoner out of a prison population think about this is a big prison people. Uh, it's loud, You never have any time to yourself, you don't have any privacy, any private room. And so that's what they got. The compensation was essentially to move out of the general population and into a much quieter much you know. In addition, they had five to late forties, they could designate compensation in terms of their drug of choice, so they could save

up morphine or heroin. UM. Because the the other thing that I haven't explained is that the drugs that are being used in the laboratory are essentially cleaned up drugs that are confiscated by the Federal Bureau of Narcotics and they are cycled back into research at Lexington after they have been um, you know, cleaned up. And so there is heroin there, and there is morphine, and they can save that up and if they want to, they can

wait until they want to use that drug. So it's called the drug bank, and we would view it today as a highly unethical practice. But at the time they weren't allowed to pay research subjects at all. They couldn't pay any money um. And so they thought about, well, what can we use to compensate people for uh, their time and their trouble and their uh you know, kind of giving giving their bodies to science um. And so

they came up with that answer. If you step back and you say, here are people volunteering for these studies and they can be given you know, later in later years money or maybe a reduction in sentence, or they can be given access to the drugs they would like for a while. And you're dealing with a population of people who say they never want to quit using drugs. It does raise the bigger question like why, really, on

some bigger level, is that on ethical? Why wouldn't I mean, obviously we can see how everybody got caught up and see how what do you mean you're giving these people drugs? You know that that's on ethical blah blah blah blah blah. You're sustaining their addiction. But these are people who went into being research subjects saying I never want to quit. I mean, so, what do you think was it really

unethical to pay these folks and drugs? Yeah? So, um, I'm gonna get myself in trouble by saying this, But to tell you the truth, the scale of human experimentation with currently illegal drugs today is huge, enormous, much bigger than the scale and the levels of control um that were in place at the Narcotic Farm, and in fact, in the book Discovering Addiction, I try really hard to

differentiate between the ethics of these studies. I try really hard to look at those kinds of questions, UM, in part because I don't have the same response that many people do. I don't say that that was unethical in the ways that other people might say that it is. The fact is the narcotic farm was a very small

research enterprise. UM and the larger pharmaceutical companies who are innovating the nineteen fifties, we were awash in new pharmaceuticals and they needed to be understood do they have addicted potential or addiction liability as they would call it UM or not? And so what they were the places where these kinds of tests were being done at to scale.

We're actually state penitentiaries where pharmaceutical companies were building clinical research facilities on the grounds of like Jackson State in Michigan up John Park Davis right ultimately becomes Fiser Right. All of these pharmaceutical companies are building clinical research facilities because after nineteen sixty two you have to go through Phase one, two and three trials, and Phase one was all done on prisoners. UM. Almost Phase one trials in

the nineteen sixties were done on prisoners. UH. There was nothing like the effort that we have today. You know, for Phase one trials and one arguably can say that we're proceeding in an unethical way today because today we ask people to volunteer for Phase one trials and um, they're largely people of color, they're largely poor people. You know, it's a very different world. Um. And you can say that they are freer, but are they That's a real question.

And I have to say, Um, so much we that we know in humans was generated initially at the Narcotic Farm. It was known basically all over the world. The World Health Organization turned to the laboratory, the Addiction Research Center UM. Prior to our having the Controlled Substances Act and the scheduling that we have today, the laboratory at Lexington rendered

decisions for whole Narcotic Control Sparatus. The Global Narcotic Control Apparatus paid attention to the science at Lexington because it was the only place where it was really set up

to be done. And that's partly because yes, they have a captive population, but it's also a population that has knowledge, has expertise, right, can be tapped to understand the effects that these drugs have on people, not animals, right, not in petri dishes or something right, but here you have people who can actually talk to you and who have a lingo, who have a way of describing their experiences, UM,

characterizing their experiences very accurately and precisely. Now in the nineties seventies, there begins to be a real UH what I would call a knowledge explosion, late sixties, early seventies knowledge explosion, and UH the Addiction Research Center is no longer the only game in town, and so they begin to be competing paradigms. That begins to be inquiry UM elsewhere. And that's really important. But one of the things about

Lexington is that the science changed over time. So in the beginning, you don't have neuro psycho pharmacology, right, you don't have neuropharmacology until the fifties, and when they begin to hire people to study the brain UM, and they hire a neuropharmacologist UM in the sixties who comes in and who begins to really look at UM what's going on in the brain, and from clinical description is able to characterize UH the opiate receptor, right, that there are

more than one, that there are multiple opioid receptors, and UH shows essentially where they are and what they're doing in the brain. And so this early identification of opiate receptors in the brain in the nineteen sixties that the Addiction Research Center is really important for our studies today.

But there's one other big piece of the research that was going on, which was the research on psychedelics and giving some of these inmates LSD and mescaline and psilocybin um, you know, not unlike what Learry and Albert were doing their early days at Harvard, and a lot of this research back in the fifties being funded, you know, quietly by the CIA. It was not publicly revealed at that time.

But there were some very serious studies, I mean, beneficial studies that are still regarded, you know, as legitimate scientific studies that came out of those narcotic farm studies of giving the inmates, uh some psycholic just say more about that psycholic thing. Yeah, it's a fascinating story. So in the nineteen fifties, I don't know, there was something like a D laboratories studying LSD. LSD was a tremendously well studied drug and um the people at the Narcotic Farm,

We're pretty sure that L. S. Steve Esklin. There was a lot of interest in those drugs because they worked completely differently. They had a different effect on the brain, They worked through different neural pathways, and that was known at the Addiction Research Center, and so they were interested in that because they realized these didn't have the same tolerance um and withdrawal effects that they were used to

seeing with morphine. And so, if you are studying LSD UM in the fifties, you are typically funded by the CIA. The CIA comes knocking at your door. The Addiction Research Center suddenly became very um well equipped as a result of these LSD studies, and they benefited for about ten years from the funding of the CIA, and in particular that UM favorite UM program UH, the mk Ultra program UH.

And so that of course got them into considerable trouble later in the nineteen seventies when Congress started to look at what had been done in the fifties. Because in the nineteen seventies, by the time the Congress, Teddy Kennedy and so forth began to investigate human research on federal prisoners, the Narcotic Farm is the only place where there are

still federal prisoners who are participating in drug studies. State prisons, yes, but federal no. And so one of the things that the a r C had trouble with in the sixties was that change that I talked about earlier in sixty six, the Narcotic Addict Rehabilitation Act. It meant that no one was at Lexington for more than six months. And um, it was a requirement at the Addiction Research Center that to be in a study you had to be drug

free for six months before release. So they could not use people who went there under the Narcotic Addict Rehabilitation Acts. So what they did I didn't realize that really is a book, because I mean a lot of the people who had been in the studies were people who had been sentenced to very long prison sentences, and that was almost,

I think, one of the requirements of admitting somebody. And so after by the mid sixties, after Narcotic Addic Rehabilitation Act, it means that nobody going to Lexington is stand there for more than six months. So I mean, as your sense, I mean, obviously you co authored a book in the Narcotic Farm, and another book grew out of a lot of the research that happened there. Would you say in retrospect it was a net plus in terms of the

American history of dealing with drugs. I always sit with the paradox that there will never be another narcotic farm. I don't think that there's a reason to return to a narcotic farm model. But um, I also think that we learned something in terms of this was a low coercion kind of institution. People who went there learned, in some cases for the first time that they were human beings.

There was a largely humane and compassionate ethos to the place, and they were respected, and some of them got well, and some of them didn't come back. And actually, I look at the rates of relapse and recidivism at the Narcotic Farm, and I have to say they're just not that different from what we see in a lot of

treatment programs, most treatment programs today. Yeah, I mean, the simple fact that a third of the inmates were people who went there voluntarily, which cannot be said of any other prison I've ever heard about in history, is a sort of remarkable fact as well. So, Nancy, I wanna thank you very very much for having this conversation with me. I mean, I just loved reading A Narcotic Farm. There's those who a documentary U based on the book that people can find I think on YouTube. I think you

can find on vimeo. Actually, Ben, thank you Ethan for all the work that you have done to bring this kind of perspective to the American people. Well, thank you very much. Okay, take care. If you're enjoying Psychoactive, please tell your friends about it, or you can write us a review at Apple Podcasts or wherever you get your podcasts.

We love to hear from our listeners. If you'd like to share your own stories, comments and ideas, then leave us a message at one eight three three seven seven nine six that's eight three three psycho zero, or you can email us at Psychoactive at protozoa dot com, or find me on Twitter at Ethan natal Man. You can also find contact information in our show notes. Psychoactive is a production of I Heart Radio and Protozoa Pictures. It's hosted by me Ethan they Adelman is produced by Noam

Osband and Josh Stain. The executive producers are Dylan Golden, Ari Handel, Elizabeth Geesus, and Darren Aronovsky. From Protozoma Pictures, Alex Williams and Matt Frederick from My Heart Radio and me Ethan Edelman. Our music is by Ari Blusien and a special thanks to a. Brios f Bianca Grimshaw and Robert Deep. Next week we'll be talking about the country with perhaps the most fascinating drug policy in the world. That's the Islamic Republic of Iran, which has also been

a huge supporter of harm reduction policies. My guest will be Mazzi ar Gabi, professor at the University of Exeter in the UK. I just kind of recall a statement by the late Amany, you know, the leader of the revolution Supreme Lider Iran in the eighties that he said that we have to fight the war on two fronts. The first front the war against the Iraq, but the

second front was the war against drug and addiction. So this is just to give you a sense of how entrenched it was with the political history of revolution Iran. It made me understand that it really needed to be discussed with all new attention. Subscribe to Cycleactive now see you don't miss it.