History and the Opioid Crisis

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Proponents of methadone also believed that its use would enable heroin users to get and keep jobs. A 1970s U.S. federal government manual on methadone maintenance claimed that those addicted to heroin couldn’t hold down a job, but “a methadone patient, in contrast, can and often does get and hold a job. The result can be a stabilization of his whole life pattern.”⁴ Without this stabilization in wider society, many officials feared former addicts would slide back into drug use. At a 1974 New York conference on drug use and the workplace, one prominent banker argued that “we must accept the doctrine that an ex-addict without employment is an ex-addict without cure.”⁵ In practice, however, merging work and recovery proved complicated.

In the 1970s, just as now, people living with and recovering from substance use disorders faced prejudice and mistreatment at the hiring stage and in the workplace itself. There were no legal protections against being fired or not hired because of receiving methadone treatment. At a 1973 national conference on methadone, Joan Randall (a patient advocate and co-chair of the Methadone Coalition for Equal Opportunity) called out employers like Macy’s and the New York City Transit Authority for their refusal to hire methadone patients, although she claimed they were already employing hundreds of methadone patients they didn’t know about.