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On Nov. 9, 1970, after years of heroin addiction, Vicente Alba decided to finally stop using drugs.
He had settled in the South Bronx from Panama City when he was 10. By 14, he was regularly shooting up. And he wasn’t alone: Substance abuse was common among teenagers and young people in the neighborhood, as he recalled in a recent interview. But he couldn’t have predicted that his decision would coincide with a revolutionary moment in American history.
The next day, the Young Lords, a radical Puerto Rican civil rights group, took over Lincoln Hospital in the South Bronx for the second time that year to demand better health care for all.
Their first takeover, in July, was a daylong affair while Young Lords negotiated with city and hospital officials. News coverage of the move helped raise broader awareness about the hospital’s unsuitable conditions, but did little to improve care. The second takeover, in November, led to a program that lasted eight years.
Activists saw the hospital as emblematic of the city’s neglect of the area, and community members often called it “the butcher shop” because of the high mortality rate and the dangerous conditions — dilapidated ceilings, cockroaches, blood-spattered floors.
The Young Lords had been pushing for expanded social services and a drug detox center in the South Bronx, but were frustrated by what they saw as the city’s lack of progress.
“Our parents raised us right,” said Mickey Melendez, 78, a founder of the Young Lords. “Always ask first, and if they don’t acquiesce, then you figure out what to do.”
In developing their ideology, the Young Lords, who often worked alongside the Black Panthers, looked to revolutionary movements across the world, including in Algeria, Vietnam, Cuba and China. They dreamed of a socialist society and advocated Puerto Rican independence, self-determination for Latinos, women’s liberation and gay rights. Public health was top of mind almost from the beginning.
“We had all these great, glamorous ideas about revolution,” Mr. Melendez said, “but we started talking with the people and we realized what they needed was to have someone clear garbage from the streets.”
The Young Lords used the term “diseases of poverty” to refer to many endemic conditions in their communities, including tuberculosis, drug addiction and asthma, and their approach to health care was central to their politics.
The scholar Johanna Fernandez, who published a book about the Young Lords, noted that many people who came to be involved with the group had firsthand knowledge of disparities in medical treatment from a young age.
Those experiences, Ms. Fernandez said, gave them an understanding of the injustice of “discrimination when you’re most vulnerable, when you’re ill.”
Taking over the hospital for a second time was a dramatic measure. But the Young Lords had earned widespread community support and the backing of the staff, Melendez said, and entered a tentative understanding with the city.
They devoted the hospital’s auditorium to a drug detox clinic, calling it Lincoln Detox. The clinic was largely staffed by volunteers, many of whom worked as interpreters for the doctors. Political education was an integral part of the treatments.
The clinic initially detoxed patients using methadone, administering decreasing dosages over a 10-day period. But many Young Lords and volunteers had concerns about the approach from the beginning, feeling they were simply swapping one drug for another.
Walter Bosque del Rio became involved with Lincoln Detox when he was a nursing student, in 1971. “We used to call methadone ‘liquid handcuffs,’” he said in an interview.
There were downsides to the treatment: Patients who took home doses reported that children would accidentally ingest the drug, and they couldn’t get enough doses to allow them to travel, Mr. Bosque del Rio recalled. Methadone has been proven to substantially decrease the risk of fatal overdose, but the Young Lords saw it as a tool of state oppression.
So when they learned in 1971 of an acupuncturist in Thailand whose treatments reduced a patient’s craving for opium, they were intrigued. A group went to Chinatown and came back with needles and charts indicating points in the ear that could benefit from needling. Though they had zero acupuncture experience, they began practicing on oranges and each other.
They quickly realized the effectiveness of the treatment. Stimulating points in the ear induced tranquillity. Though acupuncture didn’t mimic the high of an opiate, it reduced anxiety, stress and cravings.
Soon, the clinic was detoxing 600 patients every 10 days, Mr. Melendez said, and at the start of the fiscal year in July 1971, it began receiving funding from the city. Patients traveled from New Jersey, Connecticut and Pennsylvania for the treatment. Some clients were skeptical, and workers realized the irony of using a needle-based treatment to help people stay off drugs. “We’d stick needles in ourselves or break them open to show patients there was nothing dangerous inside,” said Mr. Bosque del Rio, 77.
In 1974, a group, including Mr. Bosque del Rio, presented at an acupuncture conference in Montreal, sharing patient testimonials about the efficacy of acupuncture in addressing drug addiction and withdrawal symptoms. He and three others then graduated from an acupuncture institute in Quebec.
Still, there were barriers to the approach. Even after receiving formal training and licenses, Mr. Bosque del Rio and others could perform acupuncture only under the supervision of physicians. Their holistic approach didn’t always align with accepted medical guidance, Mr. Bosque del Rio said, and their politics made the group a target. People associated with Lincoln Detox were found dead under murky circumstances, including Dr. Richard Taft, a progressive white doctor at the clinic.
And there was near constant political pressure. The Young Lords had a better working relationship with Mayor John Lindsay’s administration, Mr. Bosque del Rio said, but many politicians opposed the clinic. Chuck Schumer, then part of New York’s State Assembly, had pushed for the eviction of the Young Lords from the hospital, and in 1978, Mayor Ed Koch’s administration ousted the clinic. The administration barricaded workers from entering the facility and reassigned them to other hospitals.
“Hospitals are for sick people, not for thugs,” Mayor Koch said at the time.
But the group’s detox efforts continued. In 1985, the National Acupuncture Detoxification Association, known as NADA, was formed by Dr. Michael Smith, who had worked at Lincoln Hospital. NADA formalized the protocols for addiction detox that were developed at the clinic, Mr. Bosque del Rio said.
Juan Cortez, a NADA practitioner and trainer, first encountered the protocol when recovering from drugs himself. It was a full-circle moment. “I grew up going to Lincoln Hospital with asthma attacks as a young child in the 1970s and watching the South Bronx burn,” Mr. Cortez said.
NADA has been used in contexts beyond supporting recovery from drug addiction, Mr. Cortez said, including disaster zones and alleviating symptoms of trauma. He sees his work as a natural extension of what the Young Lords began.
The approach was borne out of necessity and ingenuity, Mr. Cortez said. “It developed out of activism and a need for change: asking for help, not receiving it and having to take control of things yourself.”
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Joumana Khatib is an editor at The Times Book Review.
The post How a Hospital Takeover Changed How We Treat Addiction in America appeared first on New York Times.
