By Kate Roberts
Mother of Methadone: A Doctor’s Quest, a Forgotten History, and a Modern-Day Crisis by Melody Glenn
America’s purported War on Drugs began more than fifty years ago, yet today it’s still easier to procure fentanyl than methadone, a gold standard treatment for opioid use disorder. That contradiction is not incidental — it is the result of decades of political choices — and it is the tension that haunts Melody Glenn’s Mother of Methadone: A Doctor’s Quest, a Forgotten History, and a Modern-Day Crisis (Beacon Press 2025). As overdose deaths remain higher than pre-pandemic levels, Glenn’s excavation of methadone’s history and her own uneasy entry into addiction medicine arrives at a moment when the United States is moving towards renewing the 1970s-era War on Drugs playbook.
Glenn, an ER physician who began moonlighting in a Tucson methadone clinic, writes with the disarming candor of someone who has both enforced and resisted the profession’s stigma toward people who use drugs. Her narrative opens in a waiting room hemmed by barbed wire and bulletproof glass, where patients line up daily for a liquid dose that could keep them alive. The architecture itself tells the story: in the United States, methadone is medicine, but it is also surveillance.
The “mother” of methadone is Dr. Marie Nyswander, a psychiatrist who, along with Vincent Dole, helped pioneer methadone maintenance in the 1960s. Glenn resurrects Nyswander from the archives, combining dogged research and what scholar Saidiya Hartman calls “critical fabulation,” in which, through rigorous archival analysis and careful, transparent speculation, Glenn restores interiority to lives, the historical record filling the silences that history leaves for women. For instance, Glenn lingers over what the archival record cannot capture—imagining Nyswander alone after research meetings where her authority was publicly undermined, or tracing her unrecorded fears as federal surveillance closed in on methadone—Glenn composes these scenes to make the emotional costs of political repression visible. Nyswander appears not as a footnote but as a radical, a woman who insisted that heroin addiction was not moral weakness but a treatable disease.
Glenn’s book is strongest in these acts of recovery. She restores Nyswander to her rightful place in medical history by detailing her central role in legitimizing methadone as a maintenance treatment—designing early clinical protocols, defending long-term dosing against abstinence-only critics, and insisting that patients’ lives stabilize not through stringent penalties but through care. Yet as the program gained national visibility, Nyswander’s intellectual labor was routinely overshadowed by her male collaborators, her individual contributions folded into generalized institutional memory, and her authority treated as auxiliary rather than foundational. Glenn traces how, within a generation, Nyswander’s name receded almost entirely from the public history of methadone—an erasure driven by gendered academic hierarchies and the political backlash that recast maintenance as moral failure rather than medical innovation. She ties that disappearance to her own longing for mentorship in a profession where women’s leadership remains structurally constrained.
But Mother of Methadone is more than a biography. It is also a memoir, as Glenn confesses to the shame she once felt when she dismissed patients in the ER as “drug-seekers,” and to the professional unease of learning Addiction Medicine within a system that punishes patients for being sick. Describing a patient she assumed was “here for drugs,” she admits, “Looking back now, I am ashamed of my cruel cynicism,” and later names the broader professional culture that shaped it: “We treated users with disdain and called them ‘drug-seekers.’ We thought they were manipulative liars.” These sections are bracingly honest, showing how stigma is absorbed into the clinician’s body, not just imposed those of the patient.
I’ve spent nearly a decade as a social worker in harm reduction and treatment programs, and the scenes Glenn describes are familiar. I’ve sat across from patients who travel hours each morning to receive their lifesaving medication, and I’ve watched others lose housing or employment because clinic schedules were more rigid than their lives could bear. Glenn captures that reality with precision: methadone’s barriers are not medically necessary. They are political.
Still, the memoir occasionally falters under the weight of its own vantage point. For all Glenn’s awareness of the “doctor-as-savior” trope, patients often appear at the periphery, mediated through clinic rules and dosing schedules rather than in their own voices. The book risks re-centering the clinician even as it seeks to dismantle that hierarchy. At the same time, this limitation may be inseparable from the project itself: a story written from within medicine can only ever reckon with the system through the consciousness it has already shaped.
What makes Mother of Methadone urgent, though, is its insistence that policy is inseparable from care. Glenn reminds us that the daily humiliations of the methadone clinic — the observed urine tests, the rigid dosing hours, the denial of take-home doses — are not medical necessities but political choices. Many of these rules trace directly to the early 1970s, when methadone was folded into the logic of the War on Drugs through federal regulation and law enforcement oversight, recasting a medical treatment as a site of surveillance and control. These rules were written not by physicians but by lawmakers and law enforcement. The result: a treatment that saves lives is rationed so severely that many cannot access it at all.
Glenn situates this history amid today’s overdose crisis, which killed more than 100,000 Americans in 2021 alone. In that context, the failure to expand methadone access is not simply bureaucratic inertia but a form of structural violence. Her book makes clear that methadone is not only pharmacology — it is the embodiment of America’s ambivalence about whether people who use drugs deserve to live.
For readers outside medicine, Mother of Methadone offers both a compelling narrative and an education in how stigma is codified into law. For those of us inside the field — social workers, harm reductionists, physicians — it is a mirror held uncomfortably close: a reminder of what we inherit and what we risk perpetuating.
Glenn does not deliver an easy resolution. The book ends not with cure but with tremor — the sound of clinic doors locking, the echo of Nyswander’s name returned to the record, the uneasy recognition that medicine is still caught between care and control. That is precisely why this history matters now. If we do not confront the choices that made methadone harder to access than fentanyl, we will repeat them. Glenn’s Mother of Methadone insists that we reckon with both the lives lost and the possibilities still within reach, if only we choose care over punishment.
Dr. Kate Roberts is a licensed clinical therapist working at the intersection of women’s health and drug use, where her research and policy work aim to inform more gender-responsive forms of harm reduction and decrease barriers to substance use treatment.














































































































































