Marie Nyswander
Encyclopedia
Marie Nyswander was an American psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 and psychoanalyst known for developing and popularizing the use of methadone
Methadone
Methadone is a synthetic opioid, used medically as an analgesic and a maintenance anti-addictive for use in patients with opioid dependency. It was developed in Germany in 1937...

 to treat heroin addiction.

Biography

Nyswander was born on March 13, 1919, in Reno, Nevada
Reno, Nevada
Reno is the county seat of Washoe County, Nevada, United States. The city has a population of about 220,500 and is the most populous Nevada city outside of the Las Vegas metropolitan area...

. Her father, James Nyswander, was a mathematics professor and her mother was noted health educator Dorothy Bird Nyswander
Dorothy Nyswander
Dorothy Bird Nyswander , was an American health educator. She graduated with masters and bachelors degrees from the University of Nevada and a Ph.D. in Psychology from the University of California, Berkeley. She is considered the Mother of Health education.-Professional life and vision:Her career...

; they divorced soon after her birth, and Nyswander followed her mother to Berkeley
Berkeley, California
Berkeley is a city on the east shore of the San Francisco Bay in Northern California, United States. Its neighbors to the south are the cities of Oakland and Emeryville. To the north is the city of Albany and the unincorporated community of Kensington...

, Salt Lake City
Salt Lake City, Utah
Salt Lake City is the capital and the most populous city of the U.S. state of Utah. The name of the city is often shortened to Salt Lake or SLC. With a population of 186,440 as of the 2010 Census, the city lies in the Salt Lake City metropolitan area, which has a total population of 1,124,197...

, and New York City.
Her original name was Mary Elizabeth Nyswander; she took the name Marie as a teenager.

Nyswander graduated from Sarah Lawrence College
Sarah Lawrence College
Sarah Lawrence College is a private liberal arts college in the United States, and a leader in progressive education since its founding in 1926. Located just 30 minutes north of Midtown Manhattan in southern Westchester County, New York, in the city of Yonkers, this coeducational college offers...

 in 1937 and trained as a physician and surgeon at the Cornell University
Cornell University
Cornell University is an Ivy League university located in Ithaca, New York, United States. It is a private land-grant university, receiving annual funding from the State of New York for certain educational missions...

 medical school until 1944; while at Cornell, she was briefly married to anatomy instructor Charles Berry. After finishing her studies at Cornell, she attempted to join the Navy, but discovered that they did not allow women to serve as surgeons. Instead she took up a position at the Lexington Narcotic Hospital
Federal Medical Center, Lexington
The Federal Medical Center, Lexington is a federal prison in Lexington, Kentucky housing 1,464 male inmates at high security and 296 female inmates at a low security camp.-History:...

 in Lexington, Kentucky
Lexington, Kentucky
Lexington is the second-largest city in Kentucky and the 63rd largest in the US. Known as the "Thoroughbred City" and the "Horse Capital of the World", it is located in the heart of Kentucky's Bluegrass region...

, under the auspices of the United States Public Health Service
United States Public Health Service
The Public Health Service Act of 1944 structured the United States Public Health Service as the primary division of the Department of Health, Education and Welfare , which later became the United States Department of Health and Human Services. The PHS comprises all Agency Divisions of Health and...

, where she was first exposed to the harsh treatment then given to drug addicts.

In the late 1940s, Nyswander began studying psychoanalysis
Psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...

 at the New York Medical College
New York Medical College
New York Medical College, aka New York Med or NYMC, is a private graduate health sciences university based in Westchester County, New York, a suburb of New York City and a part of the New York Metropolitan Area...

, under the supervision of Lewis Wolberg, and in the 1950s she held a private practice in New York. In 1955 she helped found the Narcotic Addiction Research Project, a program for treating drug addicts using psychotherapy, and through the 1950s and 1960s she continued to treat addicts in two programs, a clinic for jazz
Jazz
Jazz is a musical style that originated at the beginning of the 20th century in African American communities in the Southern United States. It was born out of a mix of African and European music traditions. From its early development until the present, jazz has incorporated music from 19th and 20th...

 musicians that she founded with Charles Winick and a local church program. She also treated patients of other types and wrote two books, one about her experiences treating drug addicts and another about sexuality
Human sexuality
Human sexuality is the awareness of gender differences, and the capacity to have erotic experiences and responses. Human sexuality can also be described as the way someone is sexually attracted to another person whether it is to opposite sexes , to the same sex , to either sexes , or not being...

. During this period she was married to her second husband, Leonard Robinson, a psychoanalyst; they became engaged in 1953, divorced in 1965, and had no children. A book review from 1962 describes her as "slim, brunette ... wife of a writer and mother of a 15-year-old son".

In the early 1960s, Vincent Dole
Vincent Dole
Vincent Dole was an American doctor, who, along with his wife Dr Marie Nyswander , pioneered the highly controversial practice of substituting the synthetic narcotic agonist methadone to treat heroin addiction. Drs...

 invited Nyswander to join his staff at Rockefeller University
Rockefeller University
The Rockefeller University is a private university offering postgraduate and postdoctoral education. It has a strong concentration in the biological sciences. It is also known for producing numerous Nobel laureates...

. Dole was a metabolic
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...

 specialist who had become interested in addiction in 1962 when a colleague had gone on sabbatical, leaving a vacancy on Rockefeller's
Committee on Narcotics that Dole filled; he called on Nyswander because of her expertise with addiction. In turn, Nyswander had become frustrated by the high relapse rate of her addicted patients, a factor that prepared her to find a non-psychological explanation for their addiction. Dole and Nyswander began their research by observing the effects of different narcotics on addicts, and discovered that morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...

 and methadone
Methadone
Methadone is a synthetic opioid, used medically as an analgesic and a maintenance anti-addictive for use in patients with opioid dependency. It was developed in Germany in 1937...

 led to quite different behaviors. By 1965 (the year Dole and Nyswander married), they had data on 22 different subjects, and published their findings in the Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...

, followed up by several articles in other journals. They hypothesized that heroin addiction was a metabolic disease, and that methadone could be used as a drug to treat this disease, contradicting earlier beliefs that addiction was purely a personality disorder and that addiction to methadone remained an addiction the treatment of which should lead to abstinence. Dole and Nyswander soon set up a local program for treating addicts with methadone, and similar programs eventually became widespread around the country and around the world.

Nyswander died in 1986 of cancer, possibly caused by her lifelong addiction to cigarettes. Until her death, she continued to promote methadone treatment and to defend it against its critics.

Books

. This book already contained the idea that drug addiction should be treated as a medical problem. It begins with a description of the legal history under which, beginning with the Harrison Narcotic Act
Harrison Narcotics Tax Act
The Harrison Narcotics Tax Act was a United States federal law that regulated and taxed the production, importation, and distribution of opiates...

 of 1914, drug addiction was criminalized and clinics closed. It continues to describe the pharmacology, physiology, psychology, and sociology of opiate addiction. Although it discusses methadone as a method for getting addicts through the period of physical withdrawal, it considers psychotherapy to be a more important part of addiction treatment. At the time Vincent Dole began his researches into addiction in the early 1960s, it was the only study of street addicts he could find and in 1966 the New York Times described it as Nyswander's "definitive book".. This book, about frigidity in women, also advocates that women take a traditional family role at home, "keeping the tone of the home happy and loving" while letting "the men go out and make the money". Based on Freudian analysis, it defines women who reach orgasm
Orgasm
Orgasm is the peak of the plateau phase of the sexual response cycle, characterized by an intense sensation of pleasure...

 through clitoral
Clitoris
The clitoris is a sexual organ that is present only in female mammals. In humans, the visible button-like portion is located near the anterior junction of the labia minora, above the opening of the urethra and vagina. Unlike the penis, which is homologous to the clitoris, the clitoris does not...

 stimulation as being frigid and claims that women lacking sexual satisfaction have themselves to blame rather than their partners. In the mid-1970s this book was popularized again by the success of Marabel Morgan
Marabel Morgan
Marabel Morgan is an American author of self-help books for married women, including The Total Woman , Total Joy , The Total Woman Cookbook and The Electric Woman ....

's anti-feminist
Antifeminism
Antifeminism is opposition to feminism in some or all of its forms. Modern antifeminists say that the feminist movement has achieved its aims and now seeks higher status for women than for men.-History:...

 self-help book The Total Woman and lecture courses associated with it.

Selected papers

. This is the original 22-patient study pioneering the use of methadone to treat heroin addiction. Kuehn writes that this paper "marked a sea change in the treatment of addiction" because of its treatment of heroin addiction as a disease that could be treated by medication, and quotes Yale University
Yale University
Yale University is a private, Ivy League university located in New Haven, Connecticut, United States. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States...

 psychiatry professor Thomas Kosten as saying that this paper "has had a tremendous impact on the treatment of individuals addicted to opioids and on the larger field of addiction treatment".

Subsequent to this work, Nyswander coauthored many other papers on heroin addiction and methadone treatment. The most heavily cited of these are:
. This paper describes the effects of heroin on its addicts, the ability of methadone to block those effects, and a treatment regimen to induce this blocking phenomenon.. This is a report on a much larger-scale four-year study following on to the original 22-subject study of Dole and Nyswander..

Awards and honors

Nyswander was the co-recipient with her spouse Vincent Dole
Vincent Dole
Vincent Dole was an American doctor, who, along with his wife Dr Marie Nyswander , pioneered the highly controversial practice of substituting the synthetic narcotic agonist methadone to treat heroin addiction. Drs...

 of the first annual award of the National Drug Abuse Conference in 1978.

Nyswander and Dole's work led to the creation in 1982 of the Nyswander–Dole Award, given annually by the American Association for the Treatment of Opioid Dependence for "extraordinary work and service in the opioid treatment field". It is fondly named 'The Marie Award', and Nyswander and Dole were the first recipients. Another award in her name, the Marie E. Nyswander Award of the International Association for Pain and Chemical Dependency, is given for "lifetime accomplishments in advancing compassionate and humane treatment of patients suffering from pain".

Nyswanderweg, a street in Hamburg, Germany, was named after Nyswander in 1994. The Marie Nyswander Clinic of the Beth Israel Medical Center
Beth Israel Medical Center
Beth Israel Medical Center is a 1,368-bed, full-service tertiary teaching hospital in New York City. Originally dedicated to serving immigrant Jews living in the tenement slums of the Lower East Side, it was founded at the turn of the 20th century. The main hospital location is the Petrie...

 is also named after Nyswander.

In 2000, a special issue of the Mount Sinai Journal of Medicine
Mount Sinai Journal of Medicine
The Mount Sinai Journal of Medicine is a peer-reviewed medical journal that has been published continually since 1934 by the Mount Sinai Hospital, New York, later by the Mount Sinai School of Medicine....

concerning methadone treatment was dedicated to Nyswander's memory.

Additional reading

. Reviewer Alfred Darby writes that "Nyswander's personality comes across loud and clear" in this portrait of her work as a psychiatrist and a humanist and of her program for treating addicts using methadone. Hentoff also wrote two profiles of Nyswander in The New Yorker
The New Yorker
The New Yorker is an American magazine of reportage, commentary, criticism, essays, fiction, satire, cartoons and poetry published by Condé Nast...

, dated June 26 and July 3, 1965.
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