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Dr. Robert Newman, apostle of methadone treatment, dies at 80

A chance elevator encounter inspired Newman to create the world’s largest methadone maintenance program, establishing it in New York City under Mayor John Lindsay in 1970.

He was struck by a car in the Bronx in June and never recovered from his injuries, his son, Seiji, said.

As an assistant health commissioner for the city, he devoted his career to destigmatizing opioid addiction and treatment. He also served as president of Beth Israel Medical Center, where he presided over its partnership with St. Luke’s-Roosevelt Hospital Center and other institutions in 1997 to form Continuum Health Partners.

As a hospital administrator, Newman advocated needle exchanges for addicts long before the AIDS outbreak generated broader support for such controversial programs. He also opened an AIDS outpatient clinic, honored do-not-resuscitate requests when the patients’ rights movement was still nascent, and set up one clinic that served gay women and another that catered to Japanese patients.

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He also broke ranks with colleagues at other medical centers to guarantee job security to the hospital workers union.

Under his leadership, Beth Israel became the world’s largest provider of methadone, with about 8,000 patients by the time he retired from Continuum in 2001. From then until 2013, he directed the Baron Edmond de Rothschild Chemical Dependency Institute at Mount Sinai Beth Israel. (It has since been disbanded.)

In 2011, Newman predicted two consequences of the emerging widespread abuse of prescription opioids. “I’m afraid it’s going to become progressively more and more difficult to find a doctor who’s willing to treat chronic pain optimally,” he said, but “more and more people who do not fit the stereotype of the junkie will be recognized as having a problem and deserving help.”

In an era when heroin addiction was reaching epidemic dimensions and doctors in some jurisdictions could be prosecuted for prescribing methadone, Newman was recruited by Gordon Chase, Lindsay’s health services administrator, to expand New York City’s program by such an extent that it would offer immediate treatment to anyone who sought it.

“Gordon Chase’s compelling argument was this,” Newman recalled in a 2011 interview with William White, an addiction researcher. “'Imagine a woman barging into your office one day telling you her son, a long-term heroin addict, had applied for treatment but was turned away by your program and put on a waiting list because you had no room — and then died of an overdose.’ He said, ‘Bob, you tell me what excuse for moving slow you will give this woman that will elicit the response, “Oh, I understand."'”

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In its first year, the program admitted 20,000 addicts who sought the daily oral doses of methadone that block the craving for heroin. (He did not favor distribution of heroin.)

“It’s a medical problem — for which a treatment exists, but for which at the moment a cure does not,” he said.

When a private clinic was closing, Newman commissioned an unused ferryboat as a temporary treatment center and improvised by bringing the leftover methadone home at night in his 1-year-old son’s stroller. He also started a short-term ambulatory detox program for heroin addicts.

“I’m convinced,” he said, “that if the city had not demonstrated — in the face of the prophecy of catastrophe from all — that massive expansion almost overnight was possible and could be effective, this treatment would have continued to serve no more than a few thousand for years — perhaps to this day.”

Robert Gabriel Newman was born Oct. 26, 1937, in The Hague, in the Netherlands, to Rudolph Newman and Eva Feilchenfeld Newman. They fled Europe in August 1939, less than a month before Germany invaded Poland. His mother was a judge in Berlin, and his father returned after the war to prosecute executives of I.G. Farben, the German chemical company, for war crimes.

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Robby, as he was known, was raised mostly in the New York metropolitan area — in Mt. Vernon, Manhattan and Baldwin, on Long Island, although he spent time in the early 1950s in Frankfurt, Germany.

He earned a bachelor’s degree in 1958 from New York University, a medical degree from the University of Rochester School of Medicine and Dentistry and a master’s in public health from the University of California, Berkeley.

In addition to his son, Seiji, he is survived by his wife, Seiko Kusuba Newman, whom he met while serving in the Air Force as a surgeon in Japan; their daughter, Hana Newman; three grandchildren; and his brothers, Thomas and Steven.

Newman also taught; from 1994 to 2012 he was a professor of epidemiology and population health and of psychiatry and behavioral sciences at the Albert Einstein College of Medicine in the Bronx.

He attributed his social activism to his worldly upbringing as a teenager and to the spirit of the 1960s.

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“I never became a revolutionary,” he said, “but it made me think of communitywide issues.”

He spent a lifetime debunking criticism that methadone maintenance was substituting a legal high for an illicit one, convincing skeptics that opioid addiction could not be solved with mere willpower and that abstinence after methadone treatment was unrealistic.

“It’s like evaluating the success or the effectiveness of birth control pills by measuring the number of pregnancies that occur in the 12 months after the pills are discontinued,” Newman said.

Considering that he devoted his entire career to addiction, his introduction to it, in 1968, was serendipitous. After working on a nutrition survey for the city’s health department, he returned to his studio apartment on Manhattan’s West Side one night and was accosted in the elevator by a man who grabbed his sleeve and said: “Aren’t you the doctor who moved onto my floor not too long ago?”

“Whatever kind of doctor you need, fella, I ain’t that kind,” Newman replied. “I’m a public health doctor.”

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The persistent neighbor turned out to be Herman Joseph, a probation officer who dealt with addicts and who insisted that Newman meet two methadone experts, Dr. Marie Nyswander and her husband, Dr. Vincent Dole. He did and was captivated.

“I had never heard the word methadone, and I never thought about addiction,” Newman later recalled. “If I had missed that elevator, I probably would be a very wealthy orthopedic surgeon now.”

This article originally appeared in The New York Times.

Sam Roberts © 2018 The New York Times

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