Marie Nyswander


Marie Nyswander was an American psychiatrist and psychoanalyst known for developing and popularizing the use of methadone to treat heroin addiction.

Biography

Nyswander was born on March 13, 1919, in Reno, Nevada. Her father, James Nyswander, was a mathematics professor and her mother was noted health educator Dorothy Bird Nyswander; they divorced soon after her birth, and Nyswander followed her mother to Berkeley, Salt Lake City, 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 in 1937 and trained as a physician and surgeon at the Cornell University 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 in Lexington, Kentucky, under the auspices of the United States Public Health Service, where researchers such as Abraham Wikler were beginning to uncover the physiological basis of addiction. At Lexington, addicts were treated harshly: for instance, women at the facility were confined to their building except for a once-a-week movie. Nyswander's attempts to provide outside walks for the women were halted after they were caught sending messages to the male inmates, and she was also reprimanded for giving out morphine shots to the inmates one Christmas.
In the late 1940s, Nyswander began studying psychoanalysis at the New York Medical College, 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 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. During this period she was married to her second husband, Leonard Wallace Robinson, a writer and editor; 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 invited Nyswander to join his staff at Rockefeller University. Dole was a metabolic 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 and methadone led to quite different behaviors. By 1965, they had data on 22 different subjects, and published their findings in the Journal of the American Medical Association, 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.

Authorship

Nyswander is the author or co-author of a number of books and papers:

Books

Subsequent to this work, Nyswander coauthored many other papers on heroin addiction and methadone treatment. The most heavily cited of these are:
Nyswander was the co-recipient with her spouse Vincent Dole of the first annual award of the National Drug Abuse Conference in 1978. In 1982, they won the Nathan B. Eddy Award of the College on Problems of Drug Dependence.
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 is also named after Nyswander.
In 2000, a special issue of the Mount Sinai Journal of Medicine concerning methadone treatment was dedicated to Nyswander's memory.