BALTIMORE—Inside the Penn North recovery center one day last fall, dozens of recovering addicts propped their feet up on black folding chairs and closed their eyes. An acupuncturist stuck five small gold pins into each person’s ears.
La’Von Dobie, one of Penn North’s addiction counselors, sat down next to me. She told the acupuncturist that her right ankle was hurting, so he stuck two thin needles in her left wrist.
For 15 minutes, there was darkness and sitar music. One man appeared to give himself a silent pep talk; another held out his hand, as though ready to receive something from the sky. When the pins came out, Dobie exclaimed that her ankle felt much better.
Daily acupuncture is a mandatory part of the addiction-recovery program at Penn North, whose staff I recently spent time with as part of a larger story on racial disparities in health. It’s not the only one to employ this unconventional approach: More than 600 addiction-recovery programs in the United States use acupuncture today, according to NADA, the National Acupuncture Detoxification Association.
Some people swear by acupuncture, but recovery facilities’ use of it, along with other non-proven strategies for managing addiction, has grown more controversial as America’s opioid epidemic has raged on. Medications like buprenorphine or methadone are considered the gold standard in treating opioid addiction, which still kills more than 100 people each day. The medications dramatically reduce the likelihood of death from overdose, but they are shockingly underused: Only 3 percent of addiction treatment facilities offer all three forms of addiction-recovery medication. One recent study found that only about a third of people who overdosed were placed on medication-assisted treatment within the following year.
Meanwhile, multiple meta-analyses have found there’s no evidence that acupuncture is effective as a treatment for cocaine or opiate dependence. Many experts say acupuncture doesn’t work for addiction; while cocaine addicts receiving acupuncture did reduce their drug use in one study, actual acupuncture performed about as well as a fake acupuncture procedure.
If acupuncture does release the grip of addiction, the way it works is, like many of acupuncture’s professed health benefits, not entirely clear. Sara Bursac, NADA’s executive director, told me that pin pricks to certain points in the ear activate different organs and emotions. Other acupuncturists told me the practice stimulates the immune system or alleviates energy blockages in the body. Bursac told me the studies on the effectiveness of acupuncture might have come to different conclusions because they had different designs. She acknowledges that acupuncture doesn’t work in isolation, but she says it is effective in conjunction with services like counseling and 12-step groups.
Acupuncture might seem like an odd thing to spring up in Sandtown, one of the poorest neighborhoods in Baltimore, where rows of abandoned homes sit boarded up and men hobble from injuries sustained in the drug trade. But the addiction-focused acupuncture used at Penn North and other facilities has a surprising—and revolutionary—history. Its role in addiction treatment has wound through Maoist China, to the Black Panther Party, to the stepfather of the rapper Tupac Shakur, and finally to two white hippies from Maryland.
The common thread has been a deep distrust of traditional medicine that stems from a history of discrimination at the hands of doctors. Many people in Baltimore, including some among the staff at Penn North, remain wary of being mistreated by the medical establishment, and it affects their health-care choices today.
Acupuncture for addiction treatment spread to the United States through the Bronx in the 1970s. As a young man growing up in the South Bronx at the time, Carlos Alvarez remembers stepping over addicts nodding out with needles in their arms in the street. His neighborhood was a few square miles “menaced” by 20,000 drug addicts and 9,500 gang members, The New York Times reported back then. The article describes an utter breakdown of services, in which homes had no heat and people gathered at fire hydrants for clean water in the dead of winter. The borough’s primarily black and Hispanic residents faced long waits and commutes for drug treatment, despite having one of the highest drug-addiction rates in the city. In a story about the Hunts Point neighborhood of the South Bronx in 1970, an AP reporter described a room with “a cot with a rumpled cover … where escape from the ugliness of Hunt’s Point is sought with a needle and a packet of heroin.” A local doctor complained to visiting congressmen that she was turning away child addicts from her treatment facility because of a lack of space.
Community groups reacted by staging sit-ins at several hospitals in the poor areas of New York City to call for better medical care. In the South Bronx, the Young Lords, a Puerto Rican group, took over an administrative building at Lincoln Hospital shortly before dawn on July 14, 1970, nailing the door shut. They demanded more funds for the hospital, a grievance staff, a day-care center, and better pay for hospital workers. But after 12 hours, negotiations between the Lords and the hospital’s administrators broke down. Another sit-in a few months later, aimed at getting the doctors to stop practicing abortions, lasted three days.
Finally, that November, a five-hour protest by the Young Lords, Black Panthers, and their white supporters forced the administrators of Lincoln Hospital to agree to set up an inpatient drug-treatment program. The protesters wanted it to be run by former addicts. Alvarez, who was then in his mid-20s, and his friends made banners out of bedsheets and took to the nearby shooting galleries to recruit patients. Lincoln Detox is open the banners read, referring to the process of getting off heroin.
The first day of Lincoln Detox, a line of about 200 addicts formed at the doors of the hospital. The volunteers told everyone to place their weapons in a box, then gave them methadone, a drug that helps curb heroin cravings. Alvarez became the security guard, and gradually Lincoln Detox built up a staff of counselors and doctors.
Even though they dispensed methadone, the Lincoln Detox staffers and their allies seemed ambivalent about the drug. “The armies of slum-lords, script doctors, organized crime, greedy drug companies, methadone pushers, corrupt cops, and producers of rot-gut wine are plundering our communities,” wrote the activist publication White Lightning, which was allied with Lincoln Detox, in 1974. In the same issue, they warned of the dangers of methadone, saying the medication could cause “brainwave changes” in babies and “crib death.” Some Lincoln Detox patients complained about methadone’s side effects, as well as the hassle of picking up their dose each day. Others distrusted methadone, seeing it as just another drug.
“Methadone was highly regulated—it’s run by white doctors, in white coats, in white hospitals,” Samuel Roberts, a professor of history and sociomedical sciences at Columbia University, told me.
The dissatisfaction with methadone created an opening for a more homegrown, drug-free treatment: acupuncture. Around the same time, several prominent newspapers wrote trend stories about this foreign practice. In 1973, The New York Times reported that a doctor in Hong Kong had been able to relieve the withdrawal symptoms of 70 addicts by inserting electrified needles in their ears. While on tour in China, several members of the Philadelphia Orchestra received acupuncture for aches and pains in their hotel rooms and raved about the results.
There were already signs that acupuncture might not be an addiction panacea: When asked whether acupuncture could be used to cure a smoking habit, the acupuncturist Chang Shu Wen told a Times reporter, “No, no.” But according to the book Fighting Drug Abuse With Acupuncture by Ellinor Mitchell, several of the counselors at Lincoln Detox read the glowing accounts and became interested in acupuncture as an alternative to methadone. Some of the counselors went to New York’s Chinatown, procured acupuncture sets, and began trying them out on one another. Others traveled to Montreal to study the practice.
Among the Montreal group was Mutulu Shakur, an activist with ties to the Black Panthers and the stepfather to a boy who would grow up to become the rapper Tupac. Shakur’s work in acupuncture likely stemmed from the broader interest the Black Panthers had in the low-tech treatments used by the lay medics known as “barefoot doctors” in Maoist China. These were lightly trained rural people who were employed as part-time farmers, part-time community health workers, dispensing basic medical care to their friends and neighbors. According to Alondra Nelson’s Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination, the program was a model for the Black Panthers’ approach to health care. David Hilliard, the chief of staff of the Black Panther Party, railed against what he called “the bourgeoisie concept of medicine”: “It should be brought down to the community to teach the people how to practice medicine,” Hilliard said.
After Shakur returned from Montreal, he practiced acupuncture at Lincoln Detox. Later, he founded his own acupuncture organization, the Black Acupuncture Advisory Association of North America, before being imprisoned for the robbery of a Brink’s armored car in 1981.
Over time, acupuncture won over even skeptical Lincoln Detox employees. Nancy Smalls, a nurse and longtime Lincoln Detox employee, said she didn’t buy into acupuncture as a valid treatment for several years. But the change she saw in the addicts who received acupuncture persuaded her. “Within three days, you got an entirely different person. They’re alive, awake, alert, and asking questions, and you’re like, ‘Oh hell, what happened here?’”
By the late ’70s, controversy began to plague the Lincoln Detox program. Its medical director was found dead in a storage closet, and his co-workers suspected murder. Reports of fraud and waste within the program mounted. In 1978 future Senator Chuck Schumer, then a Brooklyn assemblyman, denounced Lincoln Detox’s “millions of dollars in unsubstantiated payrolls costs, overbilling for patient care and other egregious management failures” to the Times.
Lincoln Detox staffers were forced to move to a new building—a “dump” with no heat, according to Mitchell. In the new building, Lincoln Detox abandoned methadone in favor of acupuncture alone. In addition to auricular, or ear, acupuncture, addicted clients were asked to drink a tea called “Sleep Mix”—a blend of chamomile, catnip, peppermint, skullcap, hops, and yarrow.
Despite the negative publicity, Lincoln Detox became a training center of sorts for other progressive types who were interested in alternative forms of drug treatment. The beleaguered Bronx facility would cause acupuncture to flourish in inner-city Baltimore in the ’90s, during one of the worst drug epidemics the city had ever seen. Its method of bringing acupuncture to the masses piqued the interest of a flower child named Bob Duggan, who would go on to found Penn North, the recovery center I visited.
Duggan, a priest from New York City, met Dianne Connelly, then a college junior, in Rome in 1966, during an event that was meant to foster dialogue between clergy and laypeople. Bob left the priesthood to marry her, and together they set out on a tour of the world as part of the late-’60s “human potential” movement.
After running out of money, they made it to England, where Dianne hoped to get treatment for a stomach bug and Bob sought to get help for his hands, which had mysteriously begun to go numb. They saw an acupuncturist, and, instantly cured, decided they would devote their lives to the craft. Dianne told me they held their then-infant son, Blaize, over a map, and he drooled on Columbia, Maryland, so that is where they decided to set up their acupuncture practice. (It helped that they found Maryland’s regulations around acupuncture at the time to be favorable.)
In 1974, the Duggans established their acupuncture school in Columbia. Acupuncture wasn’t well-known in the town, a suburb about halfway between Baltimore and Washington, D.C., so to stir up clientele, Bob and Dianne would drive around and ask people, “We heard there’s an acupuncture clinic here, do you know where it is?”
Bob Duggan had been friends with one of the founders of Lincoln Detox for several years, according to Sharon Jennings-Rojas, an acupuncturist who has worked with both men, and Duggan seemed moved to create a Baltimore version of the grassrootsy acupuncture clinic. In the mid ’90s, the Duggans and some co-acupuncturists launched Penn North near one of the city’s busiest drug markets.
Bob Duggan died in 2016. His portrait still adorns almost every room at Penn North.
Some of the people Duggan brought into Penn North in the early days continue to promote acupuncture over medication-assisted treatment. One day when I was visiting Penn North, a middle-aged white man walked into the dim lobby wearing paint-splattered clothes and a baseball cap. He said he needed help with his heroin problem but couldn’t enter a residential facility because it would cost him his job. He was thinking about methadone.
A Penn North staffer named Genard Barr sprang out from behind a partition and said, “There is another option!” By that, he meant acupuncture. The man declined acupuncture, but he agreed to come back to Penn North for Narcotics Anonymous meetings.
I wanted to find out why Barr seemed opposed to methadone, despite its proven effectiveness in treating addiction, so I asked to meet with him for an interview later. Barr told me he was “born and raised” a drug trafficker in Miami, the son of immigrants from the Caribbean. He moved to Baltimore in 1997, when he found out the price of cocaine was better here. He said he was sentenced to four years of probation for a crime he asked me not to mention, but Bob Duggan convinced the judge to let Barr attend and volunteer at Penn North programs instead.
He wasn’t a believer in acupuncture at first, but he feared being kicked out of the program and sent to prison. So, he figured, sure, “you can stick me with a pin that doesn’t hurt.” Sixteen years of being stuck with pins has convinced him acupuncture works. After his prison sentence was done, he stayed on at Penn North as an intake staffer.
Penn North does refer opioid addicts who prefer to be on methadone or buprenorphine to outside clinics, and some staffers at Penn North recognize the usefulness of medication-assisted treatment. But others are, like Lincoln Detox’s young revolutionaries before them, mistrustful of the pharmaceutical-industrial complex and hopeful that traditional Eastern medicine might offer something better. To Barr, methadone is the true poison, worse even than heroin. “I have heroin addicts who’ve been on heroin for 20 years,” he said. They look spritely and healthy, he says, but “I have motherfuckers who been on methadone for two years and look like they just fell down the ugly tree, hit every branch on the way.”
The business model of companies that make methadone and other pharmaceuticals reminds Barr of that of drug traffickers. “I’m going to give you this, try it,” he says, imitating a pharma sales rep offering a free sample of a hot new drug. “If you like it, then keep buying it. The first one is free.” Just look on TV, he adds. (The United States is one of two countries in the world where drug companies are allowed to advertise on television. The other is New Zealand.)
This mistrust of Western doctors and medicine is not surprising, perhaps, since even decades after the heyday of Lincoln Detox, studies reveal shocking levels of racism in the medical profession. A 2016 study found that half of medical students believe at least one myth about racial differences in biology, such as that black people’s skin is thicker or that their blood coagulates more quickly than that of whites. A recent analysis of 15 studies found that health-care providers were biased against dark-skinned people, and this bias influenced their patient interactions and the patient’s health outcomes. As a result, African American patients are consistently less likely than white patients to be treated for their pain. More so than whites, African Americans are more likely to skip the flu vaccine because they don’t trust its safety.
Most of the dozens of lower-income Baltimoreans I interviewed liked their doctors, though most had also felt mistreated from time to time. Last year, I accompanied Coriless Jones, a black woman in her late 50s, to her primary-care doctor appointment. Jones has a variety of health issues stemming from past drug use and violence. The appointment took almost an hour and included a long lecture from the doctor about the importance of quitting smoking and drinking more water. Afterward, Jones turned and thanked me for coming with her. The doctor “was more attentive to my needs and more talkative today than she’s ever been,” she said. She had been thinking of switching doctors because “she wasn’t showing empathy or compassion in my case … By her knowing that someone was with me, she did a better job this time.”
These feelings of judgment and dismissal engender suspicion. Last year, I went to a community meeting at an apartment in McCulloh Homes, a public-housing project in West Baltimore. Over pizza in the cozy living room, the residents shared an impressive command of complicated issues like Obamacare. Still, the room was abuzz with worries about the supposed dangers of modern science. One woman believed her mother died from radiation to treat cancer, not the cancer itself. “It’s a money thing,” she said. Another speculated that “the stuff they put in paint, they put in General Mills cereal.” Several people suggested that because Baltimore’s best-known hospital, Johns Hopkins, is a “research” hospital, they would never go there. (This sentiment is a known consequence of infamously abusive studies like the Tuskegee experiment.)
At Penn North, many staffers emitted an easygoing Zen, but Barr veered between manic and exasperated. Unbidden during our interview, he launched into a litany of societal injustices —most of which, unlike the science on methadone, I couldn’t really argue with. “Now all of a sudden they are legalizing marijuana,” he mused. “I have an uncle who’s got 50 years in prison off of pot, but now it’s a legal thing.”
His righteous indignation reminded me of the Young Lords and Black Panthers. After all, many of the inequalities that moved the activists of the South Bronx to reject authority in the ’70s are still plundering poor communities today. For example, Barr tried college but dropped out, finding the debt not worth the risk of graduating with no job. “It might be a little different for you because, you know, you’re a pretty little white girl,” he said. “You are more likely with no degrees in any field to get a job before I am.” It’s true: Blacks who have attended college are less likely to have jobs than white high-school dropouts.
When I asked Barr where he gets his information about medication-assisted treatment, he Googled methadone and, in an apparent hope to lay bare its dangers, pulled up the site recovery.org. Inconveniently, the site said, “Methadone can cause a certain amount of tooth decay, but no more than any other opiate.”
He seemed to be getting visibly frustrated. It had been Baltimore’s most violent year in decades. Throughout the city, people were dying of gunshots and overdoses. And here I was, wasting his time, implying that salvation could be found in a product made by corporations and endorsed by doctors, groups he’s all too aware have abused people just like him.
He looked down, flicked open a lighter, and held the flame under his tie.
“Bullshit,” he muttered.