The Marshall Project

Treatment for Opioid Addiction, With No Strings Attached

Some doctors are abandoning the long-held belief that treating addiction is impossible without talk therapy.

By the time Ron Clark walked into Dr. Erin Zerbo’s Newark, New Jersey, addiction clinic, he had already been kicked out of two other treatment programs.

One prescribed methadone, the other buprenorphine. The meds are intended to quiet the compulsive cravings and stave off the withdrawal symptoms that keep people in the grips of opioid addiction. For Clark, they worked. But there were so many mandatory appointments: nurses, therapists, groups. Clark, 60, worked as a laborer, and when jobs came up, he would miss his appointments and the clinics refused to give him refills, he said. Without his meds, he returned to using heroin.

Traditional treatment programs tie medications to a long list of requirements: support groups, individual counseling, negative drug screens. In clinics like Zerbo’s—advocates call them “low-threshold”—those

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