The Mother of Medication-Assisted Treatment
To call Dr. Mary Jeanne Kreek the Mother of Medication-Assisted-Treatment (MAT) is no exaggeration. The physician/scientist, who died March 27 at the age of 84, was not only a core part of the team who helped make the process safe, but she “conducted landmark studies that led to the establishment of methadone as a treatment for heroin addiction.”
“Mary Jeanne was a pioneer in the biology of addiction research and made seminal contributions that led to methadone’s successful use as a treatment for heroin addiction,” said The Rockefeller University President Richard P. Lifton in marking her passing. “She was a beloved member of the Rockefeller community, notable for her extraordinary commitment to her research, to patients, and to the advancement of women in science. She will be remembered both for her dynamism as a scientist and her humanism as a physician, patient advocate, and mentor.”
Dr. Kreek happened to be a pioneer in glass ceiling shattering as well. She earned her B.A. (in Chemistry) from Wellesley College in 1958; her M.D. from Columbia University College of Physicians and Surgeons in 1962, and followed with an internal medicine residency at New York Hospital-Cornell Medical Center (now Weill Cornell Medicine). She joined Rockefeller as an associate physician in 1964, was named to the faculty in 1967, and received tenure that same year, just the fourth female professor to do so.
The good Doctor also received honorary doctorates from the University of Uppsala in Sweden, Tel Aviv University, and the University of Bologna. And she won a fistful of the most revered awards in the field, including the Betty Ford Award; the Specific Recognition Award for Research in the Science of Addiction from the Executive Office of the President; the R. Brinkley Smithers Distinguished Scientist Award; the Nathan B. Eddy Memorial Award; the Wellesley College Alumnae Achievement Award; and a Lifetime Science Award from the National Institute on Drug Abuse at the National Institutes of Health.
When the NIH’s NIDA bestows a Lifetime Science Award upon you, well, you’ve made more than a considerable mark in the field of addiction treatment.
Before Methadone Was Even a Thing
Methadone (initially pethidine) had been known to kill pain ever since the Germans devised it back in 1937. In those years though the drug was too unstable to use. After the Americans seized all German patents at the end of World War II, U.S. operatives were given a chance at it. First the Council on Pharmacy and Chemistry of the American Medical Association christened it “methadone.” Then Eli Lilly and Company introduced it as an analgesic under the trade name Dolophine. The year was 1947. And the cost to the company was $1. Really.
(BTW: the urban myth that “Dolophine” alludes to Hitler (“Adolophine”) is just that: an urban myth. Dolo refers to “dolor,” the Latin word for pain, and “finis,” meaning end. Consequently, dolophine literally means “pain’s end.”)
But the real action happened at The Rockefeller University Hospital in 1964. That was where Dr. Kreek, Dr. Vincent P. Dole (her mentor) and a few others began administering methadone to heroin addicts. The patients, a group of men in their 20s and 30s, had already been in and out of jail a number of times. And though they were once ordinary New Yorkers with respectable jobs — a musician, a truck driver, and an office clerk — they were now often dismissively labeled as “psychopaths” or “junkies.” Back then the medical establishment believed their addiction lay beyond a doctor’s responsibility, and if these people had been treated in a hospital before, they likely had been there as a prisoner.
That’s how ace science writer Bahar Gholipour summed it up in the preface of a terrific Q&A with Dr. Kreek in The Rockefeller University’s Seek. And her words convey just how much the addiction treatment would come to mean for people. They also convey actions well beyond advanced. See, prior to Rockefeller, this treatment was illegal. Nevermind how solidified the stigma. In fact, nearly 60 years later MAT is still under what Dr. Kreek called “bizarrely tough” regulations. And it’s no secret how much that stigma still exists.
Nevertheless nearly 2 million people around the world are living steady, upstanding lives because of using MAT, either during detox and/or as maintenance. And with buprenorphine now taking root, many more soon will be joining them.
Medication-Assisted-Treatment for Cocaine and Alcohol
Dr. Kreek’s Q&A also reveals advances in Medication-Assisted-Treatment for both cocaine and alcohol addiction. Let’s let the good Doctor speak for herself.
We know that certain molecules, so-called kappa opioid receptors agonists, can inhibit responses to cocaine in animals by acting similarly to methadone, albeit on a different opioid receptor subtype. We have studied them in rats and mice that learn to self-administer the drug by pressing a lever; when we give these animals a kappa agonist, they stop trying to self-administer cocaine.
We now have over 400 novel compounds that were designed by people in my lab or collaborating chemists. We’re studying each to identify any that could be developed into a safe and effective drug.
That covers coke. As for alcohol, physician-scientists are working with nalfurafine, which was developed in Japan for treatment of itching skin in individuals with kidney disease. They’re currently studying it in rodents, either alone or in combination with already-approved naltrexone. Dr. Kreek said “given that both compounds have been used safely in humans, this strategy [should] become available as treatment for alcohol addiction within the next five years.”
That interview was conducted in 2020. That makes us enticingly close to seeing an effective treatment for alcoholism. Bravo!
Healing Properties salutes the late, great Dr. Mary Jeanne Kreek for her lifelong commitment to fighting addiction. We realize such a fight couldn’t have been easy, especially with the stigma associated with addiction. That she continued to fight the good fight regardless — not to mention put up such a good fight in the first place — is a testament to a truly noble soul. We’re sure a least two million people and their families will go to bed this night extremely grateful for her great good efforts.
We also salute The Rockefeller University and its Hospital for recruiting Dr. Kreek and for enabling such groundbreaking addiction research. Few institutions have the temerity to go so adamantly against the grain, especially to help such a marginalized community. That it did so way back then only compounds their courage — and our gratitude.
How about you? Are you having trouble with opioids? Cocaine perhaps? Alcohol? Could you use some help? It’s out there, you know. It doesn’t have to be Medication-Assisted-Treatment either. Just so you get help. So please. Pick up the phone. Call someone. NIDA. SAMHSA. Even us. Just so you call. After all, the call could very well save your life.