Maintaining orthodoxy: the depression-era struggle over morphine maintenance in California

FRANÇAIS :
Avec la fermeture de la clinique de Shreveport en 1923, les USA entrèrent dans une période qui devait durer jusqu'aux années 1960, où les traitements de maintenance aux opiacés seraient limités à un très faible nombre de patients, essentiellement les cancéreux. Les toxicomanes furent diabolisés, et rarement traités hors des prisons. En effet, pendant ces quarante ans considérés comme la période d'ombre de la politique antidrogue américaine, l'abstinence allait apparaître comme le seul but légitime de tout traitement. Cependant, au cours des années 1930 il y eut plusieurs tentatives de résistance à cette "orthodoxie", notamment sur la Côte Ouest, où l'aventure d'une clinique proposant des traitements de maintenance à la morphine est retracée.
ENGLISH :
With the closure of the Shreveport Clinic in 1923, the United States entered a 40-year period during which legal opiate maintenance was limited to a small number of registered medical addicts, most of them cancer patients. Addicts were demonized, hounded by law enforcement personnel, and rarely treated outside of jails. Abstinence was the only legitimate goal of treatment. Quite correctly, historians regard the period between the mid-1920s and the mid-1960s as the Dark Ages of American drug policy. Even so, there was resistance to such therapeutic orthodoxy, notably on the West Coast. Indeed, the Los Angeles County Medical Association sponsored a morphine maintenance clinic during the early 1930s, only to see its doctors arrested and the clinic closed by federal authorities in spite of protests by the mayor of Los Angeles and the City of Los Angeles' director of public health. Relying on new primary sources, this paper chronicles the struggle between California maintenance advocates and the Federal Bureau of Narcotics during the Great Depression. (Editor' s abstract)