Herbert Kleber

Jeffrey A. Singer

Today’s Google Doodle is about Dr. Herbert Kleber, a noted U.S. psychiatrist who died on October 5, 2018. After his early work with addicted inmates at a national prison in Kentucky, he became very disappointed with the results of what was, in effect, abstinence therapy augmented by work assignments and group therapy sessions—which had been the standard approach in the 1960s. This approach was associated with a roughly 90 percent failure rate.

His research at Yale and later at Columbia University was largely responsible for the now widespread acceptance of methadone, and now other forms of what is referred to as Medication Assisted Treatment (referred to by many therapists as Opioid Replacement Therapy) for patients suffering from addiction.

Now a time-tested tool for the treatment of substance use disorder, Kleber met much resistance from the public policy community, who tended to view addiction as a vice rather than an illness, preferring incarceration and punishment over treatment. Kleber argued for an evidence-based approach to the treatment of substance use disorder. Despite extensive evidence that MAT is much more successful than forced abstinence within the penal system, resistance to this approach persists among many policy makers. In fact, in 2017, then-Secretary of Health and Human Services Tom Price, an orthopedic surgeon, dismissed methadone treatment as “substituting one opioid for another.”

A growing number of addiction researchers and therapists view addiction as a learning disorder automatized as a coping mechanism. Most of the medical community chooses to employ more of an organic disease model approach to the understanding and treatment of addiction. Both schools of thought recognize the value of MAT in helping addicts overcome the fear of withdrawal while dealing with stress-induced triggers without resorting to a drug-induced “safe space.” As their lives stabilize, MAT in conjunction with group and individual therapy gets addicts on the road to recovery.

Dr. Kleber served as Deputy “Drug Czar” in the Reagan Administration. In later years he continued research on evidence-based approaches to substance use disorder at Columbia University. In recognition of his efforts to destigmatize substance use disorder and promote treatment over incarceration, he deserves to be today’s Google Doodle.