Helen Redmond is a Harlem-based filmmaker, journalist, and licensed clinical social worker.

She's worked with people with substance use disorder for more than 20 years.

She's a senior editor at Filter. The magazine addresses drug policy, harm reduction, and criminal

justice issues, and she teaches at NYU's

Silver School of Social Work. Helen co-directed the feature-length documentary film Liquid Handcuffs,

a documentary to Free Methadone, which was released in 2019. She's now out with a new book

that came out March 3rd with the same title, Liquid Handcuffs.

Helen, welcome to the Cato Podcast.

Thanks for having me.

So methadone clinics are nowadays referred to as opioid treatment programs or OTPs.

But in your book, you claim they're better characterized as opioid treatment prisons that violate medical ethics.

So explain to listeners who may be unaware of how the OTP system works, how it currently functions, and why your characterization is apt.

Right. The reason I call them opioid treatment prisons, it's for a couple of reasons.

The first one is foundational to opioid treatment prisons is a really massive power differential

between the staff who work in clinics and patients. So when you go

into a methadone clinic, the staff controls access to your medication. You don't control

access to it. You're never 100% in control of your medication. And you have to do what the staff tell you to do. There's a whole set of rules and regulations. And I know you know some of them, Jeff, because you're familiar with methadone. And so you have to adhere to these regulations. And if you don't, you might not get your medication.

So that's the first thing, that power differential where staff control access to your medication.

And that to me, it feels a lot like correctional officers and inmates.

They control your movements. They control everything that

you do. And staff and clinics do as well. So you have to give urine toxicologies. And they're

called supervised urines. So they actually watch you while you urinate. When you swallow your medication, the nurse is behind a bulletproof plexiglass window.

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