Updated: Aug 29
Editor’s Note: Today’s post comes from one of our newest contributing editors, Dr. Jeremy Milloy. Milloy is the W. P. Bell Postdoctoral Fellow at Mount Allison University. A scholar of work, capitalism, addiction/substance use disorder, and violence, he began studying substance use and the workplace while researching his first book, Blood, Sweat, and Fear: Violence at Work in the North American Auto Industry, 1960-80, published in 2017 by the University of Illinois Press. His current book project investigates the historical relationship between work, capitalism, substance use, and recovery in Canada and the United States, considering how wage labor has influenced substance use, anti-addiction efforts focused on work, the creation of employee assistance programs, workaholism, drug testing, and methadone programs. You can reach Jeremy on Twitter (@jeremymilloy) or by email (firstname.lastname@example.org). And you can look forward to reading more of his work on Points!
Among the historian’s most valuable contributions is the knowledge that many current phenomena that seem new have actually been around for quite awhile. So it is with the current opioid crisis, which many have pointed out is a continuation of, not a departure from, longstanding trends in substance use and dependence in North American life.
The automotive industry is a good example. Today, both the major North American automakers and the UAW have identified opioid-related harms as a significant threat to their workforce, membership, and communities. As journalist Jackie Charniga has shown, the U.S. areas dealing with the most severe opioid-related harms overlap with the areas of the Big Three’s major American manufacturing facilities. Ford and the UAW in 2017 started the Campaign of Hope, which aims to educate and inspire workers to avoid the misuse of drugs. The UAW is bargaining with the Big Three to make more help available for workers and make it easier to access that help while keeping their jobs. Unionists and Ford are even working together to pilot a medical device that could possibly relieve some of the agony of withdrawal.
In this, the UAW and the automakers have come full circle. For it was concern over opioids, specifically heroin, identified in a 1971 New York Times report as endemic in at least one Cadillac plant that fueled the innovation and expansions of joint union-management substance abuse and employee assistance programs. Indeed, beyond auto, the 1970s was a crucial decade for the relationship between substance use and the workplace, with concerns about drug addiction and professionalization fueling a transformation from older industrial alcoholism policies to a broader substance use and employee assistance framework, which is still with us today in many respects. The 1970s, while the decade of Nixon’s War on Drugs, was also a decade of experimentation in drug treatment, and in Detroit, a group of autoworkers pioneered a fascinating experiment in workplace health and addiction treatment. They called it C.H.I.P.: Curb Heroin In Plants.
According to their own material, ““C.H.I.P. is a story of six black men who are about helping. They are Donzell Williams, Wille Grant, Nathaniel Smith, Tony Moore, Rufus Evans and Albert Holley. As U.A.W. Chief Stewards, these men observed a pained and deteriorating situation enmeshed in the cold, gray steel of Eldon Gear and Axle.” They believed the “the drug problem had reached gigantic proportions at Eldon.” Their solution? “A drug clinic for the working addict.”
They established a storefront clinic that combined methadone maintenance therapy with counseling. Perhaps the most interesting innovation of C.H.I.P. was how the counsellors at the methadone clinic were also stewards at the plant. Said Willie Grant, “If a man take the cure, he knows that we are always available for counseling right on the job.” This is allowed for support at work, and recognized that workplace factors and social settings mattered in the treatment of substance use disorder.
C.H.I.P. was supported by community organizations, plant management, and the U.S. federal government, which provided a million-dollar grant in 1973 through the National Institute of Mental Health. The grant was given to “test the efficacy of treatment geared to the specific needs of employed addicts and to test the utilization of union shop stewards as outreach workers for bringing employed addicts into treatment.” The University of Michigan’s School of Public Health signed on to evaluate C.H.I.P., and with the funding C.H.I.P. aimed to:
1) Eliminate drug dependency in 200 addicts recruited into the program
2) Increase the probability for each enrolled addict of continuous employment, high work productivity, improved work attendance, health status and improved psychosocial functioning.
3) Increase knowledge and improve attitudes of plant intake personnel (e.g. shop stewards) and counselors
By 1974, the UAW was issuing media releases about C.H.I.P.’s success, and Grant was reporting it had “cured” 450 workers from addiction. However, the positive spin masked a gloomier reality. C.H.I.P. struggled with expanding its program. The University of Michigan evaluation, itself beset by issues with its sample and methodology, did not indicate C.H.I.P. was succeeding in its goals to transition workers off of heroin use and improve workplace functioning or happiness. By 1975, C.H.I.P. had collapsed amidst a swirl of accusations about corruption and misappropriated funds.
Although C.H.I.P. failed, I think its story is relevant to historians and public health researchers alike. In an article published by the American Journal of Public Health in March, I argued that C.H.I.P. is an important reminder not only of the experimental diversity and breadth of the early War on Drugs period, but also that workplace actors and workplace factors played a major role. Claire Clark has demonstrated how recidivism became the obsessive focus of methadone proponents and policymakers. This worked to the detriment of methadone therapy and drug policy generally. Clark skillfully draws out how the punitive assumptions embedded in a seemingly benign therapy could easily lead to a drug policy driven by punishment when the desired reductions in crime didn’t seem to result.
Similarly, returning to work is another major metric by which substance use interventions have generally been judged by state actors and employers. What C.H.I.P. prompts us to consider is that work and workplace culture themselves could be a contributor to harmful use. This is a useful insight for the UAW and the Big Three as they tackle the current autowork opioid crisis. The history of C.H.I.P. and the current work of public health researchers demonstrates that “return to work” or “productivity” may not be appropriate yardsticks of human health. The workplace has historically been a crucial site of substance use, substance-related harms, and initiatives to promote recovery. The history of C.H.I. P. reminds us that the combination of work and recovery provides both opportunities and pitfalls.