Following the Mother of Methadone
How U of A College of Medicine – Tucson Associate Professor of Emergency Medicine and Psychiatry Melody Glenn ’06 is trying to make addiction treatment more effective — and more humane.
Glenn providing Crisis Response and Intervention Training to local law enforcement, December 2025.
Chris Richards
At 7:15 on a Tuesday morning in Tucson, Melody Glenn ’06 leans over the hatch of her Subaru, wedging boxes of bagels in next to boxes of naloxone. Just eight hours earlier, Glenn had clocked out of her shift in the emergency department at Banner – University Medical Center. The bagels are breakfast for Glenn’s colleagues; the naloxone, a nasal spray that rapidly reverses opioid overdose, is a donation to a community organization.
“It was a busy night,” she says, placing a coffee carrier between her children’s car seats. Already, the June heat blurs the parking lot pavement. But Glenn is unfazed. After over a decade of fighting for the best care for her patients, chronicled in her memoir “Mother of Methadone: A Doctor’s Quest, a Forgotten History, and a Modern-Day Crisis,” she has developed exactly the kind of countenance you’d want from someone who may have to cut you open in a pinch.
“Mother of Methadone” braids Glenn’s experiences treating substance use disorder with the history of Marie Nyswander, the physician who pioneered methadone maintenance treatment. Established in the 1960s, methadone maintenance is a controlled, daily dose of methadone to eliminate withdrawal symptoms and reduce cravings for unprescribed opioids. According to a recent Substance Abuse and Mental Health Services Administration report, “The evidence is overwhelming: methadone, as well as other MOUD [medications for opioid use disorder] reduce mortality, promote recovery, and break the cycle of addiction and incarceration that devastates families and communities across the nation.”
With the AC cranked up, we set off past dog walkers and joggers enjoying the University of Arizona Mall. We’re on our way to the School of Mining & Mineral Resources’ San Xavier Mining Laboratory, where Glenn is participating in a confined-space rescue training for National Emergency Medical Services Week. A few months earlier, she had been awarded the 2025 President’s Award from the National Association of EMS Physicians for her efforts to incorporate quality addiction medicine into prehospital care, like EMS.
Glenn's book, a hybrid of memoir and medical history called “Mother of Methadone,” was published by Beacon Press in 2025.
Glenn didn’t start her medical training with the intention of treating addiction. In 2015, when people with substance use disorders came into the Phoenix ER where Glenn was a junior resident, she viewed their care as a waste of precious resources. Medical school taught her that substance use disorder is a “hopeless condition” that lacks effective treatment. “The only detail about addiction that I remembered,” she writes in “Mother of Methadone,” “was that Dr. Drew of MTV’s ‘Loveline’ gave us the one-hour lecture.” But as Glenn gained more experience, she began to see what the gaps in her education had left out: that medications for opioid use disorder not only exist but are highly effective. She also learned about the decades of medical research that point to genetic, neuroscientific and psychological factors that lead to drug use. “There’s lots of people with past traumas who are self-medicating with drugs,” she tells me. “Traumas related to inequality and poverty, incarceration, racism and sexism.”
These gaps in understanding substance use disorders — and what approaches might meaningfully address them — aren’t limited to medical school. Although the Centers for Disease Control and Prevention report that fatal overdoses in the United States increased by over 520% between 1999 and 2023, attempts to stem or meaningfully treat substance use disorder faltered. Incarceration, hospitalization, abstinence-based therapies, wilderness therapies and even seizures of drugs at the border did not weaken the tide of deaths. Almost everything except medications for opioid use disorder failed to keep people alive — but those medications were heavily regulated and, for many, virtually unknown.
Glenn’s search for information led her to Nyswander, who spent much of her career advocating for approaches to treatment that don’t rely on incarceration or involuntary hospitalization, including methadone maintenance. “We know that when an addict is sent to jail, one of the first things he will often do when he gets out is to take a shot of heroin so that he can feel like a human being again instead of an outcast who has been quarantined,” Nyswander said in the early 1970s. “And if you’ve withdrawn him in a hospital, what will happen if he’s released again if he has not wanted to stop using drugs by himself?” Her stance was unpopular at the time, but she continued to promote methadone maintenance as the first-line treatment we know it as today. In Nyswander, Glenn found a role model committed to respecting people’s agency over their own lives.
We turn right down a dirt road, dust clouds billowing behind us. When we enter the classroom at the San Xavier Teaching Laboratory, several of Glenn’s emergency department colleagues hop up to greet us with smiles and hugs. For the next hour or so, I observe the quick-witted banter of young doctors as they learn about famous confined-space rescue missions: the 1999 earthquake in Taiwan, the 2010 Chilean mine collapse and the 2018 Tham Luang cave flooding. The goal for the day is to inform emergency department personnel about what happens before a trapped hiker or mine employee or a person stuck in a chimney comes into the ER.
The principle behind our trip today, equipping doctors with context to mitigate harm, is what Glenn is trying to provide for substance use disorder. And while these doctors may not be focused on addiction medicine, as Glenn is, they will inevitably encounter the need for it. For this reason, she has devoted herself to educating fellow physicians about harm reduction: a set of pragmatic strategies and evidenced-based tactics that reduce the negative consequences of drug use.
“People with a substance use disorder will find ways to use, whether or not they have a clean needle,” she writes. “That is the defining diagnostic criteria of addiction. So, let’s help them stay alive until, or if, they are ready to stop using.” This could mean providing users with clean needles to reduce the transmission of HIV and hepatitis or distributing fentanyl test strips to prevent overdose. It could also mean providing methadone or other medications for opioid use disorder, like buprenorphine. The first time Glenn prescribed buprenorphine to a patient who expressed a desire to stop using drugs, he went from violently retching to happily chatting on the phone. Glenn recalls that he told her he felt normal, “‘And it feels great! I haven’t felt like this in forever.’” Glenn was astounded by the transformation. “Never before had I seen a single treatment cause such a swift and total metamorphosis,” she writes in “Mother of Methadone.”
Glenn compares harm reduction to wearing a seatbelt or using sunblock. Unlike many abstinence-based treatment models, harm reduction does not ascribe religious, ethical or moral dimensions to drug use. If a person chooses to use drugs, it’s not seen as wrong, immoral or a failure to get “clean.” As such, harm reduction entails a fundamental shift away from the primacy of abstinence as the model for successful treatment of drug use — a challenge to the redemption narratives that continue to dominate the cultural conversation about substance use today.
After the confined-space rescue presentation ends, I find myself stepping into the mouth of the mine, outfitted in a hard hat, headlamp and neon orange vest. Glenn has left to take a call, so I’m on my own with the trainees. As we follow the tunnel, our headlamps spotlighting dusty, low ceilings, I imagine the multitude of situations an ER doc must be prepared for. In no time, I am witnessing a simulation of one such situation: To free plastic dummies from underneath fallen debris, the residents take turns pumping the lever of a hydraulic rescue tool known as the jaws of life. They hunch on the ground between train tracks, watching beams slowly lift off a victim’s chest. Behind us, the darkness looms. “They didn’t teach us this stuff in medical school,” a resident tells me.
In her outreach and educational efforts, Glenn tries to approach disagreement with compassion. “So many times, I had written off physicians who disagreed with me instead of trying to understand their perspective, assuming they were coming from a place of ignorant stigma,” she writes in “Mother of Methadone.” “But maybe that wasn’t the whole story. … [T]hey, too, thought they were doing the right thing.”
Her efforts have made a difference in the emergency department, resulting in a free naloxone distribution program and clarity on how and why to prescribe medications for opioid use disorder. A couple of weeks earlier, a resident had emailed Glenn to thank her for introducing him to buprenorphine during a difficult encounter. “The patient probably would have left way too soon and not gotten his treatment because he was in a horrible withdrawal,” she said. “They were able to get him comfortable and up to the ICU.”
Broadly speaking, education about medications for opioid use disorder exists because advocates for harm reduction refused to let stigma combat its efficacy; for example, naloxone is available over the counter in Arizona because Sonora Prevention Works, a harm reduction organization, lobbied for years to legalize it. In 2024, federal and state implementation of harm reduction initiatives led to a 24% decrease in overdose fatalities nationwide, the largest decrease ever recorded.
When I emerge from the darkness of the mine, Glenn is wrapping up her call with an addiction medicine fellow under the sparse shade of a mesquite tree. We walk to the next activity: hoisting a colleague into the air next to a mine shaft with an elaborate system of ropes, pulleys and a stretcher. Around us, the desert dust spreads in all directions. Soon, it will be too hot to be outside in the midday sun.
During our drive back to Tucson, I admire the saguaros and chollas along I-19 while Glenn describes the challenges of being a woman in her field. The sexism she has faced is another factor in her admiration for Nyswander; she has found herself the only female physician in a room full of men, many of whom repeatedly attempted to belittle and discredit her research on methadone maintenance. Regardless, she has stood her ground.
It’s hard to find a community in the United States left untouched by overdose fatalities. According to the Centers for Disease Control and Prevention, overdose is the leading cause of death for Americans aged 18-44. As of 2023, over 40% of U.S. adults personally knew someone who fatally overdosed, myself included; for one in five U.S. adults, that person was a close friend or family member: in my case, my cousin, who passed away in 2021.
A few years ago, I would have balked at the idea of giving people who use drugs clean needles; that’s enabling, isn’t it? At the same time, when my cousin was alive and using, access to clean needles could have prevented an infection that almost took his life years before he overdosed. If he had called a Never-Use-Alone hotline so EMS would be alerted when he became unresponsive, or had gone to a supervised injection site where health care professionals act in cases of overdose, his life could have been saved.
Above all, harm reduction has made effective, dignified overdose prevention, treatment methods, and quality medical care possible, regardless of whether people choose to keep using drugs. Glenn is part of a larger movement, one that is taking hold across the country. “If we want to heal our communities and end our country’s overdose epidemic once and for all,” she writes, “harm reduction must be the foundation upon which everything else is built.”