Ira J. Marion, MA, a leader in medication-assisted treatment (MAT) for more than 40 years, died of pancreatic cancer on January 7 at age 68. During his career at the Albert Einstein College of Medicine, Yeshiva University, he turned a pioneering methadone program—one of the first in New York City—into an integrated treatment program offering complete medical and wellness care. Under his guidance, MAT at Einstein expanded from a patient population of 350 in 1970 to what it is today—nine programs treating more than 3,000 patients.
Joyce Lowinson, MD promoted Ira to administrator shortly after he joined the program as a counselor. It turned out that he was an excellent partner to help achieve the goals for the patients, she told AT Forum. He played an important role in introducing the supervised admnistratrion of medication to patients suffering from tuberculosis; the next step was introducing primary care into the clinics.
When Suzanne Hall-Westcott, Mr. Marion’s companion, first met him, she was working at Phoenix House, a treatment center for substance and alcohol abuse. She recalled that Ira sent her an email after her husband was diagnosed with cancer – the same disease which his wife had died of recently. “He said, ‘This is a terrible time for both of you, in different ways.’” This was the kind of empathy that he had for patients, she said.
Mr. Marion became involved in MAT as a patient. He would often say he was a “product of the system,” as if he was just a patient who got lucky, said Walter Ginter, CMA, project director of the Medication Assisted Recovery Support (MARS) Project of the National Alliance for Medication Assisted (NAMA) Recovery. “Luck had nothing to do with it,” said Mr. Ginter, also a methadone patient. “He started out at the bottom and worked his way up.”
Mr. Marion was known among his colleagues for his wry sense of humor and his colorful way of sharing the stories he loved to tell. But he was better known for his empathy—not only for patients, but for everyone he came into contact with.
As a patient himself, Mr. Marion was able to identify with other patients, but that wasn’t the whole explanation for his skill, said Dr. Lowinson. “He generally showed great empathy for all the people in his life who had difficulties. He always came to the rescue.”
“Ira possessed unique talents among administrators in our treatment community,” said Mark Parrino, MPA, president of the American Association for the Treatment of Opioid Dependence (AATOD). “He always cared about how patients were being treated, and from the earliest stage was an incredible advocate for giving patients a greater voice in their treatment decisions.”
“Boy, does this guy like to talk!”
Mr. Ginter first met Mr. Marion in 1999, when he was on the methadone advisory group at the New York Office of Alcoholism and Substance Abuse Services (OASAS). “My initial thought was, ‘Boy does this guy like to talk!’” Mr. Ginter recalled. “But as our relationship grew, Ira was the one person I knew in the field who walked the walk,” he said. “We all talk about patient-centered care, but it wasn’t just words with Ira.”
In fact, Mr. Marion never refused to talk to anyone—he always had his iPhone and his iPad with him, and whether it was a patient, a provider, or a reporter on the other end of the line, he would pick up, said Mr. Ginter. “Even at the end, when he was sick, he was happiest when he was sitting in bed with his iPhone in one hand and his iPad in the other.”
Few people knew that Mr. Marion was on the NAMA-Recovery board, said Mr. Ginter. “It was a big thing for us to have him on the board—it gave us credibility, and it helped steer and guide us.” For someone whose time was so valuable, Mr. Ginter said, his NAMA-Recovery participation was very generous. “He was a gift to the field. For me that was a blessing.”
Joycelyn Woods, MA, CMA, executive director of NAMA, commended Mr. Marion as an “untiring champion of both patients’ rights and patient-centered care.” He was “courageous in expressing that he was a ‘product of the system,’” said Ms. Woods.
Influence at AATOD
Mr. Parrino first met Mr. Marion briefly in 1975 at a meeting of administrators in the New York State methadone treatment system. “I didn’t know then how our lives would be intertwined,” Mr. Parrino told AT Forum. After they both joined the Board of Directors at COMPA (Committee of Methadone Program Administrators) in 1980, the two worked on a number of projects throughout the 1980s, culminating in a trip to Hong Kong and China on behalf or New York State. “It was a wonderful trip, and I got to know Ira much better, which led to a greater and deeper friendship,” recalled Mr. Parrino.
The China and Hong Kong trip also led to more international travel for Europad and other conferences in Italy, France, Bulgaria, Bratislava, and Russia, to name a few. “Throughout these trips, I was always impressed by Ira’s clear and politically intuitive judgment, and his sense of vision,” said Mr. Parrino.
Mr. Marion had “an enormous influence in the policymaking discussions” of the AATOD Board of Directors, said Mr. Parrino.
One of the hardest things for everyone in the field is Mr. Marion’s absence. “I have come to learn that the mark of an extraordinary human being is not just the legacy of work left behind, but the enormous empty space left in the wake of such a life,” said Mr. Parrino. “Ira can be counted among those individuals—the ones whose whose efforts helped countless patients who will never quite know how much he contributed to their well being.”
Mr. Ginter recalled the day he said goodbye—one week before Mr. Marion’s death in Beth Israel’s hospice. “It was New Year’s morning, and Ira was still on the ball, joking with me,” he said.
The funeral was very private, as Ira had wanted. Instead, Mr. Marion “got what he wanted” for a send-off, said Mr. Ginter. “People honored his request. Everybody went by his house and told ‘Ira stories.’ He wanted people to remember him the way they last saw him, before his battle with cancer,” said Mr. Ginter.
With his late wife, Barbara Housner Marion, to whom he was happily married for 35 years, Mr. Marion had two children. For an online tribute created by his son, go to www.irajmarion.com.
Ms. Hall-Westcott, in an obituary she placed in the New York Times on January 29, called her time with Mr. Marion “our after ever after” life. “We both had lived ‘happily ever after,’ raised our families, and lost our spouses much too soon, to cancer. What happened ‘after ever after’ was to find joy again and dream of growing old together. He will live on in my heart forever.”