GABOR MATE SHOWS WE'RE WIRED FOR ADDICTION

Downtown Eastside physician Gabor Mate has a nifty way of measuring
some of the financial costs of the war on drugs. In a recent interview
with the Georgia Straight in an Oak Street coffee shop, Mate cited the
example of a person who finances a $100-per-day cocaine habit by
shoplifting. Mate noted that a drug addict must shoplift $1,000 worth
of goods to generate a $100 return because of the discounted price
that people pay addicts for stolen merchandise. Therefore, to feed a
$3,000-per-month cocaine habit, an addict will have to steal $30,000
worth of merchandise.

"That's the drug laws for you," Mate said. "Who is paying for that?"

Last week, the Straight published an excerpt from Mate's stunning new book,
In the Realm of Hungry Ghosts: Close Encounters With Addiction (Knopf
Canada, $34.95), a wide-ranging examination of the lives of addicts, the
neurobiology of addiction, the war on drugs, and strategies for harm
reduction and healing. He believes that most intravenous-drug addicts
experienced either extreme neglect or hard-core physical or sexual abuse in
their childhoods.

Mate's central thesis is that addiction is occurring on a massive
scale in western society because so many people have an inner
emptiness caused by societal dislocation, including the destruction of
traditional relationships within families and communities, and a lack
of proper attunement in infancy. By "attunement", he means a parent
literally being "in tune" with the child's emotional states, and being
present in a way that ensures the infant feels understood, accepted,
and mirrored. "Attunement is the real language of love, the conduit by
which the pre-verbal child can realize that she is loved," he writes
in the book.

He pointed out in the interview that parents might fail to provide
proper attunement even when they deeply love their child. This can
occur because the parents are depressed, overworked, stressed, or
dealing with crises that take them away from the child. And that's
when things can literally go a bit haywire in the infant's brain,
contributing to addiction later in life.

In his book, Mate cites child psychiatrist Daniel Siegel to suggest
that poor attunement can interfere with the development of brain
circuitry. This can lead to distorted levels of the brain's
endorphins, which soothe physical and emotional pain. Poor attunement
can also result in fewer brain receptors of dopamine, which is a
neurotransmitter that sends messages of incentives and rewards.

In the absence of a fully developed dopamine system, Mate said, a
person is far more likely to crave stimulants-nicotine, caffeine, or
drugs like cocaine-to provide incentives. Mate points out in his book
that cocaine, which increases dopamine levels and triggers intense
feelings of elation, wears off very quickly. This is why coke addicts
seek an endless supply of the drug to repeat those feelings.

Mate also emphasized that infants are born with no physiological or
emotional self-regulation. That's because a lot of brain development
occurs after birth, including in the cortex, which provides these
controls. "If the parents are not there in an attuned, nonstressed way
to regulate them, self-regulation never develops," he said. "Then
there is no impulse control. If they're stressed to begin with, then
they are going to go for anything to reduce the stress. One thing that
addictions all do is they reduce stress momentarily."

Mate offered a surprising response when asked how parents should deal
with a drug-addicted daughter. "The first step is they're going to
have to be perfectly okay with their daughter using," Mate replied.
"They have to be perfectly okay with this. Say, 'This is what's
happening.' Not resist it or resent it. Not wish her to be different.
Not work to make her different than the way she is. Because what this
girl did not get in the first place was unconditional loving
acceptance-not because they didn't intend it, but because they
couldn't deliver it because of their own stuff."

He added that if parents understood how deeply an addiction is
ingrained in the brain, they would accept their child's condition more
easily. "The only thing they can do is create an atmosphere in which
she would be encouraged to become more self-reflective," Mate said.
"And that can only happen when there is no judgement there, and there
is no push to change."

Mate's book highlights how our "attachment to externals"-status,
looks, work, achievement, alcohol, gambling, or drugs-is at the root
of addiction. He believes that any full healing should be based on the
concept of "sobriety", which is a positive approach that recognizes
the addiction, rather than on "abstinence", which is merely avoiding
the harmful substance. Mate advocates increasing one's self-perception
in a tone of "compassionate curiosity" rather than through
self-punishment.

He said that if policymakers properly applied what has already been
learned about brain biochemistry-including teaching parents the
importance of attunement-80 to 90 percent of the addictive behaviour
could be eliminated in Canada within two generations. And that would
save a lot more money and create far greater peace of mind over the
long term than continuing the war on drugs.

Go to Straight.com to read the excerpt from Gabor Mate's In the Realm of
Hungry Ghosts: Close Encounters With Addiction.