CLOSE ENCOUNTERS WITH ADDICTION

Dr. Gabor Mate has witnessed the daily sorrow and desperation of
Vancouver's streets. On a walking tour of addict hangouts in the
ByWard Market, he explains why decriminalizing all drugs is the only way to go

Gabor Mate is in a basement room in the Ottawa Mission, firing
questions at Pierre, who's finally clean after a quarter century of
ingesting everything from hash and booze to opiates and crack.

"Are you able to talk about what your pain was?" Mate asks gently.
Pierre, an articulate and intelligent 37-year-old, launches into a
familiar story, at least to Mate, a doctor who has spent the past
decade treating addicts in Vancouver's notorious Downtown Eastside.

Child of a teenage mother who put him up for adoption. Check.
Manic-depressive father, emotionally distant mother. Check. Poor
grades despite a high IQ. Check. Latch-key kid who sought solace from
his peers. Check. Sexual abuse. Check, check, check.

The drugs started at 11 or 12, after Pierre was introduced to hash by
his best friend's older brother.

Mate nods. "That's a typical story. Kids who are not connected to
adults will connect with other kids. They need to have someone."

He asks Pierre what his first drug experience felt like. "Jeez ...
like nothing. It's like all of a sudden, everything was numb. All of
that stuff, all the doubts, all everything, was gone."

Thanks to a program at the Ottawa Mission, Pierre has learned that
addiction is just a behaviour he developed to deal with the
post-traumatic stress bequeathed by his wretched childhood. He's been
clean for four months.

"I'm not an addict," he insists. "I'm a person who suffered trauma
who turned to addiction. There's a big difference."

Part of the reason he used drugs, Pierre offers, was so others "could
point the finger at me with your kids and say, 'Look, that's why you
don't want to use drugs.' I was the hopeless case you could point to.
That was my purpose in society."

"Isn't that a bit self-justifying?" challenges Mate.

"Oh, yeah."

"It almost makes you into a Christ figure."

"A martyr," Pierre agrees. "That actually used to be one of my lines,
that when Christ died for the sins of humanity, he had nothing on me."

Talking about his past robs it of its malign power to harm him, he
says. "Yeah, these things happened to me. I have absolutely no
control of that. It's done. What I do have power and control over,
and what I can affect, is my behaviour today."

"For someone who's been sober four months," Mate tells him, quietly
impressed, "you've figured out quite a lot."

Gabor Mate is in Ottawa to promote his new book, In the Realm of
Hungry Ghosts. It's a harrowingly honest, compassionate, sometimes
angry look at addiction and the people whose lives have been
disordered by it. On this frigid February day, a wind chill in the
mid-minus-20s pummels pedestrians scurrying through the ByWard
Market. But Mate gamely agrees to a walking tour of Ottawa's addict
hangouts, an excursion that leads to his encounter with Pierre at the
Ottawa Mission on Waller Street.

A lanky, intense man of 64 with a wide expressive mouth, uncombed
black hair and round wire-rimmed glasses, Mate's words tumble out in
a breathless torrent, as if his mouth can't keep pace with his racing
thoughts. That's likely a manifestation of his attention deficit
disorder, the subject of an earlier bestselling book, Scattered
Minds. His views about addiction were forged in the crucible of hard
experience. For more than a decade, he has witnessed the daily sorrow
and desperation of drug addicts as staff physician at Vancouver's
Portland Hotel, a residence and harm reduction facility in a district
with an addict population estimated at 7,000.

He's also struggled with his own addictions: to work and to classical
CDs, on which he once dropped $8,000 in a single week. While more
socially acceptable than drugs, both have done harm to his
relationships with people he loves.

Much of his new book deals with drug addiction. (Addicts are the
hungry ghosts of the title, an image drawn from the Mandela, the
Buddhist Wheel of Life.)

But addictive behaviours are everywhere, Mate points out. "People
have a hard time recognizing that the nature of addiction pervades
this whole society." By marginalizing addiction, by consigning it to
the realm of hungry ghosts, people are "protecting themselves from
dealing with what's inside themselves," he says.

We're addicted to work, to television, to jogging, to food, to video
games, to the news (hence "news junkies").

Politicians are addicted to power. Mate suggests, only
half-facetiously, that we should tour Parliament Hill instead of the
addict-ridden ByWard Market.

"We could go up to politicians and say, what is it that drives your
desire for power that much? What actually happened to you? They all
have this drive to be powerful, and very often they sacrifice their
soul for it, just the same as the addict does."

He knows what fuels addictive behaviour: it's about deadening
emotional pain, often imprinted on our brains during the first months
of life. To oversimplify outrageously, childhood trauma alters the
chemistry of the developing brain, leaving us with heightened
vulnerability to addiction.

"The whole concept that the brain develops and is very much
influenced by the environment, particularly the emotional
environment, is scientifically so clearly established," he says. "And
yet it's so unknown. It's not even taught in medical schools, even
though the research is not that new."

Mate believes addiction is at the root of our obesity epidemic. It's
a problem, he says, "of more and more people needing to soothe pain."
We turn to food for solace because the human connections that used to
sustain us are breaking down, he says.

"Human connections are being lost left and right. There's been a
massive breakdown of community, of neighbourhood, of extended family,
of nuclear family."

These multiple breakdowns also stress our children, who then eat
compulsively to soothe themselves. "That's why so many kids are
overweight. It's not because of the availability of fast foods."

With parents unavailable emotionally, kids look to their peers. But
they can't meet one another's needs for unconditional love and
support. Because they can't show vulnerability to their peers,
children are getting desensitized emotionally, Mate says. "When you
shut down that emotion, you're giving up a part of yourself. You
become more alienated, more bored. If drugs come along, that can make
life exciting."

When it comes to drug addiction, we're doing just about everything
wrong, he argues. "Our response to the drug problem is one of fear
mostly, and lack of information," says Mate, who wrote Hungry Ghosts
"to raise awareness, to bring some information to the public, to
infuse at least a bit of perspective into the debate."

Politicians don't help, he says. "Mostly they're followers, and
mostly they're followers of the meanest common denominator. Certainly
this government seems to be." Mate is withering about Ottawa Police
Chief Vern White's new policy of giving provincial welfare officials
the names of accused drug dealers -- most of whom deal drugs to feed
their own addictions -- so they can be investigated for fraud and cut
off from social assistance.

"Here's what I say to the police chief," he begins. "Chief, the
people you're dealing with are the abused children that your police
couldn't protect when they were small. It's not your fault. If you
could have, you would have. But you didn't protect them. Their brains
have been addled in a certain way. As a result, they have this drug
dependence. And you think you can deal with that punitively?"

Cutting drug dealers off welfare will only increase the violent crime
rate as they replace their lost welfare income with the proceeds of
crime, Mate says. "Or it might possibly chase the addicts out of
Ottawa and get them to go to Hull or Quebec. But it won't deal with
the problem."

Nor will the current police campaign to arrest street-level dealers
have any lasting results, Mate says. "Are they going to jail them
forever? Are they going to hang them? Once they come out, what's
going to happen to them?"

Police, he says, are trying to do the job given to them by society.
"But society gave them the wrong job. There's no right way to do the
wrong job. That's what it comes down to."

Mate is convinced that decriminalization -- of all drugs -- is the
only sensible policy. "I don't think the criminalization of drug use
is compatible with real prevention, real treatment and real harm
reduction," he says. "I think it exacerbates the problem."

While he wouldn't legalize the manufacture and distribution of drugs,
Mate would decriminalize possession for personal use and make drugs
of dependence available to confirmed addicts under medical
supervision. Once you do that, he says, "basically that would be the
end of drug smuggling, because most of the smuggling and most of the
drug crime is based on sales to confirmed addicts."

Moreover, he says, sales to non-addicts are driven by users who deal
drugs to feed their own habits. If they could get their fixes
legally, they wouldn't have to do that. "Why would they put
themselves at risk?"

Removing the criminal sanction for addicts is critical to another
shift that Mate thinks is essential -- ending the stigma that brands
addicts as societal outcasts.

"Drug addicts represent some of what's most scary about human
beings," he acknowledges. "There's self-neglect, there's neglect of
others, there's crime, there's violence, their decrepitude, there's disease."

But, he says, "we don't see that we created the monster ourselves" by
criminalizing drug use. "Better we should turn away and just blame
the individual."

If drugs were decriminalized, addicts wouldn't have to hang around on
street corners begging for money, Mate says. They wouldn't have to
shoplift or break into houses. They wouldn't look as diseased. "They
wouldn't be as monstrous in our eyes."

To help addicts, we need to stop judging them, he says. "Once you
remove the judgment, there's an opening of the mind and an opening of
the heart. Then the solutions will arise."

The problem for most people is they confuse their judgments with
reality, he says. That stops us from expressing compassion --
something addicts need if they hope to take responsibility for their own lives.

"For people who have been terribly traumatized, and continue to be,
it's just a fact that in order to take responsibility, many of them
need compassion. In fact, they'll only start giving it to themselves
when they receive it from others."

Are we mature enough to do that? Not yet, Mate acknowledges. Right
now, our society is like two tectonic plates moving in opposite
directions. "On the one hand, there's the politics, which is getting
narrower and more punitive. But there's also a tremendous movement on
the part of much of the public for more self-awareness and more compassion."

If we can ever become a truly just society, we can banish addiction,
Mate says. Addiction is culture-driven, not inherent to human nature.
"If people actually treat each other justly from birth onward," he
asks, "why would there be addiction?"

At the Ottawa Mission, Pierre is talking about stigma. Like Mate, he
wishes it would go away. "Because all that's behind that stigma for
me is fear," he says. "Their fear."

Mate prompts him. "What do you think they fear?"

"Their fear is that they might become me," Pierre responds.

"No, that's not what the fear is. You know what the fear is?

That they are you."

Pierre smiles and nods. "Yeah."

"Because if you look at the culture we live in," Mate continues,
"it's all about getting something from the outside. It's all about
satisfying some emptiness. Buy this product. Look this way. What's
the difference?"

"There is none to me," Pierre declares.

"That's what I'm saying," says Mate. "So it's not that they don't
want to become like you. It's that they don't want to know that they are you."

Pierre pauses. "Maybe the lack of compassion they're showing toward
me is a lack of compassion they're showing to themselves," he
suggests. "And I'm an easy target."

"Exactly what it is," says Gabor Mate, giving Pierre a smile. "That's
exactly right."

GABOR MATE FILE

Bio: Born 1944 in Budapest, Hungary, months before the Nazis occupied
the city. His mother's parents died at Auschwitz when he was five
months old and his father spent 15 months in a forced labour camp.
His family moved to Vancouver in 1957, when he was 13. Currently
staff physician at the Portland Hotel, a residence and resource
centre for the people of Vancouver's Downtown Eastside.

Claim to fame: Physician and author of four books. Besides In the
Realm of Hungry Ghosts, he wrote Scattered Minds, about attention
deficit disorder, and When the Body Says No, a look at the cost of
hidden stress. He also co-authored, with Gordon Neufeld, Hold On to
Your Kids: Why Parents Need to Matter More Than Peers.

Quote: "I wrote this book precisely to raise awareness, to bring some
information to the public, to infuse at least a bit of perspective
into the debate. I think it will be a phenomenally successful book,
because it speaks to something in the culture and I think it says it
in a way people can relate to."