Ghost busters

>> Gabor Maté writes about the absurdity of punishing drug addicts in his book
In the Realm of Hungry Ghosts

by JULIET WATERS

In the Realm of Hungry Ghosts: Close Encounters With Addiction, by Gabor Maté, is a big book about a big issue that continues to be brushed off like it’s a small one—hardcore drug addiction.

To illustrate how poorly understood it is, here’s what Barack Obama plans to do to change zero tolerance policies towards drug users in public housing. Nothing. “I’m sympathetic to [those who are evicted],” Obama told a community activist recently, “but not that sympathetic.” Explaining that if you want a break on public housing, you shouldn’t be messing with drugs.

If that’s the answer from a Democrat promising change, it’s not surprising Maté sounds a little bitter in our interview, as he ruefully refers to Conservative federal Health Minister Tony Clement as the “disease minister.”

Maté is a staff doctor at the Portland Hotel, which manages Insite, the Vancouver safe injection clinic that is currently having its licence reviewed. While much of his book details his experiences with Downtown Eastside addicts, the book is also a far ranging and penetrating look at addiction throughout society, and why we continue to believe that punishing addicts is effective and sane social policy.

The belief, he argues, is a symptom of cultural schizophrenia. We don’t want to face the level of addiction that currently permeates our culture, whether it’s addictions to drugs, work, entertainment, food etc. So we scapegoat the most vulnerable and obvious sufferers.

“It’s all about splitting, and never seeing the unity. Seeing only the differences in others and not the underlying connections. People grow up in an environment, just like plants do. Nobody would ever argue that you can grow good plants on bad soil, but we don’t understand the same thing in human beings. We think people should just fix themselves regardless of what environment they’re living in.”

Maté is realistic about the odds of rehabilitating hardcore addicts, who are almost always victims of severe abuse before they start hurting themselves. In a significant number of cases, the best one can accomplish is harm reduction. But a compassionate approach towards addicts can accomplish a lot for their surrounding communities.

More than 20 studies in leading medical journals have documented Insite’s accomplishments in harm and crime reduction. The Vancouver police support it, and last week, retired policemen from England and Australia flew to Ottawa to defend the project against public hearings that seem determined to close it.

Still, Clement couldn’t manage to fake neutrality all the way to the end of a press conference, where he handed out contact information to reporters of police who oppose Insite, like the Toronto superintendent who believes it’s the first step to legalization.

And if it is? “Cigarettes kill five and a half-million people around the world every year,” Maté points out. “People profit from selling and advertising cigarettes. Governments make huge piles of money off them. And then you talk about drug addicts taking public money? Talk about schizophrenia. The social problems are caused by criminalization. Not by the drugs themselves. Not that there wouldn’t be any problem, but it would be a different one. A much less intractable one.”

As for the argument that giving addicts safe access to drugs shields them from the natural consequences of their addiction, Maté says, “The natural consequences of workaholism, or the stressful lifestyle of a physician or business executive is a heart attack. So if some physician or executive shows up at the emergency ward with a heart attack, should we boot them out the door, refuse resuscitation, drugs, bypass surgery, because we’re just enabling? I love the logic of this.

“The next time somebody goes skiing and breaks a leg, they should be made to crawl around on their knees for the rest of their lives, otherwise we’re just encouraging dangerous sports...where does this stop? We don’t treat any other members of society like this.”

In the Realm of Hungry Ghosts
by Gabor Maté, Knopf Canada,
hc, 466 pp, $34.95