The following interview with Dr. Gabor Mate provides additional context for his work and beliefs about addiction. One surprising statement he makes is that less than five percent of his patients overcome their addictions – not the best of outcomes. Of course what “overcome” means and how to define outcomes are messy topics, but I am far more optimistic about the tenacity of the human spirit to change.
Addiction is most definitely a challenge, but one reason for poor outcomes has been the lack of understanding about the nature of addiction, and the need for a comprehensive solution. Watch the interview, and then let me know your thoughts about Dr. Gabor Mate’s conclusions.
Gabor Mate: In the Realm of Hungry Ghosts: Close Encounters with Addiction
See my next post on the Gabor Mate addiction podcast.
I was less struck by the low outcome rates as I was by his tenacious commitment to placing those outcomes in an environmental context. He places society at the center of the addiction issue by talking about how it punishes and uses people with addiction and how it teaches people to become addicts. Reframing the addiction question in this way, makes us not only have to address systems but also how we as individuals and as members of society define not only addiction but ourselves vis-a-vis addiction or people with addictive behaviors. Do we think of ourselves as “good” or “better” because we are not “those people over there”? Does that mask the ways in which we engage in addictions that are just as harmful to ourselves and our societies? For instance, his discussion of how many people in Vancouver define themselves as work-aholics who are listless and irritable when not at work. That kind of work ethic is often praised in capitalist societies because it produces immense profit with increasingly decreased costs, but it does not benefit alienated labor, their families, or our overall social well-being. Nor is society a catch-all in his model, instead he points to specific aspects like war, the prison-industrial-complex, and exploitation of the poor as key hindrances to addiction free societies. He also touched on what some are now calling the non-profit-industrial-complex which is about how non-profits self-perpetuate rather than help solve the key issues they are designed to serve, when he talks about how ghettoizing and concentrations of addicts in certain areas of the city go together in a model that basic looks like: there is existing class inequality that places poor and marginalized people in certain areas (ghettoizing), services rise up to meet some of their unmet needs, people seek those services so they flock there, which leads to overwhelming concentration of people with addictions in a single area. This made me think of the drive to campus over the Burnside Bridge and how early in the morning, the sidewalks are peopled with homeless people, many of whom are showing signs of both addiction and mental health issues, because the area has so many services concentrated in less than a mile of space. I think about the people in the fancy cars speeding past them with no concern for the way they often teeter out on to the street and the way that my open windows with soft music playing at stop lights often makes them look sideways at me as if I am possibly a fool but certainly anomaly because I don’t roll my windows up when they are close to the car. Every time I make this drive, I think about the systemic problems of our society that create these ghettoized hot spots of abandoned people who we systematically target and force to move further out of view and in connecting that to addiction, I wonder as Dr. Mate does here, about how we are all implicated in the cycles of addiction that people endure or struggle to overcome.
The only pause I had when watching this video was when they began to talk about the Olympics. For someone so attuned to the structural issues exacerbating the isolation and addictive behaviors
sorry that was cut off, the last paragraph should say:
The only pause I had when watching this video was when they began to talk about the Olympics. For someone so attuned to the structural issues exacerbating the isolation and addictive behaviors of people his lack of engagement in the anti-Olympics struggle seemed odd to me. As someone who worked closely to spread information from First Nations People in Canada about the impact the Winter Olympics was having on tribal lands, the poor, and especially indigenous single mothers and sex working women in the area, many of whom were addicts, it seems odd that he would not address how the “clean up” was actually creating more isolation, less housing options, and increased risk for sexual abuse and addiction in the communities in the area. Having written a conference paper on post-Olympics gentrification in other areas, like Atlanta, I can also say that there is clear data that the increased stress on marginalized communities leads to homelessness, abuse, and more addictive behaviors not more opportunities for housing and services.
Dr. Gabe makes an important point about how the biggest obstacles that the battle of overcoming addicting drugs is that the whole battle has become the battle against the addicted. He makes a point that society has molded a context to deal with these particular people. He has outlined that most of the cause because of adverse experience during childhood. He says the victims of addiction are not controlled by conscious decisions but by impulse deeper in the brain. I thought he did a wonderful job trying to not center the problem focusing on addicted individuals but at the problem of society excluding victims of addiction. The example he was using was when he was questioning reconstructing the poor East downtown Vancouver neighborhood was implemented because of saving face for the olympics or the act of humanity? Overall, he makes an excellent point that society has not done enough to focus on the victims of addiction.