Dr. Gabor Maté, a well-known addiction specialist and author, spent 12 years working in Vancouver’s Downtown Eastside, a neighborhood with a large concentration of hardcore drug users. The agency where he worked operates residential hotels for people with addictions, a detox center and a pioneering injection facility, where drug users are permitted to shoot up and can get clean needles, medical care and counseling.
Born to a Jewish family in Budapest at the time of the Nazi occupation, he and his parents migrated to Canada, where he earned his medical degree at the University of British Columbia. Maté, whose personal experience informs his work, is known for tracing substance abuse problems to trauma that often starts in childhood and spans generations.
His work has been acclaimed, but a Psychology Today columnist suggested that his theories are reductionist and unsupported by data — a contention Maté disputes.
Amid the severe opioid epidemic in the U.S., Maté recently visited Sacramento, where he conducted workshops with addiction specialists and families affected by addiction. California Healthline contributor Rob Waters caught up with him there. The following interview was condensed and edited for clarity.
Q: A big part of your book “In the Realm of Hungry Ghosts” is about how you came to see that childhood trauma and pain lie at the root of addiction. Tell me about your insights.
Downtown Eastside is North America’s most concentrated area of drug use. In 12 years, I worked with hundreds of female patients, and every one had been sexually abused as a child. Men were physically, sexually and emotionally abused, suffered neglect, were in foster care.
Thirty percent of people there are native Indians, what we call First Nations people. For generations, the government abducted their children and sent them to residential schools. Parents were barred from seeing kids. Kids were physically and sexually abused by teachers and priests. Tens of thousands died. Because of multigenerational trauma, native communities have high rates of sexual abuse, violence, addiction and suicide. It’s the most addicted population in Canada.
All addictions — alcohol or drugs, sex addiction or internet addiction, gambling or shopping — are attempts to regulate our internal emotional states because we’re not comfortable, and the discomfort originates in childhood. For me, there’s no distinction except in degree between one addiction and another: same brain circuits, same emotional dynamics, same pain and same behaviors of furtiveness, denial and lying.
Q: You were born into a Jewish family in Budapest during the Holocaust. How did that affect your life?
I was born in 1944, and two months later the Germans came in. Hungary then had the only population of Jews in Eastern Europe that hadn’t been annihilated. Now it was our turn. My mother had a stressed pregnancy. My father’s away in forced labor; she doesn’t know if he’s dead or alive. When I’m 5 months of age, my maternal grandparents are sent to Auschwitz and gassed to death. My mother is 24, terrified and depressed. In October, they start killing Jews in Budapest, taking them to the Danube and shooting them.
When I’m 11 months, she gives me to a total stranger. She said: “Please take this baby out of here because I can’t keep him alive.” I didn’t see her for six weeks. In a child’s mind, that’s abandonment. I got the template for addiction: a lot of emotional pain, which I suppressed.
Q: You write about your own addictions — being a workaholic and binge shopper of classical music, once spending $8,000 in a week on CDs.
I was not addicted to substances but I might as well have been. I couldn’t stop myself. I lied to my wife. I lied to my kids. It doesn’t matter which addiction you’re looking at; it’s the same dynamics.
Q: Last year in the U.S., an estimated 72,000 people died of drug overdoses, most from opioids. The U.S. penalizes drug use harshly and has the largest prison population in the world — 2.3 million people, almost 1 percent of the adult population. Meanwhile, 90 percent of people with substance use disorders in the U.S. are not getting treatment. What’s your take on this approach?
The more pain you cause people, the more you shame and isolate them, the worse they’ll feel about themselves. The more suffering you impose, the more you strengthen their need to escape . . .