Resources / Book of the Month

I’m certain that viewers watching the NBC broadcast of the Olympics this month will not be seeing Vancouver’s Downtown Eastside, a skid row neighborhood where author Gabor Mate cares for hard core drug addicts and works with a team of other professionals who are trying to reduce the harm that addiction causes. Mate describes a gritty world where women sell their bodies for a hit of cocaine and men turn to lives of thievery or worse to maintain a heroin or coke habit. In the midst of this, an institution called the Portland Hotel meets addicts where they are, offering a clean room, decent food and medical care. Addicts are encouraged to get clean and sober, but not required to do so prior to getting services. This technique is called “harm reduction” and Mate sees it as a far more effective form of intervention than the law enforcement model that dominates society’s current approach to the problem.

We’ve all seen and read about the ravages of drug abuse and the “war on drugs” that is being waged by the US to stop drug trafficking and consumption. In this model, the addicit is seen as the enemy. Dr. Mate takes a very different view. Approaching addiction as a problem in brain function, he sees the various human addictions ranging along a continuum. For instance, some ‘high-end’ addicts who lose themselves in work (the classic workaholic) experience escape in ways very similar to those of a low-end heroin junkie. The difference lies in degree, with the workaholic’s problem not nearly as visible as the junkie’s. Yet the workaholic is still absent from his life. He loses himself in work as an escape from painful feelings.

Mate maintains that the socially sanctioned addictions—work, shopping, exercise—stem from, and have the same impact on brain function as do the socially scorned additions—drugs, sometimes alcohol and increasingly, tobacco. He describes addiction as a process and goes into great detail about the brain chemistry behind it. And he is not afraid to get personal, discussing his own struggle with obsessive shopping and drawing parallels between his feelings of anxiety or fear and those of his clients.

This is an altogether fascinating book, which although quite detailed in its discussion of biochemistry and medicine is never boring. Mate incorporates a strong and convincing argument for an end to the “war on drugs” and a heartfelt plea to reallocate the millions spent on law enforcement to the compassionate provision of medical and social services to those suffering from addictions. I highly recommend this book to anyone interested in addiction and/or treatment for it.

--Bonnie McEwan