Kate Johnson's Medical Musings

Life through the eyes of a medical journalist

The War on Drugs: Give Peace a Chance

The War on Drugs: Give Peace a Chance

June 15, 2009

By Kate Johnson

Dr. Gabor Maté wraps a tourniquet around a patient’s arm and instructs him to pump his hand until a vein bulges below his elbow crease. Then he instructs the addict to inject himself with heroin. “I had never imagined that my  medical career would lead me to assist an addict’s self-administration of an illicit psychoactive substance in a musty Downtown Eastside hotel,”  he writes in his book “In the Realm of Hungry Ghosts”. But “under the circumstances it was the best I could do for him”.

As a staff physician at the Portland Hotel and Insite, a residence and safe-injection site in Vancouver’s Downtown Eastside, Dr. Maté has dedicated his work to treating drug abuse and addiction. But unlike the soldiers in the War on Drugs, this soft-spoken crusader has rejected all “weapons”, preferring instead the tools of acceptance and caring. It is Peace, not War that will make a difference, he insists. “The pertinent question is not why the War on Drugs is being lost, but why it continues to be waged in the face of all the evidence against it,” he writes.

“Addictions are a response to a sense of emptiness,” Dr. Maté declared at a recent seminar in Toronto for people who work with addicts. He believes most current policies which focus on addiction serve only to deepen the addict’s emptiness and perpetuate the problem. “The addict is re-traumatized over and over again by ostracism, harassment, dire poverty, the spread of disease, the frantic hunt for a source of  the substance of dependence, the violence of the underground drug world and harsh chastisement at the hands of the law – all inevitable consequences of the War on Drugs.” “Stressing people chronically and mercilessly can in no way promote their capacity for healthy transformation….[we must] envision approaches that rely not on moralizing but on science and humane values…If we want to support people’s potential for healthy transformation, we must cease to impose debilitating stress on their already burdened existence.”

On a social policy level, Dr. Maté is an advocate of decriminalizing the possession of drugs for personal use, and promoting a harm reduction approach – in other words trying to reduce the dangers associated with the addiction until the addiction  can be overcome. That is how he finds himself instructing the addict on how to self-inject heroin, or writing regular methadone prescriptions for more than one hundred heroin addicts. “We are neither condoning nor encouraging addiction: the addiction exists and will continue to savage the person’s life no matter what we believe. Our only choice is between compassion and indifference,” he says.

Dr. Maté works with “the sickest, the neediest, and the most neglected of any population anywhere”, and on this day he is speaking to a group with some equally desperate clientele. As a medical journalist I have no such clientele, but his words are just as relevant to individuals like me and my readers. Because the War on Drugs is not only an impersonal battle fought by policy makers and law enforcement organizations. It is also an intimate struggle endured by parents and grandparents and aunts,uncles and siblings. It is not only fought on the streets in the rough parts of town, it is also fought in the living rooms of suburban, middle-class class homes.

It’s a sad, yet frighteningly common story. A family fight, an ultimatum, a suitcase, and finally, a child’s empty bedroom. Many a parent finally resorts to banishment, unable to accept their teenager’s drug habit. In parenting language this is often called Tough Love – in society it is called Law Enforcement – but Dr. Maté has come to view both as adding fuel to the fire.

As a father and the author of another bestseller on parenting – “Hold on to your Kids”, Dr. Maté has just as much to say about the family War on Drugs, as he does about society’s war. Regardless of the battleground, his call is still the same: lay down your arms and take up the tools of acceptance and caring. “While it is natural for the loved ones of an addict to wish to reform him, it cannot be done,” he writes. “The only way [addicts] can escape drug addictions is if their pain is alleviated.”

At the root of it all is a void of Love, he says, as I explained in an earlier blog. “The void is not in the parent’s love or commitment, but in the child’s perception of being seen, understood, empathized with and ‘gotten’ on the emotional level,” he writes. In today’s fragmented society, even if parents are physically present, they may often be emotionally absent from their children, distracted by personal, marital, medical or professional stresses, he explains. Acting out, and addiction, serve to temporarily fill a child’s feelings of emptiness – but banishment will not break the cycle. “If the developmental roots of the addiction process lie in insufficient attachment, recovery includes forming attachments,” he reasons. And the first step down this road is acceptance and caring. –KJ

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June 15, 2009 - Posted by | Addiction, Parenting, Prevention, Psychology | , , , ,

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