Gabor Maté - In the Realm of Hungry Ghosts - Close Encounters with Addiction

Vincent Felitti, M.D., Clinical Professor of Medicine,

University of California, and Co-Principal Investigator,

Adverse Childhood Experiences Study

VINTAGE CANADA EDITION, 2009

Copyright © 2008 Gabor Maté

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Published in Canada by Vintage Canada, a division of Random House of Canada Limited, Toronto, in 2009. Originally published in hardcover in Canada by Alfred A. Knopf Canada, a division of Random House of Canada Limited, Toronto, in 2008. Distributed by Random House of Canada Limited, Toronto.

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LIBRARY AND ARCHIVES CANADA CATALOGUING IN PUBLICATION

Maté, Gabor

In the realm of hungry ghosts: close encounters with addiction / Gabor Maté.

Includes bibliographical references.

eISBN: 978-0-307-37173-7

1. Compulsive behavior. 2. Substance abuse. 3. Maté, Gabor—Mental health. I. Title.

RC533.M38 2009 616.85'84 C2008-903680-8

v1.0

FOOTNOTES

*1As Vancouver is often described internationally, most recently in the New York Times , 8 July 2007.

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*2Infections fester from bacteria injected into the tissues during drug injection and are carried by blood circulation to internal organs like the lungs, liver, heart, spine and brain.

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*3In popular usage “narcotic” may refer loosely to any illicit drug. In this book, as in medical language, narcotics is a term only for opioid drugs either derived from the Asian poppy, like heroin and morphine, or synthetic, like oxycodone.

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*4A patient’s report that a stimulant drug like cocaine or crystal meth has a calming effect is virtual confirmation that he or she has ADHD (Attention Deficit Hyperactivity Disorder). See Appendix II.

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*5Italics mine throughout unless otherwise noted.

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*6 Arbeit macht frei (“Work liberates”) appeared on signs on the gates of Nazi concentration camps, including Auschwitz.

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*7As I do final revisions on the manuscript in October 2007, I’m happy to note that Remy has for the past two months stayed clear of cocaine and is doing well on methylphenidate.

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*8The Cobalt is another Downtown Eastside residence, not under the Portland umbrella.

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*9This paragraph and several others in this chapter are adapted from Scattered Minds —the book I wrote about Attention Deficit Hyperactivity Disorder (ADHD) (Vintage Canada, 2000).

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*10Since I wrote this chapter in February 2006, I have made significant changes in my relation to my addictive habits, as I will describe later.

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*11From dicere (“to say”) and the prefix ad -(“to”).

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*12Remission: an abatement or reduction of symptoms in illness or addiction.

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*13I’m not suggesting here that for those people who do not become addicted it’s safe to use these drugs. I’m making a scientific case regarding the nature of addiction itself.

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*14PET: Positron Emission Tomography; MRI: Magnetic Resonance Imaging. Two recently developed, sophisticated imaging techniques that are now yielding new information about brain structure and functioning.

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*15Head, Affective Neuroscience Research, Falk Center for Molecular Therapeutics, Northwestern University.

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*16The brain structures for conscious recall develop during the first years of life, and aspects of the implicit memory system, which stores emotional memories, are present at birth. (And if they are present then, they likely existed before, as well.)

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*17Such information ought to increase our respect for, and social and cultural support for, the parenting task. No one becomes depressed on purpose and, in my observation, depression in a new mother often reflects a lack of sufficient support in her environment.

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*18As noted earlier, oxytocin is not an opioid. Therefore, it has no relationship whatsoever with narcotic drugs like Oxycet or OxyContin; only the names are similar.

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*19In the human context “maternal” does not necessarily refer to a female mothering figure or to a biological parent. It can also refer to primary caregivers of either gender.

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*20Dr. Bruce Alexander’s soon-to-be published next book is aptly titled The Globalization of Addiction.

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*21 Hold On to Your Kids: Why Parents Need to Matter More Than Peers

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*22Due, for example, to the spraying of pesticides on large tracts of agricultural land to raze hemp or coca or opium crops.

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*23“Sick” here means to go through withdrawal.

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*24Speedball: a combination of heroin and cocaine, prepared for injection

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*25Richard L. Gregory, Professor of Neuropsychology, University of Bristol

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*26B.F. Skinner of Indiana University is considered the founder of the hugely influential behaviourist school of psychology, which focuses only on behaviours, excluding “invisible” factors like emotions from its analysis of human conduct and relationships.

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*27If B.C. accounts for 10 per cent of Canada’s population, the national figure would be about $20 billion annually; by extension, the comparable U.S. sum would be over $200 billion per year.

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*28In nonaddicts methadone is a more potent analgesic than morphine, but addicts on methadone often become tolerant to its pain-killing effects.

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*29Dr. Dan Small, a medical anthropologist at the University of British Columbia, and Dr. Ernest Drucker, an epidemiologist at the Albert Einstein College of Medicine, New York

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*30The White House drug czar was actually reported to have said “slow assisted state suicide,” but we can assume this is what he meant.

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*31And since then, in a nonacademic book for the general public, Magic Trees of the Mind.

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*32The UCLA four-step method is detailed in Dr. Schwartz’s first book, Brain Lock. This slim volume, meant for the general reader, deals with OCD, but it does contain the suggestion that its recommendations may also be used in conditions characterized by the addiction process, including overeating, sexual addiction, pathological gambling and substance abuse.

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*33The Gospel of Thomas

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*34In other words, Step Ten is commitment to the regular, daily application of Step Four. For the Twelve Steps, see Appendix IV.

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*35In learning how to talk to others without judgment and with compassionate understanding, the work of Marshall Rosenberg on nonviolent communication is invaluable. I highly recommend his DVDs, CDs and books, especially Nonviolent Communication: A Language of Life.