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

I have also witnessed officers treat my clients calmly and with kindness, but I know that’s not the face they always turn toward the addict.

The Downtown Eastside addicts are acutely aware of their lack of power in any conflict with authority, be it legal or medical. “Who would believe me; I’m just a junkie” is the refrain I hear over and over again as patients complain of being beaten in jail or on the darkened streets or of being dismissed rudely by nurses or doctors at an emergency ward. Such experiences, for the addict, add more links to the chain of utter powerlessness that began in childhood.

With revolving-door regularity addicts are brought before the courts for crimes they commit to support their substance dependence. A few judges are mindful that addiction came upon these people as a defensive response to what they endured before their eyes went dead: heroin for the pain, cocaine to enliven dulled spirits. Some judges will speak to them with compassion, urge them to reform and offer them what narrow avenues of redemption our social and justice systems provide. Other judges appear to see them as society’s evildoers and miscreants. Empathic judge or hanging judge, both are eventually compelled to send the addict-criminal to prison. Incarcerated in institutions where fear and violence often rule, many will re-experience exactly what they suffered early in their lives and ever since: helplessness and isolation. While on the positive side, jail at times gives people a much-needed break from their compulsive drug use, on release most of them will relapse into drug taking and, of necessity, into the illegal acts required to sustain those habits.

In any war there must be enemies. In the War on Drugs the enemies are most often children like the ones Detective-Sergeant Gillespie could not rescue or rescued too late. They are not the generals, of course, the masterminds or the profiteers. They are the foot soldiers, the ones who live in the trenches—and as in all wars, they are the ones who suffer and die. Or, they become what the military calls collateral damage.

The War on Drugs, from the Hastings-facing window of the Portland Hotel, is manifested in the pregnant Celia kneeling on the sidewalk, handcuffed wrists behind her back, eyes cast on the ground. There was no Detective-Sergeant Gillespie to protect her when, as a little girl, she was raped by her stepfather and subjected to the nocturnal spitting ritual, so in the War on Drugs she has become one of the enemy.

Also a foe in the War on Drugs is thirty-eight-year-old Shawn, who periodically disappears from my methadone practice. When he fails to show for his appointment, I know he’s back in prison. He’s a street dweller and petty thief, so his crimes never result in long jail terms. One time he was gone for nearly a year, but usually the absences last only weeks or months. Cocaine is his other habit apart from narcotics, and like many others, he unwittingly began to use this chemical as self-medication for his undiagnosed and untreated attention deficit hyperactivity disorder. His recollection of school life is typical for ADHD. “I was bored and restless waiting and watching the clock until I could get out of the classroom. I felt like I was in a jail cell. I could never pay attention.”

In an attempt to help him establish a more stable life, his social worker recently sent Shawn to my office with a detailed medical disability application which, if approved, would get him off the street. It would be superfluous to tell Shawn’s life story—the reader will have some sense of it by now—but it is instructive to see how the enemy describes himself. With his permission I reproduce here, precisely as he wrote them, the words Shawn scribbled at the beginning of the disability form:

In My opinion My life as I no it to the truth. It started when I was about 11–12 yrs old and I was in the wrong crowd of people to associaiate with. Because of that my life as been in jail for approx 18 yrs out of 37. from being where I have been and seen what I have seen was a big problem and bad influence on my own life and for example at age of 18 seen a coulpe burttle murders happen within 7–8 yards as well people committing suaside. Plus I have now lived on Vancouver’s worst streets. Skid row and using IV drugs heroin cocaine. Ive lived here homless and in hotel rooms for 15 years minus all the jail time. I have Hepatitus C from IV use. P)luse Ive lost my ability to manage money because of addiction.

I grew with an alchol addiction from the he would Physicly Beat my Mom as was us kids.

Because I’m physically addicted to Methadone I’m very limited to what I can make extra money from, since all this has happened Ive lost a lot of self esteem and get a mild paranoia from other peers. witch I’m on medication for.

This a Breif opion of why I need Disability support.

Thank-You for you Time.

This man with severe ADHD and learning disabilities, post-traumatic stress disorder and deeply entrenched drug addiction; with no employment skills; with no history of successful human relationships—this is one of the culprits the police devote their time, skills and energy to investigating and arresting; about whose misdeeds prosecutors versed in the law gather evidence; whom socially conscious and poorly recompensed Legal Aid defenders assist; and whom learned judges admonish and repeatedly incarcerate. Such is the War on Drugs.

Another foe, now dead, was the Vietnamese refugee Raymond, who wasted away from AIDS, steadfastly refusing treatment for years as the disease corroded his immune system and his health. I never found out much about his life, but there are other addicts in his family and, as far as we could tell, much pain and disconnection. Raymond had been an engineer before he succumbed fully to his addiction. In the Downtown Eastside he survived by running a small-time cocaine operation. Lisa, the child-like crack addict depicted in Chapter 15, had been his client. She, too, is one of the enemy and, as such, deserves to be known a little better. A glimpse into her world and her mind is given by a scrawled note she addressed to the dying Raymond. Once more, I reproduce the document exactly as written:

Mr. Raymond R:

I’m sorry, for been a pain on your butt. But i’m just a drug addict! who can not helpped it on knoking on your door to ask you for help. If I do it againg, and again it’s because i keep my word to pay you and you know that right!

I apreciate what you do for me very much, that is the reason why I respect you and pay you exactly what you give me, sometimes you said I own you less and I tell you the truth by letting you know I own you more.

Raymond: You know, I don’t still or sheet [steal or cheat] specialy to you whom has give me the chance to prove you that I did not use you or hurt you in any way. I haver had hard feelins agains you. Even do you though I stoll your money, I got hurt really bad I could even end up dead just because I was brock and a drug addict you acusme it’s OK we all make mastakes, but why are you saying I don’t pay you when I do.

You know last time you accusse me because you belive these girls, I hope this time you are accussing me in your own with out been told what to do, because you are smart intelegent enough to make your own decitions.

Lisa’s semiliterate plea to her drug pusher for understanding could be turned toward a larger issue. I believe that if all of us as individuals and as a society were “smart, intelegent enough” to make our own decisions, we would not punish the addict or wage a war in which human beings like Celia, Lisa, Shawn and Raymond are treated as the enemy. We would seek peace.

As Lisa suggests, we all make mistakes. The War on Drugs is one of them, as we’ll next see.