Deaths of despair: Gabor Maté urges empathy during B.C.’s toxic drug crisis

A question that’s not often considered is why people turn to illicit drugs in the first place. A world-renowned expert in addiction offers powerful insights.

He’s a best-selling author with millions of people around the world watching his TED Talks and interviews, but Dr. Gabor Maté still calls Vancouver home and wants his fellow British Columbians to educate themselves about the many factors leading to drug use and what he calls “deaths of despair.”

Long before he became a world-renowned expert on addiction and trauma, Maté was a family physician working at St. Paul’s Hospital and the Downtown Eastside. He repeatedly witnessed the effects childhood trauma can have on the brain.

“The more stress, trauma, instability there is in an environment, the less these circuits develop properly,” he explained. “The more traumatic experiences people have in childhood, by far, the greater the risk of addiction.”

Those traumas can range from an acrimonious divorce between parents to sexual assault. Multiple studies outline the link between trauma and addiction, and those with lived experience are increasingly voicing their personal struggles confirming that’s the case.

“Don’t ask ‘why the addiction,’ but ‘why the pain?’” said Maté. “People are desperate to soothe their pain, so desperate that they’ll take the risk of taking lethal (illicit) medications. Well, what is that if not despair?”

Poverty and indifference to suffering

Whether it’s Richmond or Nanaimo, there’s opposition to new supervised consumption sites in some British Columbian communities, even though dozens are operating without much public awareness trained staff are reviving drug users who overdose.

Drug use outside the sites and street homelessness are cited as the main complaints by opponents, while others are uncomfortable with the idea of drug use that could be near children, even though the facilities are behind closed doors. There have even been protests against their implementation.

“Both the science and the empathy is missing from the public discourse,” said Maté. “The more inequality there is in a country, the more addiction there is, the more illness there is, and the more hostility there is.”

Prevention is complicated

Maté is a proponent of harm reduction measures, which he points out aren’t intended as cure for drug addiction, but are intended to prevent the spread of diseases like hepatitis and HIV, while avoiding preventable deaths.

He believes true prevention starts with pre-natal care, so that fetuses aren’t exposed to the mother’s stress while in the womb. Education outlining the link between trauma and addiction for physicians, teachers, and even police and lawyers are also measures he supports to provide emotional support to troubled children as early in their life as possible.

“The most prevalent myth around addiction is that people are choosing to behave the way they are, and therefore they need to be controlled or punished or ostracized,” he said. “We can both protect our children and our neighborhoods – which people have every right to want — but at the same time show humanity to the suffering segments of our society.”

This is the second installment in a five-part series exploring British Columbia’s response to addiction and toxic drugs, as well as factors contributing to the crisis.

Read part 1 here: How B.C.’s approach to toxic drugs and addiction is changing

Read part 3 here: From shame and secrecy to Suboxone: B.C. drug users credit harm reduction for recoveries

Read part 4 here: Detox wait times plummet after B.C. innovates drug treatment intake