Dr. Gabor Mate on Addiction

Addiction Specialist Dr. Gabor Mate discusses addiction in the documentary The Culture High.

It is interesting to see or to ask who becomes addicted. People can have sex without being addicted to it, they can go shopping, but some people become severely addicted to all these pursuits. Is a pack of cards addictive? Well, no or yes, depending on the individual. So it is the same process, no matter what the addiction is. The only difference is really is that the substance addict is getting the dopamine from an outside substance, whereas the behavior addict is having it triggered from the particular behavior.

If I speak to a group of a 100 people or a 1000 people and I ask: well, how many of you have addiction issues to any substance, a number of you will take their hand up and I say: “What did it do for you? Not what was bad about it, we already know that, but what did it do for you? What was positive in your experience of it? Well, it gave me a sense of peace, it gave me a pain relief, it made me feel more connected, it made me more confident, I could speak now and interact with other people. In other words, the addict is just after wanting to be a normal human being, and the real question is what keeps them from having those qualities in their life and what happened to them? And so that the addiction should be seen not as the problem, although it is a problem, but it is not the problem, it is the addicts attempt to solve a problem in the first place.

The adverse childhood experience studies, done in California, looked at conditions such as physical, sexual, emotional abuse in the child’s life, the loss of a parent through death or rancorous divorce, or a parent being jailed, or a mental illness in a parent, or addiction in a parent, or violence in the family, and for each of the adverse childhood experiences, the risk of addiction goes up exponentially. By the time a male child has had six of these adverse experiences, his risk of having become a substance dependent, injection-using addict is 4600% greater than that of a male child with no such experiences.

Why is that?

It’s because that trauma shapes the brain in such ways as to make the addictive substances more appealing to the individual. That trauma also gives that person the pain that they will try to then escape from or to soothe through the addictive behaviors. It is the social and emotional environment that shapes the actual biology of the brain. So if you want to understand somebody’s addictions you have to look at what created pain in their lives.

The person occasionally has a beer, occasionally smokes marijuana, but generally has no negative consequences, does not impair their health, does not endanger their lives, does not impair their personal relationships, you can’t call those people addicts and you can’t call those behaviors addictive. So that we have to make a real distinction between the use of substances and the addiction to substances. Which then brings us to the war on drugs. Basically the war on drugs is being waged against people that were abused and traumatized in children and have mental health problems. There is enough punishment in there, in the negative consequences of the addiction that we don’t have to add punishment onto that.


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