‘Addicts are predisposed to addiction and do not have a choice’ – Dr Gabor Maté

‘Individuals with addiction are treated vastly differently than those who have physical conditions,’ says addiction expert, author and doctor, Gabor Maté. Picture: Pixabay

‘Individuals with addiction are treated vastly differently than those who have physical conditions,’ says addiction expert, author and doctor, Gabor Maté. Picture: Pixabay

Published Feb 20, 2023

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Medical science is a discipline that boasts of research, new theories and a modern lens for looking at how to eradicate age-old ailments.

Yet, individuals with addiction are treated vastly differently than those who have physical conditions. This is according to addiction expert, author and doctor, Gabor Maté.

Maté has made it his life’s work to shift the practise of medicine to focus not only on physical illness but also on the environment, society, trauma and state of mind in which they take hold.

“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the centre of all addictive behaviours.

“It is present in the gambler, the internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there,’’ he wrote in his 2008 seminal book on addiction, “In the Realm of Hungry Ghosts”.

When he was five months old, his grandparents were murdered by the Nazis in the infamous Auschwitz prison camp in Hungary.

This tumultuous past affected his perspective on society, sickness, and addiction. He moved to Canada in 1956 and earned a BA from the University of British Columbia in Vancouver before working as a teacher.

Maté afterwards returned to university to pursue a career as a doctor. During the next 20 years, he conducted a family practice. Maté, a well-known author, urges society to investigate the conditions that breed addicts in his latest book, “The Myth of Normal: Trauma, Sickness, and Healing in a Toxic Society”, which he wrote with his son, Daniel Maté.

The doctor also critiques the ‘choice’ model. This is the view that individuals readily elect to become addicted. “The ‘bad choices’ view of addiction, which if we’re honest amounts to little more than ‘It’s your own damn fault’ is not only disastrously ineffective; it is utterly blind.

“Most addicted people had little choice even before their habits took hold. Their brains arrived on the scene already impaired by life experience, especially susceptible to the effects of their ‘drug of choice’.’’

On whether those who have addictions choose to stay hooked on the substances, he cites Nora Volkow, the head of the US National Institute on Drug Abuse, who said that recent studies have shown that repeated drug use leads to long-lasting changes in the brain that undermine voluntary control.

“The choice model ignores the question of what would drive a person toward addiction in the first place,’’ Maté said.

The physician also takes issue with the “disease paradigm’’ that is embraced by addiction specialists and various treatment programmes.

However, he sees this model as more compassionate even though it “misses the human element. It separates the mind from the body … Seeing the brain in purely biochemical terms. Personal and social life events filtered through the mind shape the brain over a lifetime,’’ he wrote.

According to Volkow, the brain becomes an impaired organ with diminished capacity to make rational choices and becomes intent on satisfying addictive urges.

“Just as we would not think of blaming the owner of a diseased kidney, it makes no sense to reproach someone for having a ‘sick’ brain.’’

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