Rethinking How We Treat Addiction: An Interview With Dr. Gabor Maté

Vancouver’s Downtown Eastside is notorious for being one of Canada’s poorest neighbourhoods, where rates of drug use are high and where Indigenous women go missing or are murdered just blocks away from the multimillion-dollar condos of the city’s elites. It’s also the place where Dr. Gabor Maté has made groundbreaking discoveries about the causes of addiction.

“It’s a lot simpler than we think,” says the Canadian physician, who spoke at Harpa on June 12. “Addictions are in every single case the outcome of childhood trauma, and until we deal with that trauma, we cannot heal the addiction.” It’s that thesis that has garnered Gabor both acclaim and critique from others in the medical world. But Gabor says his ideas are nothing new, and are just an extension of what we already know about how people are affected by human interactions. “We’re created in relationships, we develop in relationships, and we suffer because of relationships,” he explains.

Addiction Misconceptions

That’s why Gabor has been outspoken against how people with addictions are treated, and how they are represented in the criminal justice system. “One of the talks I give is called ‘The Seven Myths of Addiction,’ and one of them is that addiction is a choice that people make,” Gabor says. “So if they’re making a choice, then we’re going to blame them for it, we’re going to criticise them, and we’re going to punish them.”

In Canada, Indigenous peoples (First Nations, Métis or Inuit) are disproportionately represented in the country’s prisons. These communities are also disproportionately represented in statistics relating to addiction and childhood trauma. “The people who are in jail, if you do the research, are the most traumatized people in the population,” Gabor goes on. “So we traumatize people, and then they soothe their pain with some addictive behaviour, and then we throw them in jail. Now that’s a criminal system.”

Politicising Medicine

It may not surprise you that these kinds of positions have placed Gabor at the centre of a number of controversies. Some have even taken to calling him the “rebel doctor.”

In Vancouver’s Downtown Eastside, Gabor worked at InSite, North America’s first supervised injection site. At the clinic, addicts can safely inject drugs with clean needles under the supervision of doctors who assist in the case of overdoses. Gabor has vehemently defended this clinic against critics.

But Gabor insists his ideas are not controversial. “When I talk about the safe injection site, what am I saying? I’m saying it’s better if people use sterile water than puddle water from the back alley,” he explains. “Why is that controversial? Is it better if people use puddle water?”

“There’s no intention to become political. The intention is just to heal,” Gabor says. “So things become political not because I’m political, but because everything is.”

Learning From Trauma

One of the reasons his ideas have not caught on yet in the medical mainstream is because of a gap in what students are taught in school, according to Gabor. “You can go to medical school in Iceland or Canada or the United States or Britain, and never hear the word ‘trauma,’” he says. “We just learn about diseases, as if they were the problem.”

Although much of Gabor’s work has addressed issues that may seem specific to Canada, such as heroin users in Vancouver or Indigenous communities that have been traumatized by generations of colonialism, Gabor says his lessons on trauma can be applied everywhere. “The essence of trauma is not what happens externally, but what happens internally,” he says. “And what happens internally is that person feels pain, and that person disconnects from themselves, and that person feels shame. And that happens in Reykjavík as much as it happens in Canada.”

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