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Whatsapp People who had a traumatic childhood are more likely to have issues with addiction.

Addiction, whether to substances or behaviours, can wreak havoc on people's lives. But the addicted mind is complex, and we know from history that there's no easy fix. Now, one physician is attempting to heal the 'hungry ghost' of addiction by looking at addicts' childhood environment. Lynne Malcolm and Olivia Willis report.

Dr Gabor Maté, a physician who studies and treats addiction in Vancouver, has developed a controversial theory after many years of working in the city's Downtown Eastside—one of the most concentrated areas of drug use in North America.

I never met a single female patient over a 12-year period who had not been sexually abused as a child.

Maté plays down the contribution of genetic factors and suggests that addiction goes back to the pain that many people experience in childhood.

'Genes do not cause addictions. At the very most, they will make somebody more susceptible to them,' he says.

'But we know, both from animal studies and from human experience, that even creatures with the genetic predispositions for addiction will not be addicted if they are brought up in a proper environment.

'In the 12 years of work in the Downtown Eastside of Vancouver, working with people heavily addicted to heroin, cocaine, crystal meth and other drugs, I never met a single female patient over a 12-year period who had not been sexually abused as a child.

'I also never met a single male who had not suffered either sexual or other forms of abuse or neglect and abandonment—not once in 12 years.'

According to Maté, large-scale studies show degree of addiction strictly correlates to the degree of trauma people experienced in childhood.

Maté references the Adverse Childhood Experience (ACE) study, which looked at 17,000 mostly middle-class Americans.

'Childhood adversity meant physical, sexual or emotional abuse, the death of a parent, a parent being addicted, a parent being mentally ill, a parent being jailed, violence in the family or a divorce,' says Maté.

The study found that for each adverse experience, the risk of addiction increased exponentially.

'People use drugs to escape the pain that is ingrained in them by their childhood experiences. They use the drugs to escape from the sense of discomfort with the self that is a necessary and unavoidable outcome with childhood adversity,' he says.

According to Maté, most doctors today fail to recognise how the brain itself is shaped by early experiences. Without a set of nurturing, connected and emotionally available adults in our childhood, our brain cannot develop optimally, he says.

'So what you have in the case of adversity is emotional pain, poor self-esteem, shame and alienation, and disturbed brain circuits, and this is the setup for addiction.'

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Although Maté is supporter of the popular 12-step drug treatment program used in Alcoholics and Narcotics Anonymous, he disagrees with the idea that people should accept they are drug addicts 'by nature'.

'Nobody is a drug addict by nature,' he says.

'If you look, for example, at any population, addiction shows up, under certain circumstances, and those same populations don't have addiction when those circumstances are different.'

Of course, many young people try drugs not because of pain or trauma, but rather curiosity or peer pressure.

'If you look at the research, it's in the context of the peer group that most people are introduced to drugs. But being introduced to drugs and becoming an addict are two separate questions,' says Maté.

'I mean, if alcohol was addictive, then anybody who drank would get addicted, but most people don't. It's the same with food, same with sex, same with gambling, same with shopping, same with heroin.

'What causes addiction is if there is a susceptible brain there.'

Maté explains that narcotics serve as a temporary soothing mechanism for psychic pain because they work in much the same way as pain relief.

'Cocaine is a local anaesthetic, it is used that way in medicine. Alcohol, as you know, is an analgesic. Cannabis, as you know, is an analgesic, it's used that way in medicine.

'Not just the drugs, by the way, but all the behaviours of addiction … they distract you from your emotional pain and discomfort.'

As a result, Maté has coined his own mantra: 'The first question is not why the addiction but why the pain?'

It's a question Maté often asks his clients at the Portland Hotel, a residence, resource centre and harm reduction clinic for drug addicts in Downtown Eastside.

He focuses on improving the lives of addicts by examining the how and why of their addictions.

'First of all we have to see the drug addict as ourselves,' he says.

'The only difference between myself and my clients in the Downtown Eastside is they suffered more than I did, hence their desperation for soothing and pain relief was greater than mine.'

Maté believes that society should take a less judgmental approach to the issue of illicit drug use and recognise that our judgement of drug addicts reflects a refusal to deal with certain parts of ourselves.

'If we understood that, we'd have a completely different social approach,' he says.

'We would put the funds and the resources into rehabilitating people, into helping them, and we would also make sure that young families get the proper support.'

According to Maté, the 'war on drugs' is a misnomer.

'You can't make a war on inanimate objects. There's a war on drug addicts is what there is.'

'The jails in the United States and Canada, I would guess in Australia as well, are full of people who suffered trauma in early childhood, began to use drugs to soothe their pain, then began to engage in criminal activity only because the drugs are illegal and therefore expensive.

'What we are actually doing is stressing large numbers of people, which makes it more sure that they are going to stay addicted, because we know that stress is the biggest factor in causing addictive relapse.'

According to Maté, there is so much more we could be doing to combat drug addiction, and at no extra cost.

'We would have to have a complete shift of perspective,' he says.

'All we have to do is consult science and our experience and our hearts, and we know what to do.'

The addicted mind Listen to this episode of All In The Mind.

An exploration of all things mental, All in the Mind is about the brain and behaviour, and the fascinating connections between them.



