In the Realm of Hungry Ghosts is a wide-ranging look at the topic of addiction from a doctor who has had plenty of opportunity to study it. Gabor Mate works at a clinic in Vancouver’s notorious Downtown East Side district, an area rife with homelessness and hard drug abuse. In this book Mate explores addiction through his encounters with his desperate, addicted, but strangely courageous and grace-filled patients — as well as exploring the shadow addiction casts on his own respectable middle-class life.
Mate is careful not to equate his own “socially acceptable” addictions and compulsions with his patients’ drug abuse in terms of the impact on his life and the lives of those around him, but he argues that all addictive behaviors — from his patients’ suicidal abuse of heroin and crack to his own compulsive shopping and spending — are only points on a continuum. Addictive behaviors, he suggests, may have many causes, but all are ultimately driven by our unwillingness as a society to allow ourselves (and each other) to really feel and experience pain, frustration, fear, and all the negative emotions that are part of being human. In a culture in which so much effort and energy is expended on entertaining ways to distract people from feeling human, should we be so surprised that many people — usually those with the deepest wounds from childhood — choose the chemical shortcut to avoid those emotions, and become trapped there?
I found this book extremely engaging and compelling, and it challenged a lot of my assumptions and beliefs about addiction even while it confirmed others — like his rationale for why he likes working with the type of clients he works with: though drug addicts will cheat and steal and manipulate to get a fix, they also have a refreshing honesty — they don’t hide behind a mask of all-rightness; they tell you how they really are and what they really think of you. Which is, basically, why I like teaching the kids I teach rather than a bunch of safe, successful straight-A students.
I guess I approach the question of addiction — its causes and what to do about it — from a different perspective than Dr. Mate does. He works with hardcore addicts who have suffered years of addiction, and as a result of that perspective, he is an outspoken advocate of decriminalization and harm reduction strategies such as safe injection sites and prescription heroin. I work with young people who are often at the beginning of what may turn out to be that kind of life, as well as being a parent of young children who I hope will never use drugs — so I look at it from the perspective of “How do we prevent addiction? How do we make drug use less attractive to kids, and pull young drug users back from the brink so they don’t end up dying in places like the Downtown East Side?” The book didn’t completely convince me that decriminalization of all drugs and radical harm reduction strategies are the best way to go, but his passionate argument against the current “War on Drugs” mentality helped me understand the basis for his views a lot more clearly than I had ever done before.
This book is touching, absorbing, compelling, and challenging. Whatever your interest in the topic of addiction, whether personal or professional, you should read this.