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Prisoner of War

Gabor Maté, a leading expert on Downtown Eastside addiction, introduces the enemy in our so-called war on drugs
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Gabor Maté, a leading expert on Downtown Eastside addiction, introduces the enemy in our so-called war on drugs

Shawn is a heroin-addicted patient of mine who periodically disappears from my methadone practice. One time he was gone for nearly a year, but usually the absences last weeks or months. When he fails to show for his appointment, I know he's back in prison. He's a street dweller and petty thief, so his crimes never result in long jail terms. Like most Downtown Eastside petty criminals, he steals or deals to feed his drug habit.

Shawn (not his real name) grew up in a small town in Ontario, the child of an alcoholic father and a much younger, intimidated mother. Like many addicts, he unwittingly began to use cocaine as self-medication for his undiagnosed and untreated attention deficit hyperactivity disorder. His recollection of school life in Kelowna is typical for ADHD: "I was bored and restless waiting and watching the clock until I could get out of the classroom. I felt like I was in a jail cell. I could never pay attention." Self-medication became addiction, to heroin as well as cocaine, and another criminal was created.

Canada's war on drugs-or, more accurately, on drug addicts like Shawn-is about to heat up. The Harper government is proposing legislation to increase the penalty for possession of illegal substances. In any war there are enemies-in this case, human beings whose childhood traumas have driven them to find relief in the use of psychoactive chemicals like heroin and cocaine. From a physiological perspective, these drugs are painkillers. As a physician working with drug-addicted people on the Downtown Eastside I can verify what the research literature has made abundantly clear: in the vast majority of cases, injection drug use is the result of overwhelming trauma in early life. Such trauma not only sets up a lifelong psychological craving for chemical relief; it also primes the neurobiological brain circuits that respond to narcotics and other street drugs.

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