Close Encounters with Addiction. Gabor Mate

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СКАЧАТЬ external goals and suffering? Well, in North America the answer is straightforward. The popular answer, the legal answer, the social answer, the acceptable answer is just a “choice.” Hence, you have the “Just Say No” campaign by Nancy Reagan. This is the same ideology that in a more sinister way underlies the whole concept of the war on drugs, because it is only if addiction is a choice that it makes any sense to punish those who struggle with it. Only if it’s a choice that people make does it make any sense to attempt to deter them by the imposition of the punitive measures that we visit upon people who engage in substance abuse.

      In the United States, I may not need to tell you, the land of the free makes up 5 percent of the world’s population, but 25 percent of the world’s jail population—mostly because of the drug laws. And the drug laws are mostly based on the simplistic idea that it’s not even worth debating too much because its all a matter of choice. Because if it’s not a matter of choice, if it’s anything else other than choice, what sense does it make to punish people? Clearly, if it’s a choice and if you make the punishment dire enough, you can deter people, but if it’s not a choice, it makes no sense whatsoever. And yet that is the socially dominant response to the dilemma of addiction.

      The other perspective on addiction, which is more accepted in the treatment community, in twelve-step groups, and in the medical community is that addiction is a disease of the brain. Now, of course, there is proof to that. You can do brain scans on addicts and you will see certain surfaces won’t function very well. Furthermore, you can also show on serial brain scans that the longer a person uses drugs, the more fragmentation in brain anatomy will be noticed, the more loss of brain anatomy will be noticed, and the more loss of functioning in terms of psychological and sexual behavior will be noticed. So the disease hypothesis certainly has a lot of scientific grounds for it.

      However, when you ask the question, what causes the disease, the answer that society gives, insofar as it considers addiction to be a disease at all, is that it is a problem of genetics, a problem of heredity. And by the way, the medical profession loves that perspective on everything. You notice I don’t stand still very much. Why not? Because I have Attention Deficit Hyperactivity Disorder, more commonly known as ADHD. And the perspective on that, along with everything else, is that it is largely determined by genes. You just had the bad luck to inherit the wrong set of genes. Now I won’t hold to that perspective at all despite the fact that two of my kids have been diagnosed with it. I just don’t think it is genetic at all. Or rather, very little about it is genetic.

      Incidentally, when I was at KPFK this morning, it was mentioned that a recent study at UCLA showed kids with ADHD have an increased risk of addiction. Once more they’ve reinvented the wheel as this information has been known for at least a decade. That’s fine, another study proves it. If you look at the very issue of conditions like ADHD and autism, childhood developmental disorders, and conduct disorders, and you see the burgeoning numbers, the increasing numbers of kids who are being diagnosed with one condition or another, right away that should tell you that it can’t be genetic, because genes don’t change in a population over a short period of time. They can’t. Not even over 100 years, let alone a decade. So either we are over-diagnosing, or we are better at diagnosing, or indeed there are many more kids who are troubled now.

      If you actually look at the question of why are these childhood conditions, each of which predispose them to addiction, are increasing in our society, then you open up a different perspective, because it can’t be genetic. Something is happening in society that is affecting a large number of people in a similar way; affecting large numbers of children in a similar way. Now for that perspective there is lots of evidence, and not just, by the way, for mental health conditions or the developmental problems of addiction. It’s true of disease across the board.

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