“Spiritual work and psychological work are both necessary to reclaim our true nature. Without psychological strength, spiritual practice can easily become another addictive distraction from reality. Conversely, shorn of a spiritual perspective we are prone to stay stuck in the limited realm of the grasping ego, even if it’s a healthier and more balanced ego.”  Gabor Maté

“There is no evidence from anywhere in the world that harm reduction measures encourage drug use. Denying addicts humane assistance multiplies their miseries without bringing them one inch closer to recovery. There is also no contradiction between harm reduction and abstinence. The two objectives are incompatible only if we imagine that we can set the agenda for someone else’s life regardless of what he or she may choose. We cannot. Short of extreme coercion there is absolutely nothing anyone can do to induce another to give up addiction, except to provide the island of relief where contemplation and self-respect can, perhaps, take root.

Those ready to choose abstinence should receive every possible support — much more support than we currently provide. But what of those who don’t choose that path? The impossibility of changing other people is not restricted to addictions. Try as we may to motivate another person to be different or to do this or not to do that, our attempts founder on a basic human trait: the drive for autonomy. “And one may choose what is contrary to one’s own interests and sometimes one positively ought,” wrote Fyodor Dostoevsky in Notes from the Underground. “What man wants is simply independent choice, whatever that independence may cost and wherever it may lead.”

The issue is not whether the addict would be better off without his habit — of course he would — but whether we are going to abandon him if he is unable to give it up. Are we willing to care for human beings who suffer because of their own persistent behaviours, mindful that these behaviours stem from early life misfortunes they had no hand in creating? The harm reduction approach accepts that some people — many people — are too deeply enmeshed in substance dependence for any realistic “cure” under present circumstances.

There is, for now, too much pain in their lives and too few internal and external resources available to them. In practising harm reduction we do not give up on abstinence — on the contrary, we may hope to encourage that possibility by helping people feel better, bringing them into therapeutic relationships with caregivers, offering them a sense of trust, removing judgment from our interactions with them and giving them a sense of acceptance. At the same time, we do not hold out abstinence as the Holy Grail and we do not make our valuation of addicts as worthwhile human beings dependent on their making choices that please us. Harm reduction is as much an attitude and way of being as it is a set of policies and methods.”        Gabor Maté

“Addicts should not be coerced into treatment, since in the long term coercion creates more problems than it solves. On the other hand, for those addicts who opt for treatment, there must be a system of publicly funded recovery facilities with clean rooms, nutritious food, and access to outdoors and nature. Well-trained professional staff need to provide medical care, counseling, skills training, and emotional support.

Our current nonsystem is utterly inadequate, with its patchwork of recovery homes run on private contracts and, here and there, a few upscale addiction treatment spas for the wealthy. No matter how committed their staff and how helpful their services may be, they are a drop in comparison to the ocean of vast need. In the absence of a coordinated rehabilitation system, the efforts of individual recovery homes are limited and occur in a vacuum, with no follow-up.

It may be thought that the cost of such a drug rehabilitation and treatment system would be exorbitant. No doubt the financial expenses would be great — but surely less than the funds now freely squandered on the War on Drugs, to say nothing of the savings from the cessation of drug-related criminal activity and the diminished burden on the healthcare system.”      Gabor Maté

“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience,” Maté wrote in his 2010 bestseller, In the Realm of Hungry Ghosts: Close Encounters with Addiction. “A hurt is at the center of all addictive behaviors. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden — but it’s there.”   Gabor Mate      

“Addiction, properly understood, is neither a disease to be cured—though it has aspects of a disease—nor a problem to be eliminated. On the contrary, addiction is the individual’s attempt to solve a quandary. Before we can address addiction, this simple fact must be understood.”

“What is the problem that addiction is meant to resolve? As the Rolling Stones guitarist Keith Richards wrote about his own heroin habit, it can be a search for oblivion. He writes of “the contortions we go through just not to be ourselves for a few hours.””

“Why would a person long to escape themselves? Because, as a result of their life experiences, they are intensely distressed and may feel trapped within their situation”

“To put it another way, all the addictive substances (and addictive behaviors) soothe pain or at least distract from pain. Specifically, abusive substances like opiates are powerful painkillers, both physical and emotional; as is cocaine; as is alcohol.”

“Hence, the question is not why the addiction, but why the pain? And, again, the answer resides neither in genes nor in “choices,” but in the lives and experiences of the addicts.”  Gabon Mate

Dr. Gabon Mate’s website

Addictions and the “false” window of tolerance