Dr. Gabor Maté’s Review of Wasted

So we’ve slept on the review by Gabor Maté of Wasted in the Globe and Mail, and while we’re, of course, delighted to get attention from the Globe & Mail and from Gabor Maté, we feel that Dr. Maté has himself wasted an opportunity.

He used fully half of the review of our book to expound on his own theory about the roots of addiction – childhood trauma – leaving the reader to essentially guess at what the book’s science exploration was about. Yes, we could certainly have made mention that much addiction involves childhood trauma. As a psychotherapist, Mike knows all too well how childhood trauma destroys the soul and sends so many to seek relief in substances. But we didn’t choose to focus on the roots of the problem.

We wanted to write about solutions, solutions that haven’t received a lot of ink – like medications, motivational interviewing, and CRAFT (Community Reinforcement and Family Training). We don’t necessarily buy into the disease model, but as long as the Canadian Medical Association calls addiction an illness, it is a duty of doctors to treat it. And that is largely not happening in this country.

We’re all for a substance user who has suffered childhood trauma taking on the difficult work to heal, but wouldn’t it be great if doctors helped treat their symptoms in the meantime? We only wish the esteemed Dr. Maté had taken the opportunity to make readers aware that there is now a broader toolkit to treat our number 1 health problem.

– Mike and Maureen

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5 Comments

Michelle

I had to come here to see how you reacted to the Review by Gabor Mate in the Globe. I am looking forward to reading your book, but the review left me… concerned. I am an – almost – 4 years Sober alcoholic and child of a highly ” functional” ( award winning professional) now deceased alcoholic father. My Sobriety was a tough fight – Counselling, Rehab, After-care. I too almost lost everything (job, house, marriage), but fight I did, and I feel my Sobriety is one of my greatest achievements. I found myself VERY concerned about Mr. Mates review, speaking beyond the content of your book, as I started to question my whole reality and ” trauma what trauma?” I am fortunate that I can’t isolate ” one incident” of this beyond years of being around alcoholic behaviour and then mirroring it in myself, until, well, I wasn’t able to get out on my own. And that was a shock in itself. I looked down really deep today, and I still couldn’t find the “trauma”. And yet I am I chip Carryin – own my own story – (recovering) Drunk. AA has helped me, but I have a good sober friend who can’t abide it, and yet we both live and celebrate our sobriety – we were lucky we both got what we needed at the right time. We know what we are, we just need to keep going and be inspired and hopefully inspire others who struggle just to get out – anyway they can. So thank you for introducing me to your blog, and your book. I look forward to reading. Mr. Mate’s theory does not work for me, but I was concerned I was yet again maybe fooling myself, …. we addicts do that.

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ATNS Team

Hi Michelle, well, when it comes to the issue of childhood trauma, that’s where Dr. Mate and I differ. YES, I do work with people, many of who battle a substance use disorder and suffered childhood trauma. But I also have many clients who grew up in happy homes. In those cases, I think genetics matter a lot more than Dr. Mate thinks. NO you are not fooling yourself. This addiction field is exploding with new ideas, new research. Keep an open mind and know in your heart what is true to you. Great recovery work! Well done. – Mike and Maureen.

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Robert Evans Houston

Addiction is never linear nor is Recovery. All of our stories are never the same. I’m happy that you brought to light the fact that many pharmacology treatments are available to assist in helping people to find Recovery. Here in Canada we are way behind in this science. Aa is the fix all at least in Manitoba where I live. My Addictions do involve childhood trauma, genetics, add, and mental illness but I was never aware of these things until I self medicated myself into an awful place. I have been in Recovery and active treatment since 06/24/2011. My life now at 50 has never been this stable. I loved your books and the show. Keep us informed on how your doing. It really made me smile when you touched on your relationship in Recovery. It made me smile to hear Maureen say she was gonna stick with you. So many people wouldn’t even take a chance on people like us.

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Carla

While I do not buy in to Gabor Mate’s take that all alcoholism/addiction is centred in childhood trauma. I am greatly concerned about offering a pharmacological solution. Addiction is addiction, as most of us with a measure of sobriety behind us know, transferring our addiction from one substance to another is a non solution. Years ago when I was in treatment for the second time , I was offered Antibuse when leaving. It was positioned as a support crutch, but even at that time I looked at it as a band aid that would lead back to drinking. During my active addiction I had used the white knuckle method , as most of us try , with the predictable backslide . I refused the antibuse and sought out support instead. Part of that in the early times were AA meetings. I didn’t find them hugely supportive as my gender was as is typical , under represented. The stories I heard rang true and it did help me accept that I truly suffered from an illness and not lack of character. Focused treatment taking me out of my illness long enough to remember the pluses of living without fog and nausea was the correct method for me. Now with considerable sobriety I can say that I am happy and proud that I did not rely on another drug to distract me from my d/o/c alcohol. We don’t need alcohol/drugs/substances to survive. So much more rewarding and positive reinforecment to achieve sobriety by abstinence. Of course the “no effort, on your part, just take a pill” method you advocate will appeal to the addiction which is in charge of people’s thoughts. Alcoholism is a family disease and almost always a cycle down to the next generation. How unrealistic to sit your children down and say, well go ahead out and have fun but when you are ready to straighten out, here’s a pill. This will encourage irresponsible behaviour and an in and out of addiction society. I don’t think the pharmacological solution is an enduring solution, or an assist to finding recovery.

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ATNS Team

Carla,

Thank you for your comment. We appreciate your experience and very glad you see your disorder as not a character flaw, but a real medical disorder, described by the world’s addiction experts as a “biopsychosocial condition.” And like many medical conditions, especially mental health conditions, as that is what addiction is, medications can help. It is not weak, as you suggest to take a medication to try to beat addiction. It’s about accessing any and all means available to get well. The new generation of medications block opioid receptors in the brain and from the dozens of emails we’ve received, have helped people who fought the disorder for decades, resist cravings and maintain sobriety. Like cancer has chemo, radiation, medications (tamoxifen for instance ) and surgery, a wide variety of options to get well, we are now able to offer a much better menu of options to those battling addiction – CBT, motivational interviewing, mindfulness meditation, Smart Recovery, AA and YES medications.

You say you are “happy and proud that I did not rely on another drug to distract me from my d/o/c alcohol.” Surely because you didn’t need this approach, you wouldn’t deny it to others? So many struggle to maintain sobriety, they cost us tens of billions every year. Isn’t it better for our society to help as many people as possible, as opposed to insisting on “white-knuckling” through a cycle of repeated relapse, because of an outdated belief about replacing one drug with another?

There are many people today who would be dead if it were not for anti-depressants. They don’t work for all, but work for many.

We need the same approach with addiction. And we should not judge or shame anyone for any choice they make to get well, as long as they get well.

Yours in harm reduction,
Mike

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