In the Realm of Hungry Ghosts summary

Like any music lover, Dr. Maté’s soul is moved by particular sounds. But his adoration for music is also accompanied by addiction. This means that no amount of listening will satisfy his cravings. Despite the fact that his obsession distracts him from his marriage, his children, and his profession, he can’t stop purchasing new CDs.

Any passion can similarly become an addiction, whether it’s for reading, working, painting –⁠ you name it. Put simply, an obsessive passion that a person can’t control, and that harms themselves or others, is an addiction.

To paraphrase Harvard Medical School psychiatrist Lance Dodes, addiction resides in people, not in drugs. Drugs alone are not addictive. If that were the case, it wouldn’t be safe to administer painkillers like morphine to anyone, because everyone would get addicted to them. So what determines who does get addicted?

The answer is, in a word, the environment. A predisposition for addiction is primarily established during the earliest years of a person’s life, beginning in the mother’s womb. Stress on the mother while she’s pregnant, for instance, results in high levels of the hormone cortisol reaching the baby. Chronically elevated cortisol harms important brain structures, many of which are implicated in addiction.

Ever heard a public figure advocate fighting addiction through “just saying no?” If so, you’ve come into contact with the War on Drugs, a set of misguided policies designed to curb and prevent drug use through harsh punishments. Despite its stated goal, the War on Drugs has had many tragic consequences – among them excess incarcerations, the ripping apart of families, street violence, political instability, and health disasters. 

More than that, the evidence shows it’s failing miserably at preventing drug use. Between the 1990s and the mid-2000s, the percentage of American high school seniors who smoked marijuana daily more than doubled. So did the rate at which Americans aged 15 to 24 died of drug overdoses between 1999 and 2005. 

Notice how the last section ended with a description of “fighting” addiction? That wasn’t an accident –⁠ much of the language we currently use around addiction centers around war-like metaphors. We think we can “beat,” “triumph over,” or “defeat” addiction. But metaphors are fundamentally unkind. Waging a war against addiction would mean waging a war against parts of ourselves.

Instead of harsh judgments and self-hatred, what we as addicts require to address our condition is compassionate curiosity. It’s simple: just be genuinely curious about your own actions and behaviors.