Don’t Ostracise Drug Users – Empathise With Them

Award Winning Trauma and Addiction Expert Dr Gabor Maté.

Dr Gabor Maté was recently awarded the Order of Canada for his work on trauma and addiction. The following is adapted from his book ‘In the Realm of Hungry Ghosts: Close Encounters with Addiction’: #HealingTrauma

“From Abraham to the Aztecs, ancient cultures exacted human sacrifices to appease the gods – that is, to soothe their own anxieties and to placate false beliefs. Today, we have our own version of this, as evidenced by the overdose crisis sweeping North America.

These lost lives are offered up, we might say, for the appeasement of our own false beliefs and denial. Addicted people are victimized by our society’s disinclination to come to terms with the root sources, psychology and neurobiology of addiction, especially of substance dependence.

We could stem the fatal tide, end the sacrificial cycle, if we grasped what drug use is really all about, recognized the universality of addictions throughout our culture and adopted practices that reflected reality rather than prejudice:

In other words, if, instead of ostracizing drug users, we grounded our approach in science and empathy.

These “ifs” have never been more urgent than now, and not only because of opioids and other substances of addiction. The World Health Organization has declared “gaming disorder” to be a significant threat to mental health and social functioning.

‘Gaming disorder’ is now a medical condition, but not all experts agree with that designation. Hopkins alum Michelle Colder Carras says the decision by the World Health Organization lacks nuance and may overlook important social components of gaming. #YouBelong

Need we mention the devastating prevalence of addictive overeating, sexual compulsion, pathological gambling or shopping? Or the lethality of perfectly legal habits such as cigarette smoking or excessive drinking.

We shame and marginalize drug users to camouflage our discomfort with the broad reach of addiction in our culture. The essence of all addictive habits was succinctly expressed by former heroin user, Rolling Stones guitarist Keith Richards:

“It was a search for oblivion, I suppose, though not intentionally,” he writes. “The convolutions you go through just not to be you for a few hours.”


Why are people so uncomfortable in their own skins that they need to escape themselves, even at the risk of self-harm? What engenders such unbearable pain in human beings that they would knowingly risk their very lives to escape it?

“We need to talk about what drives people to take drugs,” the famed trauma psychiatrist Bessel van der Kolk has said, pointing out that there is almost a direct correlation between childhood trauma and addiction.

“People that feel good about themselves don’t do things that endanger their bodies… Traumatized people feel agitated, restless, tight in chest. You hate the way you feel. They take drugs in order to stabilize their bodies.”

Pioneering Trauma Expert Bessel van der Kolk.

“I’m not going to ask you what you were addicted to,” I often say to people, “nor when, nor for how long. Only –whatever your addiction – what did you like about it? What, in the short term, did it give you that you craved so much?”

Universally, the answers are: “It helped me escape emotional pain… it numbed me… helped me deal with stress… gave me peace of mind… a sense of connection with others… a sense of control.”

Such responses illuminate that addiction is neither a choice nor primarily a disease, genetic or acquired. It originates in a person’s attempt to solve genuine human problems: those of emotional loss, of overwhelming stress, of lost connection.

Hence my mantra: the first question is not, “Why the addiction?” but “Why the pain?” In my 12 years of work in Vancouver’s Downtown Eastside, the answer could not have been more stark. Every single one of my female patients had suffered sexual abuse as a child.

Janine Henry. #March4Justice

None of my patients – male or female – had been spared major trauma of some kind. Not all addictions stem from such severe hurt, but all are rooted in sorrow, helplessness, and alienation.

“Even the most harmful addictions serve a vital adaptive function for dislocated individuals,” Bruce Alexander writes in his seminal work, The Globalization of Addiction: A Study in the Poverty of the Spirit. “Only chronically and severely dislocated people are vulnerable to addiction.” By dislocation he means “an enduring lack of psychosocial integration.”

Psychologist and Professor Bruce Alexander.

Whether we call it dislocation or trauma, there is no effective way of addressing addiction without addressing its fundamental origins. As a society we are far from embracing this inescapable truth, in face of all the scientific, narrative and epidemiological evidence for it.

Forty years ago, I graduated from medical school at the University of British Columbia without ever, in four years, hearing a single mention of psychological trauma and its impact on human health and development. Disturbingly, nor do most medical students even today, despite the voluminous and persuasive research linking trauma to mental and physical illness and addiction.

“What the data look like is a society gripped by despair, with a surge of unhealthy behaviours and an epidemic of drugs,” the Nobel Prize winning economist Paul Krugman wrote in The New York Times back in 2015. The situation has only grown more dire since then.

Nobel Prize winning economist Paul Krugman.

How are we to address the manifestations of despair without addressing the despair itself? How are health practitioners to help people when they themselves remain ignorant – by training! – of the source of the problems their patients present with, when academia and major treatment institutions have yet to absorb the new knowledge? How, in the absence of awareness is the legal system to address addiction? How is the political system to confront it rationally?

Compassion Prison Project, USA. #YouBelong

How, in the end, can society cope with an epidemic it misperceives? The circumstances that promote despair – and therefore, addiction – are with each decade, more and more entrenched in the global industrialized world:

more stress, more economic insecurity, more inequality, more fear, more anxiety among youth, more isolation and loneliness. As the magazine Adbusters noted: “You have 2,672 friends and an average of 30 likes per post and no one to have dinner with on a Saturday.”

Greta Thunberg, Climate- and Environmental Activist with Asperger’s.

If there is any positive glimmer in the current opioid crisis, it is the possibility of change. We are being forced to re-examine our assumptions. Harm-reduction practices, such as supervised drug-use sites are now being implemented across the country.

Two of our national parties are at least discussing ending the insanity of the so-called War on Drugs (really a war on traumatized people), of adopting the realism and humanism of a country such as Portugal, where the possession of substances for personal use has been decriminalized, with remarkable results.

Chasing the Scream: The First and Last Days of the War on Drugs by Johann Hari

Johann Hari’s world famous TED Talk Everything you think you know about addiction is wrong:

“The opposite of addiction is not sobriety. The opposite of addiction is connection.”

Beyond legal questions, heartening possibilities for healing arise from a broader understanding of addiction and from an appreciation of its sources in human suffering.

Required for treatment is a multilevel approach that accepts people as they are, in which compassion replaces stigmatization and rehabilitation supplants punishment.

This would include: Supervised drug-use sites in as many communities as feasible; for those who need them, medically supervised opiates or opiate substitute maintenance, while for others, abstinence-based programs, without legal or moral coercion; for all, personalized trauma therapy, recognizing that there is no one-size-fits-all solution. Everyone working with addicted humans needs to be trained in trauma.

We also have much to learn from the resilience and age-old teachings of those who among us who have, as a community, suffered the most from trauma, dislocation, and addiction: the people of Canada’s First Nations.

No Pride in Genocide. #YouBelong

Their traditional values always emphasized communality rather than dog-eat-dog individualism, restoration of the fallen to the community rather than retribution, inclusion rather than separation, and, most importantly, a view of human beings that balances our physical with our mental, emotional and spiritual needs.

Current social, legal and medical responses to addiction have long ago demonstrated their inadequacy. Our mounting losses, our needless human sacrifices, cry out for a radical revision.

Uncle Jack has appeared in films, plays and television shows since the 1970s. A member of the ‘Stolen Generations’, taken from his mother when he was just a baby and sent to a boys’ home where he was abused, he was also homeless and addicted to heroin. In 2019, he was awarded a Lifetime Award at the National Indigenous Art Awards.

Source: Dr Gabor Maté (2018). Special to the Globe and Mail. Human development through the lens of science and compassion:

Now you know the power of Trauma Informed Care. Let’s turn this framework into a mindset for personal, social and political change. If you are unable to, you might need help first, to get safe or become ‘unstuck’ from trauma. Reach out for trauma informed care. #YouBelong

With love,

Dr Louise Hansen
PhD in Psychology.
Human Rights Activist.

#HealingTrauma #Justice4Australia #YouBelong

Florence + the Machine – Dog Days Are Over (2008):

“Happiness hit her like a train on a track
Coming towards her stuck still no turning back
She hid around corners and she hid under beds
She killed it with kisses and from it she fled
With every bubble she sank with her drink
And washed it away down the kitchen sink
The dog days are over
The dog days are done
The horses are coming
So you better run
Run fast for your mother, run fast for your father
Run for your children, for your sisters and brothers
Leave all your love and your longing behind
You can’t carry it with you if you want to survive
The dog days are over
The dog days are done
Can you hear the horses?
‘Cause here they come
And I never wanted anything from you
Except everything you had and what was left after that too, oh
Happiness hit her like a bullet in the back
Struck from a great height by someone who should know better than that
The dog days are over
The dog days are done
Can you hear the horses?
‘Cause here they come
Run fast for your mother, run fast for your father
Run for your children, for your sisters and brothers
Leave all your love and your longing behind
You can’t carry it with you if you want to survive
The dog days are over
The dog days are done
Can you hear the horses?
‘Cause here they come
The dog days are over
The dog days are done
The horses are coming
So you better run.”


For all of us, lost or found, in between.
“The Uluru Statement from the Heart is an invitation from First Nations to all Australians to realise a better future. Learn more and help us educate other Australians.”

“Not everything that is faced can be changed, but nothing can be changed until it is faced.” – James Baldwin
“Feeling overwhelmed by the amount of support we received overnight! We’re able to fund one more Indigenous Psychology student for a full three year Psychology degree from just a 10 minute appearance on ABC #TheDrum.” – Dr Tracy Westerman AM

If you would like to donate, please visit:
My partner Marcelo Alegre Rubic who taught me do not let anyone control your life. #YouBelong

Trauma Informed World was inspired by Kopika and Tharnicaa; two faces that remind us everyday of Australia’s cruel refugee system. One of many systems in Australia that remind us of the negative operation of power. #HomeToBilo

Kopika (left) and Tharnicaa (right) were kept at Christmas Island Detention Centre for nearly two years despite trauma informed calls to return them to Biloela, Queensland. Tharnicaa has spent most of her life detained by the Australian Government and is still in community detention to this day. #YouBelong

***Since the creation of this website the Biloela family were released from detention, returned to Biloela and granted permanent protection in Australia. However, hundreds more people still remain stuck in a system that requires urgent reform.***

Welcome to the Kaldor Centre for International Refugee Law. Join us to make positive changes for refugees around the world.

New Kaldor Centre policy brief proposes reforms to Australia’s temporary protection system | Kaldor Centre:

You can listen my talk with Dr Cathy Kezelman AM, President of Blue Knot Foundation on my own healing journey, training and study and how it has informed my work and advocacy for a trauma informed world here:

Trauma Informed World acknowledges and respects Aboriginal and Torres Strait Islander people as the Traditional Custodians of the land and waterways on which this educational resource was inspired. I acknowledge and respect Elders past, present and emerging. I honour the continuation of educational, cultural and spiritual practices and celebrate the extraordinary diversity of people and relationships worldwide. This website contains images of deceased persons. There are also swear words in some of the songs presented that portray intense emotions. This website is not intended to trigger people who have experienced trauma. However, if you do find any of the content triggering, each page has a link to Australia’s National Helplines and Websites for immediate mental health support. These are my own personal views and comments and may not reflect the views of my employer.

Australia’s National Helplines and Websites:

To provide the best information possible, Beyond Blue has listed national helplines and external services. All services linked to Beyond Blue are reviewed before they are posted.

Published by Dr Louise Hansen

This is a free educational website on Trauma Informed Care for survival and wellbeing. While each injustice differs, all stories share the same trauma: the negative operation of power. Let’s break the cycle of injustice and trauma together one day at a time. The byproduct of clarity is peace. Joy is peace dancing. Trauma is disconnection. Empathy fuels connection. Knowledge is power: “Love is the absence of judgment.” – His Holiness the Dalai Lama. #YouBelong

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