Gabor Maté: Cory Monteith death reflects media's lack of curiosity about causes of addiction

It is always big news when a celebrity is stricken dead by a substance overdose. What never makes the news is why such tragedies happen.

The roster of drug- and alcohol-related show-business deaths is ever expanding: Janis Joplin, Jimi Hendrix, Elvis Presley, Keith Moon, Kurt Cobain; in the recent past, Heath Ledger, Michael Jackson, Amy Winehouse, Whitney Houston; and, most recently of all, Cory Monteith. A complete list would, of course, include many others.

The popular media gathers around the famous dead like vultures around a cadaver, picking their stories clean to feed the public appetite for intimate and irrelevant details. What friends did Cory spend the evening before his demise? How does his girlfriend feel back on the set of Glee, the TV program where Monteith found stardom?

My daughter works part-time as a hostess at a bar in Vancouver’s Gastown area. One night, shortly after Monteith’s death, two British journalists showed up.

“We drove up from LA,” they said. “We have heard Cory had some drinks somewhere in this neighbourhood the night he died. We are tracing his last steps. Did he come in here by any chance?”

Clearly, for readers in Britain it was of pivotal importance that these intrepid scribes identify the exact watering hole where the actor may have had his last drinks. They had driven more than 2,000 kilometres to find out.

In our celebrity culture only the demise of a famous person attracts press attention to what is a daily human tragedy across North America and the world. Many other human beings succumb to drugs, an entirely preventable carnage that almost completely eludes public notice. Car crashes, murders, accidental deaths from other causes are the fodder for excited headlines. The death of the drug afflicted passes under the radar.   

If a celebrity suffers, the media deems it essential information. When a famous unfortunate, say, Charlie Sheen, publicly displays his bipolar illness and self-medication with alcohol with a nubile woman on each arm, that rivets media notice. If a star dies, that is front-page material until the next celebrity gives birth or sleeps with someone. But even with all this obsessive focus on one person’s decease from drugs, the question of why this happened (much less why it happens to people in general) is seemingly of little interest.

Striking about the coverage of the Monteith saga was the lack of investigation into what it may have been about life that made this talented young man seek refuge in drug use. There was virtually no discussion of why a number of treatments and interventions, since his teenage years, had failed to divert him from his fatal course.

I was encouraged, therefore, when a reporter for People magazine contacted me for an interview. “Hi Dr Maté. I'm a staff writer at People. We are writing, in the wake of Monteith's death, about the struggles of addicts, the problems of heroin addiction, and the easy availability of heroin in Vancouver. Seems you would be uniquely qualified to talk as an expert, so I'm hoping we can connect…”

I had no high expectations, given People's dedication to superficiality and its adoration of the short attention span. Still, I did welcome this opportunity to inject at least a tincture of science and experience into the public discourse. Even at my age, sometimes my own naiveté amazes me.

It did not matter that the reporter seemed not to have researched my very publicly expressed views, having happened upon my name through a contact in Los Angeles. Here was my opportunity to explain my perspective: Addiction is not the fundamental problem, but the addict’s desperate and doomed attempt to solve a problem—that of unbearable emotional pain, self-loathing, and emptiness.

Trauma and childhood emotional loss are the template for addictions. They instill the pain, engender the self-loathing, and create the emptiness. Crucially, they program the very chemistry and physiology of the brain to make the cerebral circuits more receptive to the soothing or exciting effects of substances. Interventions, treatment programs, laws, social opprobrium do not work—often make the addiction more tenacious, in fact—because they do not address causes, only behaviours. Behaviours are effects and you don’t solve a problem by tampering with effects.

Monteith’s life was a case in point. His parents had divorced when he was seven, after who knows how many years of rancor and stress. He had learning difficulties and, quite likely, ADHD. In the most incisive, and perhaps only in-depth analysis of his history, the wonderful journalist Maia Szalavitz described the appalling treatments he had been subjected to:

"Monteith’s history with ineffective and harmful anti-drug programs started almost as soon as he began using, at 13. Between that age and 16, he attended some 12 different schools, including several aimed at ‘troubled teens,’ a phrase that has become shorthand for harsh programs that we now know can backfire.

“During the years when he was locked inside troubled teen programs—1995-1998—tough love reined. Tactics were aimed at 'breaking' youth through physical and emotional abuse—everything from solitary confinement, punitive restraint and sleep and food deprivation to public humiliation like wearing signs saying, ‘I am an asshole,’ being made to dress in drag and being forced to scrub bathrooms with the same toothbrush you must later use to brush your teeth.”

Monteith experienced the physiological and psychological consequences of early childhood in a dysfunctional home. Effectively bereft of nurturing adult contact, from adolescence, he was traumatized by a system ostensibly designed to help him. It is a near certainty that none of the treatment programs he later attended ever helped him to understand and overcome the impact of trauma: most treatment programs ignore trauma.

The issue, I pointed out, was not “the easy availability of heroin in Vancouver”. A recent New York Times article lamented the growing problem of heroin in New England where, in New Hampshire for example, 40 people died of overdoses in 2012. And heroin is certainly available in LA, where Cory lived and publicly suffered from his opiate addiction. The issue was the terrible misunderstanding, at all levels of our society, of why people become addicted and how they can be helped.

The People reporter seemed genuinely interested in all this material, asked intelligent questions, and expressed appreciation. We spoke for well over half an hour.

The article never appeared, and I didn’t hear from the journalist until I wrote to ask. “The editors were planning a sidebar story on abuse issues with expert commentary, but they scrapped that plan later in the game when space got cut. Sorry about that.”

I understood perfectly. In Britain Kate Middleton gave birth and in Hollywood someone was probably sleeping with someone. How would a discussion of the causes of addiction and of the failure of our current system to understand it compare with matters of such urgent import? 

Can we hope that perhaps the next celebrity casualty will ignite the needed discussion around addiction? Unlikely. What is certain is that in the meantime many other humans, unworthy of notice in the media mindset, will be buried daily—victims of drugs and, even more so, victims of ignorance.

Comments (26) Add New Comment
Seriously, what is there to discuss? Someone chooses to do large amounts of drugs (celebrity or no), they might die. No one can stop another person from doing whatever they want, so talking about why is pretty much a waste of time. I managed to overcome my addictions when I realized it really didn't matter why I did drugs, the ONLY thing that was important was that I stop. That's what I did. I soon realized that I had wasted large amounts of time in my life trying to figure out why I chose to do drugs in the first place. I'm reminded of a question from Buddhist monk Thich Nat Hanh - If your house is burning down, is it more important to go after the person who set the fire (or in this case the reason your house is on fire), or is it more important to put out the fire???
Rating: -44
Won Hung Lo
Why do they intentionally seek out illegal hardcore drugs and not something more attainable like alcohol to drown their sorrows?
Both substances can be addicting.
Where do you even get heroin anyways?
Rating: -64
Good article although Mate ALWAYS overstates what is behind addiction as if it is true for every addict and not as much so for those who do not become addicts. In doing so he creates a harmful labeling which could damage many addicts willingness to admit to addiction. He always leaves out that many addicts do not have the same issues while many people who are not addicts do have all those concerns.
There are most definitely physiological and biological-predispositions for addiction. It is not as one-sided as Mate makes it. However, for those who have those emotional problems, usually they need deep, long-term healing actions to stay straight.
That said, this article points out very well the inanity and superficiality of most of the media coverage.
Rating: +11
Aaron Chapman
The point that the fascination with celebrity is going to be louder than any discussion about the root causes of drug addiction when it comes to these kinds of casualties is arguable. Hoping for some civility and intelligent discussion above the din about what's happening with the Kardashians, or the celebrity diet I suspect might even leave a humanist like Dr. Maté hoping if anybody is going to get addicted and die of drug addiction it might be the readers of those magazines....

But I'd be interested in his analysis in what of those who find themselves addicted, not because of some dark wound in their past like parental divorce or "rancor or stress" that haunts them -- but what makes up another portion of drug overdoses who's lives are "too good" and find themselves addicted because of the addictive quality of the substances? Is there always without fail trauma in an addicts past, and if not how is that treated differently? I know too many people, particularly in music who were having too good a time and "partying", who wound up going the chemical distance without returning.
Rating: -6
Unless you have lived it, or seen someone you love live through it, you have no idea what you are talking about. I highly doubt Cory Monteith or my brother or anyone out there decided "you know what I want to do? become a heroin addict!" No one wants that for themselves. So many can judge and say that it was their choice but addiction is an illness. To the previous commenters: You are lucky people because you can see it that way and have that type of self awareness and internal locus of control to know better than to take drugs to ease your pain. I thought the same for many many years. However now I can see it as a disease. My little brother suffered from anxiety and since there is so little information out there, and such a taboo when discussing any form of mental illness he kept it to himself. He is a heroin addict now. At first I blamed him, then my parents, even myself some days. The reason why we need to discuss why and how one becomes an addict is to raise awareness. Everyone needs to be educated that a drug addict isn't always the person you see strung out on the street, it can be anyone. People who are going through depression, anxiety, or any other form of MI need to know what their options are.
Rating: +40
Admiral Benbow
Personally, I doubt that Cory Monteith was a "heroin addict" as this article seems to imply. He was probably what is known as a "recreational user" which is extremely dangerous and probably more dangerous than a regular or daily user, as overdoses are much more common for a variety of reasons.
Rating: -2
I am currently at onsite detox above insite supervised injection facility and I would like to say if cory had used insite .... he would still be alive GURANTEED!!!!!!! Insite has saved my life and so has onsite!!!!! and guess where it is??? the only place that could have saved his life is in the DTES!!!
P.S I recognize fully (in large part due to Gabor's book.. HUngry Ghosts) that i used drugs because of a life tiem of abuse like Cory, its just too bad he couldn't recognize that before it was too late, and then take responsibility to do something about it..... it's not my fault i am an addict but now i know there is a solution and what that solution is... it's NOW MY RESPONSIBILITY TO DO SOMETHING ABOUT IT.... blaming the DTES is like blaming the producer who paid him millions, saying that the producer was the enabler... bull shit!!!! RIP Cory, my fellow fallen hungry ghost, lord knows there are far too many of us including my own friends!
Rating: +29
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I think a question we should also be asking is why so many more males have alcohol and substance abuse addictions than females? I rarely see a gendered analysis about this problem. Cory Montieth's experience at the treatment programs reflects how troubled the system has been in understanding issues like hegemonic masculinity and taking a gender-sensitive approach. Here's an excerpt from a book I'm reading:

"In 1997, Terrance Real, a family therapist, published a deeply moving book, "I don't Want to Talk About it: Overcoming the Secret Legacy of Male Depression". Drawing from his own painful experiences and those of men he had counseled professionally, Real argued that many of the problems experienced by men, including depression and substance abuse are linked to the male socialization process. Real states that boys are 'greatly encouraged (by their families and society) to develop their public, assertive selves but they are systematically pushed away from the full exercise of emotional expressiveness and the skills for making and appreciating deep connection" (p23). The more brutally a boy is pushed in this direction, Real cont'd, the more likely he will hide and deaden his feelings of vulnerability through compulsive drinking, drugging, womanizing and workaholism and externalize his pain thru explosions of rage and abusive behaviours that isolate him from true intimate contact with others. To help troubled men counter these strong socialization forces and overcome their hidden pain, Real recommends that we show compassion to men, empathize with the shame and fear they have about being vulnerable, help them to recognize the wounded child within them and teach them how to be emotionally expressive and experience true Intimacy."

~"Men Addiction & Intimacy" (2012) Mark Woodward
Rating: -1
Barry William Teske
Fine, all well said and intended.
But the real elephant in the room is still in its corner, stirring together a new batch of addiction.
Addiction needs a distributor.
Without it, addiction has only withdrawal to fear.
But withdraw it can.
There is a huge disconnect to this simple dynamic.
Yes now I'm going to be told how self defeating and useless the war on drugs has been and still is.
Agreed, because it is in that war dynamic the disconnect found new life or competition if you will.
Change or preclude the distribution by new and improved means ie: distribution, and the elephant might just have to leave the room.
The movement to change the distribution dynamic of marijuana provides insight to this new and improved dynamic.
Ending prohibition is also an eye opener as to how this might work.
No, not all abuse of addiction can be stopped.
But the enablers sure do lose a lot of business don't they?

Rating: -26
Some us beat back at the depression from childhood trauma with substances and manage to maintain a level that we can cope in the world and not die from addiction.
"you are the effect not the cause of my ways"
rip Cory.
Rating: +11
I appreciate this as an intelligent discussion of the topic, both on the part of the author and the ones leaving comments. There are valuable insights in every perspective offered. This is definitely a complicated, multivariate issue: addiction, and recovery from addiction affects many individuals in our society (in many different socioeconomic groups, not just in the abused or economically deprived).
As a health care practitioner myself, I often find it very helpful when the "why" behind any health problem or behaviour is investigated, analyzed and discovered. If it can be brought into the person's awareness, avoidance of the damaging behaviour can then be offered as a potential solution. However, it is also important to consider that one can get "stuck" in analysis--thereby creating yet another obstacle or barrier to recovery.
I feel it is important to always remember the "why" as simply another tool that can help lead a person to a solution--but in itself is never the solution to the problem. Different people respond to similar situations in different ways. Similarly, different people respond to different cures in different ways. As we all know, there is not one fix-all solution to any problem. We must be cognizant of individual differences, and ensure first and foremost the person feels he/she is being heard, is felt to be important/cared for, and that the person is reminded the solution to the problem is not only possible (give hope), but is valuable for both that person and for those in his/her community.
How do we go about doing this?
As Dr. Mate mentioned, educate, educate, educate. Talk about the potential sources of problems, not just the effects of the problems.
As W.S. highlighted, be open to different cures. Try things that have worked for others in similar situations. In mirroring what cuz added, we need to also remember that the solution to the problem is what we're looking for, not just the answer to the question: "Why is this happening?"
Finally, I appreciated EMC's comments reinforcing the importance of 'awareness' when considering any problem, as it leads to a more intelligent discussion about a person's options.
My main point is that instead of trying to disregard another's opinion, it is important to consider different perspectives in the interest of the person/people afflicted.
Rating: +27
S Jackson
Many thoughtful comments here. I liked Dr. Maté's article. It is not only the causes of addiction that are ignored by the mainstream media but anything to do with mental health unless there is an axe and blood in there somewhere.

Both visible and non-visible disabilities are of no interest whatsoever, to the detriment of many, since there are more people out there with non visible disabilities than most of us will ever know.
Rating: 0
L. Inglis
I found Dr. Mate's article very informative. I agree that causes and treatments for addiction and mental health issues are multifaceted and individual. I believe that far more compassion for these issues and the people who suffer from them is called for. Fear of harsh judgement from society often leads to "suffering in silence". Until the silence is broken, stigma and misunderstanding will persist. Thank you Dr. Mate' for your compassionate approach. Rest in peace Cory. I'm a "Gleek" through and through and will miss you.
Rating: +3
Wow --- I was interested in reading this Article - as I have been going through 15 years of a Meth addiction-----
True --- I CHOSE to use when I was in the early 20's ---- I used to go to Raves --- do E and K sometimes Crystal meth ----- this was only on the odd weekend......... year after year goes by -- and when I was 30 -- I was like ---- TOO OLD --- gotta stop ------ 5 years later --- counselling / rehab -- finally kicked the habit.

Yes - I chose to use --- but I didn't chose to become an Addict.

Gabor Mate outlines in his book a few theories for how Addictions come about ---- but you have to remember that his major dealings with Addictions was in the DTES ---- homeless / low income --- and yes --- TRAUMA.

And Trauma doesn't have to mean physical or even overt emotional abuse --- it can be as little as not getting being a sibling that is overshadowed by an older brother or sister.....

I came from a middle class family ----- both parents still together ---- both great jobs -----had 2 children who did well academically (myself becoming a Doctor). WHY AM I AN ADDICT??????

That is the question I kept asking myself --- everything was somewhat "perfect" compared to the Situations I have seen other people in. I came to understand that trauma for me --- was being teased in highschool for being gay ---- not only that --- my parents were open about how wrong being gay was ---- so, as a 6 year old boy, knowing that his parents don't like "gay people", I emotionally put up a wall ----

Anyway, this isn't about being gay -- it is about education the "critics" that think Addiction is all "our fault" ---- Do you know, that whenever I get really nervous, or even excited --- (like at an amusement park ) -- that rush of adrenaline you get ---- You ALL KNOW you LOVE to get the adrenaline rush ------- But for me --- that adrenaline rush is hard wired in to my brain -- which has been re-wired over the years of amphetamine abuse ---- My mind and focus will immediately go to using --- and that is difficulty --- our body tricks us into using ----- that trigger bypasses that 2 or so second delay that it takes to process through the higher functions of the brain -- the part of the brain that says "hey ---wait -- you don't want or need this" -- it is like an automatic reaction --- and once that state is reached ---- you need to learn the coping skills to overcome it
Rating: +10
I was a recreational drug user for 45 years. I quit because it started to affect my nervous system negatively. I would still be doing drugs if this didn't happen. I also eat to fill my emptiness. I recognize that I will never be a happy person. I can laugh and in fact have a great sense of humour, but I've always carried inside a deep sadness. Resulting losses over my life have added to this deep feeling of sadness. I get what happened to Cory. He probably felt the same and lived a similar life. We both grew up in the same city. He easily got some heroin when he came to Vancouver, used it randomly throughout his stay, and then, because he was leaving town the next day, decided to just "use it up." Fatal mistake, unfortunately. I've been there. I've done that. I've worked in the corporate world for over 40 years and no one would ever even guess how many and how much drugs I've taken. We hide it well. We hide our pain. And I am certainly not alone. Where did the pain and sadness come from? Who knows. I can't remember ever feeling differently. We are not all born the same, and perhaps some of us with a draw to overdo things like drugs, food, alcohol and sex, just have an extra longing to be complete. To be whole. Maybe we feel separate from others and these outside things help us feel as though we are not separate. But once the stomach empties, the booze or drugs wear off, we can carry it for a while, but then the longing to be a part of the whole kicks in again, and off we go to find something to make us feel connected. To make us feel as though we belong, rather than just being a burden on society or on those whom we love. And we definitely need it to numb the ever-present pain. It's got nothing to do with how much we have, but how little we feel we belong. Those of you who don't or haven't felt this type of pain and emptiness will never understand how it feels. But you will always judge those of us who do feel this way as being "less than you." And therein lies the circle. We become separate once again and believe me when I tell you, because we really are all one, those of us in pain feel the rejection and then we feel like a burden and then it starts all over again. What the world needs more than anything is compassion. That's what Cory needed. Just to be enveloped in the arms of compassion. Peace to you Cory, and thanks Gabor. A thought-provoking article.
Rating: +14
Dennis Ryan
I take my cue on drugs from no other than the late, great Sammy Davis Jr. In an interview he spoke very candidly about his "drug years" and what he did to get high. No surprise, since even at the height of his fame he had to deal with the blatent racism of his time. But when asked why he stopped, his answer was direct: "It just ain't worth it" was his answer. Thank you, Sammy Davis Jr.
Rating: -12
A loved child is a safe child. For a deeper understanding of addictions I highly recommend Gabor Mate's "In the realm of Hungry Ghosts"
Rating: -8
It IS about the ready availability of heroin in Vancouver. Vancouver's original downtown core has become a testing ground for influential people like Dr Mate who have decided that drugs should be easy to find and easy to ingest with little chance of arrest or incarceration in order to further their so-called 'harm reduction' philosophy which runs contrary to the Controlled Drugs and Substances Act and to the Charter of Rights which maintains that governments must maintain a right to personal security for all citizens. These open drug markets entice thousands of individuals from all walks of life and engender more suffering than an even application of the law would. It is time to end the social experiment of Insite and restore order to Vancouver. The behaviour on display in Vancouver's Downtown Eastside on a nightly basis would not be tolerated in any other Canadian city. The civic government abdicates its responsibility to provide a livable, walkable downtown core. The provincial government abdicates its responsibility to provide a reasonable amount of income to welfare claimants, and the federal Conservatives are so afraid of being labelled as reactionaries that they allow this sad state of affairs to continue in pursuit of the centralist vote. What a depressing result for Canada's largest west coast city. Dr. Mate's comments humanize Monteith, but dehumanize every other Canadian by advocating for the long-term availability of hard drugs in Vancouver and beyond. He is a career-driven ideologue who does not care how many bodies he leaves behind.
Rating: -31
I'm glad to see that someone is looking into underlying causes and the different ways in which addiction can be addressed. Too often one-size-fits-all approaches are advocated, simplistic solutions to complex problems, which tend to write off those who struggle. Finding that the program that's supposed to help you is yet another thing that doesn't fit just makes it all worse.

Cory Monteith was very clear about what he felt would have made a difference for him, in the causes he supported and in how he argued for them. He supported outreach programs for people who were at-risk, programs that deal in compassion rather than judgement. He supported ways of giving kids inspiration and somewhere they feel they belong, and helping people who are trying to overcome their difficulties. And he is known for always being kind, treating everyone like they mattered. Over and over again, he talked about the need kids have for somewhere to belong, and he wanted to help provide that for others. We should listen to him all the more because he can no longer speak for those who become lost like he did.
Rating: +3
In reading some of the comments about this article I'm struck by how so many individuals "cling" to certain statements made by the author, and in the end they completely miss the point the article.

I have read a lot of Mate's work, have seen him speak numerous times, and I have worked in the addiction field for 8 years. In addition to all of this I have personal experience. In no way would I profess to be an expert on the topic but I can say with confidence that addiction IS caused by a complex set of factors all of which are interrelated. In the field we call this a biopsychosocial perspective. Mate speaks to this quite eloquently in this article.

It's true that not everyone's trauma looks the same-trauma is defined by the individual who experiences it and not everyone will be traumatized by the same circumstances. For one person it might be a car accident, for another it could be sexual abuse, and for many celebs it's the pressure that goes along with their lifestyle. It's true that often times individuals are enticed to use drugs because they enjoy it, but those who have mental health issues and/or trauma in their backgrounds are more at risk of developing a problem. It is also true that not everyone who has childhood trauma will develop addiction issues, but they often develop many other maladaptive coping strategies-could be unhealthy relationships, eating issues, shopping or gambling addictions, and so on.

The point that Mate is trying to make that so many of you missed, is that we need to stop focusing the behaviour,which in this case addiction. Mate is arguing that we need to put more emphasis on the issues that lead to these maladaptive behaviours AND more importantly try to understand them with a degree of compassion.
Rating: -459


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