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

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      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.




      Aug 14, 2013 at 5:22pm

      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???

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      Won Hung Lo

      Aug 14, 2013 at 6:00pm

      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?

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      Aug 14, 2013 at 8:53pm

      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.

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      Aaron Chapman

      Aug 14, 2013 at 10:09pm

      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.

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      Aug 14, 2013 at 11:01pm

      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.

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      Admiral Benbow

      Aug 15, 2013 at 3:56am

      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.

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      Aug 15, 2013 at 7:19am

      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!

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      Aug 15, 2013 at 7:41am

      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

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      Barry William Teske

      Aug 15, 2013 at 7:56am

      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?

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      Aug 15, 2013 at 7:57am

      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.

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