Chasing the Scream: The First and Last Days of the War on Drugs (33 page)

I find myself walking in circles through the Downtown Eastside after one of my conversations with Gabor, past addicts who are half collapsed on the street. They are wearing the exaggerated stage makeup of the street prostitute, or hawking drugs or random items they have discovered in dumpsters—old VHS tapes and half-broken shoes. They shout and holler, at me, and at the world.

I picture the look of judgment on the faces of people who stumble into this neighborhood by mistake. I can see them now. The people from stable families, who glance at addicts and shake their heads and say, “I would never do that to myself.” I feel an urge stop them and wave Gabor’s statistics in their face and say—Don’t you see? You wouldn’t do this to yourself because you don’t have to. You never had to learn to cope with more pain than you could bear. You might as well look at somebody who had their legs amputated in a car crash and declare: “Well, I would never have
my
legs cut off.” No. You haven’t been in a car crash. These addicts—they have been in car crashes of the soul.

And then, just as I am rehearsing this self-righteous lecture in my mind, I notice that I, too, am hurrying past the street addicts, with a look on my face that seems a lot like—what? Fear? Disgust? Superiority? Recognition?

All this information had been available in scattered sources before Gabor began to write about it. But, he told me, “What absolutely surprised me was that all this information hadn’t been brought together before. Nobody had brought together childhood trauma, brain development, and the stories of the addicts that we work with, to provide a coherent theory of addiction.”

But—as Gabor is the first to point out—even with these discoveries, our picture is still incomplete. It plainly cannot be the case that all addicts were treated appallingly as kids. It is an important factor in addiction—but it is not enough. As Gabor worked at the Portland, not far away, on another part of the Downtown Eastside, another man was working, a professor named Bruce Alexander. He agreed with Gabor’s analysis about childhood trauma, but he was trying to answer this further question. Some people do not have traumatic childhoods, yet they still become addicts. What, he wanted to know, is going on with them?

As I sat with Gabor over dinner in a Greek restaurant near the end of my time with him, I kept thinking: How should the facts he has uncovered change the way we think about the drug war?

He has shown that the core of addiction doesn’t lie in what you swallow or inject—it’s in the pain you feel in your head. Yet we have built a system that thinks we will stop addicts by
increasing
their pain. “If I had to design a system that was intended to keep people addicted, I’d design exactly the system that we have right now,” Gabor would tell me. “I’d attack people, and ostracize them.” He has seen that “the more you stress people, the more they’re going to use. The more you de-stress people, the less they’re going to use. So to create a system where you ostracize and marginalize and criminalize people, and force them to live in poverty with disease, you are basically guaranteeing they will stay at it.”

“If negative consequences led people to transformation then I wouldn’t have a single patient left,” he says, “because they’ve experienced every negative consequence in the book. Being jailed. Being beaten up. Being traumatized. Being hurt. HIV. Hepatitis C. Poverty.” Gabor looks at me, his eyes sagging a little, as if picturing it all. “What haven’t they suffered yet?”

But what if we replaced this war on addicts with a war on the causes of addiction?

Gabor says that since child neglect and abuse is a major cause of addiction, if we were serious about reducing the number of addicts, we would start “at the first prenatal visit, because already the stresses on the pregnant woman will have an impact on the potentially addictive propensity of the child.” We would identify the mothers who are most stressed and least able to cope, and we would give them extensive care and support and coaching in how to properly bond with their child.

Then, after birth, we would keep carefully identifying mothers who are having problems bonding with their babies and offer them wrap-around care. We would be highly vigilant for the parents who still can’t provide a safe home, or who become abusive, and find an alternative loving home for the child if we had to. These are approaches that would, over time, reduce addiction, instead of deepening it, as our current strategy does. Of course, services to help mothers and vulnerable kids already exist in all developed societies, but outside Scandinavia, they are usually threadbare and chronically underfunded. Wouldn’t it be better to spend our money on rescuing kids before they become addicts than on jailing them after we have failed?

Of all the ideas I have heard, this seems to me to be the one that would have been most likely to save the life of Chino’s mother, and Marcia Powell, and Billie Holiday. It sounds persuasive, I tell Gabor. But what about once an adult addict has already been created? What can we do for them?

For the last ten years of her life, Hannah—the addict who had been removed from her reservation and then starved in a room for three years as a girl—lived in her own suite at the Portland Hotel Society, where she was surrounded by people like Liz and Gabor who listened to her and reassured her she would never be cast out again.

Liz helped her to find the family she had left behind on the reservation all those years ago. Her family came to visit her in her own room at the Portland, and she cooked for them, and she felt proud. When Hannah would fall into her furies and call herself a worthless junkie, Liz said to her: “You are an amazing human being . . . You show more resilience and tenacity and strength than any person I know . . . You’re strong. You’re beautiful. Can you tell yourself today you did an amazing job surviving?”

Hannah never stopped seeking out abusive relationships, and she never stopped drinking, although over time she did transfer from heroin to methadone. She had contracted the HIV virus back when there were no needle exchanges in the city, and so she died in the hotel of AIDS at the age of forty-eight. Because of the Portland, she did not die alone. She was surrounded by people who loved her and admired her.

To the prohibitionists, Hannah is a failure, because she continued using drugs. To the Portland, she was a success, because she knew she was loved.

One day, a very senior government minister came to visit the safe injection rooms, and to meet the addicts. He asked Liz: “What percentage of people who use this place would you consider to be write-offs?”

She paused and looked at him, trying to figure out how to tell him that the answer is none.

Chapter 13

Batman’s Bad Call

Bruce Alexander received his first lesson about addiction from Batman. As a small kid, he grew up on a series of military bases of the United States, where his father was a training officer. One day, he was reading a comic in which a group of crooks beat up a junkie while Batman hid behind a building, watching, impassive.

“Dad,” Bruce asked, “why would Batman just hide there while they’re beating this junkie to a pulp? Isn’t it Batman’s job to stop criminals?”

“Well, really, no one cares if they beat a junkie to a pulp,” his dad replied, “because they’re worthless human beings.”

Bruce believed it. Yet as an adult, on the streets of the Downtown Eastside, he was going to make two of the most important breakthroughs about addiction in the twentieth century—ones that would overturn everything we have been taught.

I first heard about Bruce years ago when I was studying psychology at Cambridge University, and I read about an experiment
¹
he had conducted on rats. At first, it sounded quirky and intriguing, nothing more—but I found that his experiment kept coming into my mind at unexpected moments for years and years. It was only when I decided to begin this journey into the drug war that I resolved to dig deeper.

I met Bruce in the café on the first floor of the library in Downtown Eastside. It is a Spartan place with hard chairs and track lighting, and almost everybody there that fall day seemed to be homeless addicts, warming themselves with weak coffee. Bruce looked a little incongruous there at first: he is a genial gray-haired man in his sixties who looks like both the professor he is, and the Canadian he has become. He wore a smart sweater and a friendly smile. Soon, it became clear to me that my first-glance impression was wrong: he does belong here. Not long after we started talking, we were interrupted by an addict who has known him for years—and knew about his work and what it meant for her. After she had gone, he began—then, and over several subsequent interviews—to tell me the story of his experiment. It was going to change how I thought—about addiction, about some of the people closest to me, and about the world.

In the early 1970s, Bruce was a young professor of psychology at Simon Fraser University in British Columbia, Canada. He was told by the faculty to teach a course called Social Issues that nobody else wanted to bother with. He knew the biggest social issues of the day were the Vietnam War and heroin addiction, and he couldn’t go to Saigon, so he went to the Downtown Eastside. He headed there wearily, to learn just enough to explain it to his students, and no more. The same parade of addicts that Gabor would see years later passed before him on the streets, and he thought of them just as Batman taught him to—as zombies whose minds have contracted to the single drooling dimension of their drug.

Since Bruce was trained in family therapy, he figured that the best way to bring himself up to speed would be to provide counseling to addicts at a local treatment agency.

One of his first patients was Santa Claus. Every Christmas, this man was employed at the local shopping mall, where he would arrive in a helicopter, climb down a rope ladder, ho-ho-ho at the local children, use some smack backstage, and then promise to grant their wishes. Bruce persuaded Santa Claus to invite his parents in for family therapy, since behind the beard and the reindeer, he was only twenty-three. The parents were terrified their son would die; the son felt he couldn’t stop. And one day, they were discussing his work as a smacked-out Santa, and they all began to laugh helplessly.