Theo grew up with a mother barely able to get out of bed most mornings. By age nine he was looking after himself and drifting into gangs. He coped with coming home to an empty fridge and the emotional abandonment that crept over him like a tattered blanket by turning to his older peers who were happy to look after him. As long as he stole for them, they were there for him. It was, after all, safer for him to do the stealing because he was young and couldn’t be sent to jail if he was caught.

It wasn’t long before he started using drugs as a way to numb himself to the gnawing feelings of neglect that left him lonely no matter how many friends he seemed to have. What other choice did he have? Growing up, Theo just couldn’t find any better solution.

More and more, we are understanding that children who are traumatized during their childhoods grow up to become adults who are at risk of mental and physical health problems. In fact, if you are an adult who was abused or neglected as a child, your chances of developing heart disease, of being obese, and of abusing substances is much greater than for a person who was not maltreated. Early trauma reverberates throughout our adolescence and adult years.

Dr. Gabor Maté, in his intense look at the root causes of addictions, has suggested that the addiction (whether to drugs, alcohol, sex, shopping or gambling) is a search to address the “hungry ghost” inside us who feels unloved and unconnected. The addiction satisfies a need to overcome the pain that lingers from our earlier trauma. What else could propel serious addicts from harming themselves and those they love repeatedly and putting themselves in a perpetual state of discomfort (when not fulfilling their addiction)?

Many others think the same way. One of the most prominent voices in the study of adverse childhood events is Dr. Vincent J. Felitti with Kaiser Permanente in California. He asks a compelling question in relation to the most addictive harder drugs: Could heroin be a way to relieve the profound anguish of early childhood abuse? And might it be for some the best, and indeed, the only coping strategy ever found? Controversially, can we understand such harmful paths to self-healing as an imperfect attempt to undo the traumatic aftereffects of being abused by those we wanted to love us but who neglected their responsibilities? And if addictions are about trauma, then will the war on drugs and other efforts to suppress addictions ever succeed? Sadly, the answer is no.

Addictions are health issues, not issues for the criminal justice system to solve.

Maté tells us that the traumatized child in the grown-up’s body will persist with taking personal risks even when there is the threat of incarceration. The solution is to find ways to reduce the harmfulness of the addiction while addressing the inner need for attachment and safety. That means treatment that shows compassion rather than incarceration. In Vancouver, Maté and others like him have supported over the years a safe injection site called Insite where heroin addicts can take their drugs under the supervision of medical staff who provide them with access to clean needles. It may seem like Insite promotes drug use, but a closer look shows that it brings people who are desperate to cope with past trauma closer to those who can help them, while keeping the entire community safer by decreasing the transmission of disease.

It’s not a perfect solution, but it is at least an effort to solve a problem in ways that makes sense to those who are caught in cycles of self-harm that mask trauma. Whether policymakers like it or not, addiction is a health issue, not an issue of morality or criminality.

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