Themes
Key
LitCharts assigns a color and icon to each theme in Chasing the Scream, which you can use to track the themes throughout the work.
Drug Legalization and U.S. Policy
Addiction and Human Connection
Prohibition and the Cycle of Violence
Stories and Human Psychology
Summary
Analysis
To understand the small minority of drug users who do become addicted, Hari visits a group of scientists in Vancouver. Their story begins with Judith Lovi, a Jewish woman living in the Budapest ghetto during the Holocaust. Her husband had disappeared, and her parents were about to be murdered at Auschwitz. One day, she suddenly stopped producing breastmilk for her newborn son, Gabor, who was crying constantly. She called the doctor, who told her that all the Jewish babies he saw were crying. Judith ultimately reunited with her husband, and they escaped to Vancouver. Gabor grew up to become a doctor. And the Budapest doctor’s insight about crying Jewish babies helped Gabor discover the mystery of addiction.
This story brings Hari to a point that he has repeatedly hinted at throughout the book so far: drug addiction is often a response to trauma. The doctor’s comment about crying Jewish babies indicates that, even before they can speak, infants can sense when adults are facing stressful and traumatic situations. And even if they’re too young to form distinct memories of that trauma, it can still have lasting effects on them.
Themes
At the beginning of his research, like most people, Hari assumed he knew how addictions form. He thought that drugs contain “very powerful chemicals” that change people’s brain chemistry and make them physically dependent on those drugs. Indeed, many experiments have shown that caged rats compulsively take drugs like cocaine until they kill themselves. In fact, Harry Anslinger and Henry Williams even agreed on this “pharmaceutical theory of addiction.” But others don’t—including Gabor Maté.
The “pharmaceutical theory of addiction” (which Hari also calls the “drugs-hijack-brains theory”) is such a pervasive, commonsense idea that many readers likely don’t even know that it’s not settled science. Of course, part of why it’s such a popular theory is that it squarely supports the drug war: if the chemicals in drugs cause addiction on their own, then clearly it’s preferable to keep these chemicals out of people’s hands. Yet doctors who reject this theory don’t dispute the clear fact that drugs contain “very powerful chemicals.” Instead, they dispute the idea that these chemicals are the primary cause of addiction. For instance, Hari will soon show that, counterintuitively enough, the rats in the cocaine experiment don’t drug themselves to death just because of the strong chemicals in cocaine.
Themes
Hari interviews Gabor Maté in Vancouver. After becoming a family physician, Maté started working in Downtown Eastside, a rundown neighborhood with one of the highest concentrations of drug addicts in the world. Most North American cities kick addicts out of public housing and off of social support, but this only makes their lives even worse. In contrast, a Vancouver nurse named Liz Evans founded the Portland Hotel Society, which gives addicts housing and tries to treat them as humanely as possible. Most doctors thought she was crazy, but Gabor Maté thought she had a point, so he went to work for her.
In the U.S. and Canada, addiction and homelessness frequently go hand-in-hand, but people rarely question this association. In reality, Hari explains, it’s because rents are expensive and most cities have adopted policies to prevent addicts from getting subsidized housing. Following the drug war’s norms, these cities punish addicts for using drugs by taking away their access to social services. This kind of policy is based on the assumption that the threat of losing services will deter people from using drugs. But the Portland Hotel Society takes the opposite approach, based on the idea that a lack of services like housing is actually one of addiction’s causes. In other words, where drug war policies assume that addiction is a choice that people will abandon if their conditions become poor enough, Evans assumes that addiction is actually a response to poor conditions, so these conditions have to improve before people will quit drugs.
Themes
At the Portland Hotel Society, Maté realized that most serious addicts “spent their lives being chased away or chastised” by authority figures. But Maté was different. Even though he still judged and looked down on addicts, he also listened to them with sympathy. He learned that addicts turn to drugs because they’re the only thing that can prevent them from constantly “feel[ing] disgusting and ashamed.” (Indeed, this describes addicts like Billie Holiday, Deborah Hardin, and Marcia Powell, who all used drugs to cope with traumatic childhood experiences.) Maté concluded that drug addiction is a response to serious emotional damage, not a cause of it.
Maté’s observations strongly supported Evans’s hypothesis: worsening addicts’ living conditions won’t convince them to stop using drugs, because their drug use is generally a response to poor living conditions in the first place. Maté’s patients were all addicted to drugs because they preferred constant intoxication to living with overwhelming emotional pain. While addiction often worsened this pain, it was almost never the original cause. Thus, it makes little sense to treat addiction as the root cause of addicts’ problems. At worst, punitive policies only drive addicts deeper into addiction by amplifying the pain that their addiction helps them withstand.
Themes
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Every day, millions of people legally take opiate painkillers in hospitals around the world. According to the pharmaceutical theory of addiction, they should all become addicts. But in reality, Maté has found, very few do. He concluded that addiction involves two distinct factors: “a potentially addictive substance or behavior and a susceptible individual.” In fact, the highly detailed Adverse Childhood Experiences Study has found that traumatic childhood events significantly multiply the odds of addiction, and that two-thirds of injection drug users can trace their addictions to childhood trauma. Another cutting-edge study found a clear link between indifferent or cruel parenting and drug use, impulsivity, and “personal and social maladjustment.” All this data shows that most people’s common assumptions about addiction are completely wrong.
Maté doesn’t deny that drugs have powerful chemical effects—only that these effects can cause addiction entirely on their own. After all, the pharmaceutical theory can’t explain why the vast majority of drug users, like the patients who receive opiates in the hospital, never become addicted. In fact, blaming addiction on drugs themselves is confusing the symptom for the cause. Ultimately, it’s just another way to scapegoat drugs for the actual problems that lead people to use them. Just like Anslinger once blamed drugs for social unrest, for example, doctors now blame drugs for people’s maladjustment and emotional pain, which generally have deeper, often less readily identifiable causes.
Themes
Both Billie Holiday and Harry Anslinger recognized that there is a relationship between early trauma and addiction, but they didn’t entirely understand why. Neither does Hari, and he wants to find out. A year into her work at the Portland Hotel Society, Liz Evans came up with an answer. A woman named Hannah, who funded her serious alcohol and heroin addictions through sex work, was living at the hotel. Like many indigenous Canadians, Hannah was taken from home and forced into an abusive foster family as a child. One night, she came back to the hotel covered in blood, after a man beat and raped her. While Liz carried Hannah up to her room, Hannah repeatedly blamed herself for everything that had happened to her. Liz suddenly understood that people turn to drugs to deal with this kind of pain.
Hari uses Hannah’s story to clearly illustrate Dr. Maté’s theory of trauma and addiction. Of course, Hari also wants his readers to empathize with drug users by understanding the unbearable levels of suffering that many of them endure. Indeed, Hannah has lived through a great deal of trauma, so it follows that she dedicates her daily life to forgetting as much as possible. Her drug use might make her trauma worse in the long term, but it clearly didn’t cause it in the first place. And when Evans saw Hannah’s trauma up close, she finally understood that childhood trauma follows people throughout their whole lives, unless they manage to resolve it for good. Drug use is a convenient, if temporary, way to cope with it.
Themes
Hari concludes that childhood trauma explains the difference between the minority of drug users who become addicted and the majority who don’t. But understanding this doesn’t make dealing with addicts any easier. Gabor Maté’s patients insult, threaten, and spit at him. (One is a Nazi who taunts him about his grandparents’ deaths at Auschwitz.)
Maté’s ideas about trauma not only explain who becomes susceptible to addiction—they also help explain Hari’s analysis of the drug war. Namely, Hari has pointed out that many people who have caused serious pain and suffering through the drug war first joined it because of their own striking childhood experiences. For instance, Harry Anslinger heard his drug-addicted neighbor’s screams, Chino Hardin had to cope with his drug-addicted mother, and Leigh Maddox joined the police after her best friend was murdered by a drug gang. Just like Maté’s patients, these drug warriors chose to manage their trauma in ways that inadvertently passed it on to others.
Themes
Meanwhile, Maté has developed an addiction of his own: he randomly rushes to the music store and buys CDs he never even listens to. When he learned about the link between traumatic childhood experiences and compulsive behavior, he thought of his own infancy in the Budapest ghetto. He didn’t understand what was happening, but he absorbed Maté’s mother’s stress. Music was the only thing that helped her relax. Still, his patients’ trauma is even more extreme.
Maté connects the dots between his music-buying addiction and his own childhood trauma from spending his earliest years in a Jewish family living under Nazi occupation. Even though he was too young to understand what was happening at the time, he still absorbed his parents’ trauma—and the strategies they used to cope with it. This is why music still helps him relax. Notably, Maté’s analysis of his own childhood also shows that trauma isn’t all-or-nothing—instead, it’s a spectrum, and the more severe trauma people experience, the more likely they are to turn to extreme measures like drug addiction to deal with it.
Themes
Hari walks around Downtown Eastside, wishing he could tell the ordinary people who look down on addicts that addiction is really a response to deep pain. He wonders how the addicts see him. Meanwhile, he notes that childhood trauma can’t explain addiction in its entirety, and he points out that another Vancouver professor, Bruce Alexander, wants to explain the other factors involved.
Hari’s account of his walk shows how Maté’s theory helped him change his perspective on addicts. While the drug war encourages people to think of addicts as evil criminals, Hari has always viewed them with a mix of revulsion and pity. But Maté’s principle about trauma causing addiction enables Hari to truly empathize with addicts for the first time: he learns to see their outward suffering and disarray as reflections of their inward emotional pain and dysregulation.
Themes
Over dinner, Gabor Maté tells Hari, “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.” The drug war attacks, ostracizes, and criminalizes people, which exacerbates the pain that drives them to use drugs. Consequences like incarceration, violence, disease, and poverty simply don’t discourage drug use. The key to actually fighting addiction is providing better health and social services to families, including prenatal care and programs to identify and stop child abuse. These programs currently exist, but they’re inadequate almost everywhere in the world.
Maté’s theory explains why the drug war doesn’t decrease addiction (as people like Leigh Maddox have already pointed out to Hari). The drug market is driven primarily by addicts’ demand for drugs, and this demand is driven by emotional pain and trauma. Thus, the more pain and trauma a society inflicts on its people, the more drug use (and drug sales and trafficking) that society can expect to see. The drug war is specifically designed to inflict pain on addicts—clear examples of this include Harry Anslinger’s persecution of Billie Holiday and the conditions at Joe Arpaio’s jails. Thus, the drug war actually worsens the conditions that lead people to use drugs, so it tends to increase addiction over time. The alternative is to stop scapegoating drugs as the cause of social problems and actually fight the problems themselves.
Themes
Meanwhile, addicted adults need support, reassurance, and acceptance from the people around them. For instance, through her connection with people like Liz Evans and Gabor Maté, Hannah gradually improved at the Portland Hotel and even reconnected with her birth family. Evans believes that all of the people she treats deserve love and respect.
In addition to yielding a different set of policy priorities for society as a whole, Maté’s theory also offers individuals clear, actionable strategies for helping people in their lives overcome addiction. By understanding that addiction is rooted in trauma, people can learn to empathize with the addicts in their lives—and this empathy is exactly what addicts need in order to move beyond trauma and improve their lives.
Themes
