Chasing the Scream

by

Johann Hari

Chasing the Scream: Chapter 14 Summary & Analysis

Summary
Analysis
Vancouverites constantly tell Hari that Downtown Eastside used to be far worse. They largely attribute its change to a homeless poet and drug addict named Bud Osborn. Hari meets Osborn in his book-filled apartment, and Osborn tells Hari about a fateful day two decades before. Homeless and addicted, Osborn heard ambulances all day and kept wondering if they were for his friends. He ran into a friend named Margaret, who explained that her cousin just overdosed, and then her partner found her body and committed suicide—all right in front of their young son. Osborn remembered his own childhood and thought, “This has to stop.” He resolved to fight the system.
The fifth and final part of Hari’s book strikes a much more optimistic note: it focuses on how reformers have successfully combatted the war on drugs in different places around the world, and it uses these experiences as a springboard to encourage readers to fight for policy change. Bud Osborn’s story shows how even the most powerless and reviled people, like addicts, can make a difference by organizing. Margaret’s story speaks to the profound pain that both drives addiction and results from addiction. Needless to say, Osborn recognized that he and other addicts were living out the same cycle as Margaret’s cousin, and they needed healthier and more effective ways to deal with their trauma than by using drugs.
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Bud Osborn’s father, Walton, was a bomber pilot during World War II. When his plane was shot down over Austria, the Nazis took him as a prisoner of war, but he survived and ultimately returned to the U.S. Walton drank nonstop. When his wife, Patricia, began seeing another man, he had a breakdown, and his friends took him to the local jail to sober up. Walton hanged himself in his cell, and the local newspaper blamed Patricia for his death.
Osborn’s father experienced the kind of deep trauma that Gabor Maté has argued is typical of drug addicts. Just like in Chino Hardin’s family, this trauma passed itself down in a cycle: because Walton Osborn failed to deal with his own trauma from the war, he ended up traumatizing his wife and child through his suicide.
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Patricia and Bud were ostracized, and she fell into alcoholism, too. She started telling Bud that his father died in the war. For many years, Bud thought that she was right—and that his memories of his father were all hallucinations. Patricia would disappear for days at a time, and Bud blamed himself. One day, Bud was forced to watch a man rape his mother in their trailer. He attempted suicide, then started writing poetry, playing sports, and disassociating from the world in order to avoid his pain. Then, he discovered pills and alcohol. In college, he kept attempting suicide, but he also found meaning through poetry.
Just like Walton inadvertently passed his trauma onto Patricia, Patricia ended up inadvertently passing her trauma onto Bud. She led him to seriously doubt his own sanity and worth. Then, her rape further traumatized both her and Bud. Of course, this episode likely explains why Margaret’s story reminded Bud about his own childhood: just as Margaret’s cousin’s child watched his parents overdose and commit suicide, Bud had to watch his mother endure one of the most traumatic possible experiences. Understandably, Bud devoted his life to looking for strategies to cope with his pain.
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Bud Osborn went to New York to volunteer for a government antipoverty program, and he ended up staying in the city. That’s where he discovered heroin. It made him truly feel good for the first time in his life. By helping his traumatic memories fade away, it even enabled him to have sex for the first time—while listening to Billie Holiday. Then, for five years, Osborn fled across the country to avoid fighting in Vietnam. He didn’t use heroin, but he was suicidal. He attempted suicide yet again but failed, so he continued living on the streets. Osborn’s mother contacted him from a psychiatric hospital to report that she was running for president. Osborn decided that he had to leave the U.S., so he fled to Vancouver.
Bud Osborn’s drug use fits perfectly into Gabor Maté’s theory that addicts are people who spend their entire lives in deep pain and can only find relief through drugs. Far from Anslinger and DuPont’s theory that drugs hijack people’s brains and make them crazy, heroin actually allowed Osborn to feel safe and normal for the first time. Moreover, it’s significant that Osborn relapsed into depression after stopping heroin use—again, this supports Maté’s theory that for addicts, drugs are actually the solution to pain (even if they end up causing more pain down the line).
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On the day that Osborn met Margaret, he already knew that the drug war made overdoses far worse. Under drug prohibition, addicts don’t know how pure their drugs are, so they can easily underestimate their dose. And they use drugs in secret to avoid police attention, so when they do overdose, passersby are less likely to find them and call for help. Osborn also knew that several European countries had virtually eliminated overdose deaths by letting addicts use drugs in safe rooms, under medical supervision. He decided that the addicts needed to organize, so he began leading political meetings in a local church.
Many of the key sociological findings about prohibition and addiction are simply common sense to addicts like Osborn. Scientists and policymakers might debate whether banning drugs makes them more dangerous, for instance, but Osborn knew firsthand that it does. And because he knew that other countries had successfully made drug use safer, he knew that it would be possible to do the same in Vancouver. Of course, this echoes Hari’s goal in this final part of his book: he wants activists, addicts, and their loved ones to know that there are successful alternatives to the drug war, and that they do have the power to help create those alternatives.
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At Bud Osborn’s meetings, the addicts agreed to organize patrols to identify and stop overdoses. They also learned to perform CPR. Soon, the drug users started organizing for bigger changes and participating in city meetings to represent their community. They genuinely tried to help others, even when the public was hostile—for instance, when parents complained about needles on playgrounds, Osborn organized a patrol to clean them up. At the time, Vancouver’s conservative mayor, Philip Owen, wanted to lock up every drug addict and dealer, and the police simply ignored drug users’ concerns.
To Hari, one of the main issues with drug prohibition is that it essentially bans collective action to reduce the harms of drug use. The government certainly won’t facilitate this sort of action, and medical professionals and charity organizations that choose to step in often face legal challenges. This is why Osborn’s approach was so ingenious: he got addicts themselves to implement harm reduction strategies. In addition to making their own lives much better, their collective action helped them connect to one another and made them a visible group in local politics. In other words, it gave them a voice and helped them combat the stigma against drug use. Osborn’s activism provides a clear template for how addicts and activists can bring about change in their own communities.
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Osborn and his group formalized their organization, naming it the Vancouver Area Network of Drug Users (or VANDU). They put a thousand wooden crosses in a public park to represent the thousand people the city had lost to overdoses in four years. Then, they started protesting at city meetings with a wooden coffin. Hari notes that these tactics were possible because the Portland Hotel Society ensured that addicts wouldn’t lose their housing for publicly coming out. For the first time ever in the drug war, addicts “were putting prohibitionists on the defensive.”
Like ACT UP’s famous AIDS protests in New York, VANDU’s protests were designed to make the public confront the suffering they were imposing on a marginalized group. Before VANDU’s protests, political inaction’s serious consequences were largely invisible, but VANDU made it impossible to ignore the high death toll from drug prohibition. Hari’s point about the Portland Hotel Society is not just a side comment to connect this chapter to previous ones—it’s actually central to his analysis of why VANDU succeeded. Just as addicts often need love and support in order to stop using drugs, they also needed stable housing in order to have the luxury of protesting. This shows how providing basic services to addicts can have a domino effect by helping them build power and achieve greater political change in the long term.
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To satisfy VANDU, the city gave Bud Osborn a seat on the board. While the rest of the board admitted that they hoped Downtown Eastside’s addicts would all get HIV and die out, Osborn secured funding for VANDU and built a safe injection site. All across the city, people were starting to see addicts as humans with dignity, not worthless monsters. Meanwhile, addicts felt better about themselves because of their participation in VANDU. And for the first time ever, Osborn felt like he truly belonged somewhere. His story supports both Gabor Maté’s theory that trauma causes addiction and Bruce Alexander’s theory that a supportive, enriching environment can solve it.
VANDU’s trajectory shows how marginalized people’s social movements can succeed: they have to build power outside institutions until those institutions let them in. Then, they can use a combination of outside and institutional power to change policy. Once Osborn was on the board, city leaders and residents could no longer view addicts as irrelevant and sub-human. Meanwhile, Hari also shows that political activism can help addicts find the human connection and sense of purpose that they generally need to overcome addiction.
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Quotes
Vancouver still faced a serious overdose problem, so VANDU got the city to declare its first ever public health emergency. While city leaders knew they couldn’t dismiss addicts as irrelevant anymore, there was one holdout: Mayor Owen, who refused to change any drug policies. But eventually, Owen agreed to meet addicts—and he started to understand their problems and stories. He agreed to give VANDU members a voice during public press conferences and open North America’s first safe injection site in Downtown Eastside. He gradually abandoned all of his prohibitionist ideas and came out in favor of legalizing all drugs.
While Osborn and VANDU began achieving greater and greater victories, once again, power trumped truth: Mayor Owen remained totally committed to the drug war’s myths (just like Anslinger, DuPont, and so many others). However, in a remarkable turn of events, VANDU built enough power to make truth win out. Mayor Owen’s switch from prohibitionist to drug activist shows how hearing addicts’ stories and personally connecting with them can be a transformative process. Needless to say, Hari wrote this book in part because of his faith in such stories.
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At Vancouver’s safe injection site, InSite, addicts get clean needles and private booths where they can safely use drugs. It also has trained nurses, counseling services, and a detox center. Vancouver is now North America’s most progressive city in terms of drug policy. Many local residents worried that InSite would increase drug use and crime, but it did just the opposite. In a decade, the neighborhood’s life expectancy increased by 10 years, and its overdose rate decreased by 80 percent.
The public’s initial attitudes toward InSite made sense in the context of the drug war, which presents all drug use as a dangerous crime. However, the program’s effects showed just the opposite: making it safer for addicts to use drugs dramatically reduces the harms associated with drugs. In fact, InSite succeeded where the war on drugs had failed for years. This strongly supports Hari’s thesis that drug prohibition causes the harms usually attributed to drugs themselves.
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When Bud Osborn died of pneumonia in 2014, the city closed off streets and held a huge memorial service for him. Before his death, he finally completed his dream of changing a life through poetry. He read a poem about suicide for a group of high schoolers. One of them had just survived a suicide attempt, and she insisted on keeping a copy of the poem. 
Osborn’s final years show how addicts can overcome pain and dislocation by finding a sense of purpose. Sometimes, paradoxically enough, this doesn’t even require them to give up drug use. His memorial service also shows how addicts can use politics to collectively fight their marginalization and win respect.
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