I'm not the target audience for this book because I already pretty much agree with Dr. Maté's view of addiction and the war on drugs. I even agree in broad strokes with his spirituality. As a result, I kind of found myself noticing the parts of the book that were more background to it's main thrust. For me, it became a story of the author's spiritual struggle to find meaning in his life.

As a doctor, there were many paths open to him but he chose the one less traveled by. In this context, he celebrates the rawness of life on the streets--people with no buffer other then chemistry from the pain and joy and terror of being alive. He could have had a cushy doctor's existence but instead he chooses to be the savior of the fallen, those forsaken by "the system" and living on the margins. Is this choice somehow related to his having himself been rescued from the Nazi death camps by his parents managing to send him abroad while they remained behind to die in Auschwitz? Is he paying forward his own rescue?

Too young to understand what was happening, he remembers feeling abandoned and rejected by his parents actions. He attributes his feeling of being unwanted and not good enough to that separation and his subsequent psychological problems to an attempt to escape those feelings.

In his view, addiction is an understandable response to unbearable feelings. Those feelings are imagined to be worse than any of the real world consequences of their drug use and thus the threat of punishment will not convince an addict to give up their drug which is their only escape from a much worse punishment. Maté' sees himself in the same situation, compelled to purchase classical music CDs to relieve his inner turmoil. And yet he knows he's not really the same as those he cares for. There's a class difference, and often an education difference as well--one exception being the Ralph who can quote Goethe from memory in between his neo-Nazi drug-inspired rants. Gabor knows we're all just humans but he finds himself judging and lecturing and retreating to his caretaker role.

Gabor wants to assert that he's an addict too, but his classical CD addiction is a first-world problem. He doesn't have to live out on the street. It would be good to get over it but it's not going to kill him. He can mine it for insights into the addictive process and it will help with his book. I see an element of survivor guilt--he, the rescued, wanting to be one of the victims.

Ths book, though insightful and beautifully written at times, is way too long as if Dr Maté thinks he can overwhem his critics with logic. He wonders why obviously failing policies are continued and expanded while he himself simultaneously understands that logic is limited in its ability to cause change. Logic couldn't even change his own addiction. He blames himself for failing to surrender even as he knows self-blame is more problem than solution. He forgives his patients for finding him annoying but he can annoy his readers as well with that same preachiness. In the end I will give him 4 stars rounded up from 3 something as a vote for him to continue his work.