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Why use drugs?

A longtime Downtown Eastside resident challenges this question by asking a better one: What happened?

July 3, 2025

What does the average person see when they walk the Downtown Eastside?  

The first thing they see is homelessness, poverty. Some construct makeshift shelters. Some sit on the sidewalk surrounded by possessions that are vital for survival.  

Then, of course, they see rampant drug use everywhere. People using drugs. People passed out on the sidewalk. People bent-double as they walk. People talking to themselves, having conversations with invisible enemies — a sad and sometimes disturbing symptom of their mental illness and drug use.  

People with horrible wounds or sores on their bodies from picking at themselves while high on crystal meth. People with swollen feet and ankles as a result of what we call “street feet.”  

So what does the average person think when they see all this? Some may think: How can they live like this? Why don’t they change their lives? Why don’t they stop using drugs? Why do they want to be high all the time? Why do they choose this kind of life? Some may even think: Why don’t you just die already rather than live your awful life? 

These may be some of the most common questions that the average person may ask themselves.  

But instead of why, here’s what I think the better question is: What happened?  

What happened that resulted in them being this way? Why drug use?  

I like to refer to Dr. Gabor Maté — a trauma and addictions expert who has worked extensively in the Downtown Eastside, He has conducted many interviews and sessions with drug users who have shared their stories. 

According to Maté, addiction is not a choice and it is not inherited. Drug use distracts people from their pain. Addiction is an attempt to solve a problem. 

For example, Maté says that out of all the Indigenous women he has conducted interviews with in the Downtown Eastside, all of them said they were sexually abused as a child.  

Trauma impacts people’s lives, especially at a young age, and often becomes the root cause of drug addiction. According to Maté, a child’s brain doesn’t fully develop when affected by abuse. The neural pathways that release natural dopamine and opiates needed in natural growth of the brain become blocked or inhibited — making street drugs all the more attractive. 

Among many of Maté’s bestselling books on trauma and addiction, he lists seven main consequences of childhood trauma. 

The first is separation from self. Take gut feelings, for example. Have you ever had a gut feeling that you ignored and were sorry for it after? Gut feelings are the strongest guide for what a person needs in the world. We lose them when we feel disconnected from ourselves.  

The second consequence is feeling disconnected from others — feeling alone and isolated. 

The third is an altered world view. However you see the world is the world you live in. Trauma distorts your view of the world in a negative way. You see the world as hostile and dangerous.  

The fourth is lifelong pain, wounds that never heal that you need to escape from until you somehow recover. 

The fifth is brain development. Fetal Alcohol Syndrome, for instance, inhibits brain development in the womb. Also, for those who grow up with substance-using parents, the child becomes the parent’s caretaker, forgetting his or her own needs.  

The sixth is personal shame. Trauma results in people having a shame-based view of yourself, which totally degrades your self-esteem and self-worth, and impedes your personal growth. 

The seventh is difficulty being present — you become stuck in the past. You think you’re in the current time, but actually you’re reacting to the past in most situations and interactions. 

These are serious issues that people with trauma have to deal with. They can’t do it alone and there are not enough resources to help them. I hope that Maté’s research has helped shed some light on any questions, and how you or your friends perceives the events and the people that are caught up in drug addiction.  

You may ask yourselves what can be done to help these people? You might wish there was some way that you could help. You may experience a sense of helplessness, and that’s OK. It just shows that you’re a good person. 

The fact is, there are things that you can do to help. You could email your local MLA and express the need for building more low-income supportive housing. More bed-based community treatment centres. More detox centres. 

You could promote safe supply for all to help put a stop to the toxic opioid crisis and save lives. More mental health teams to help with mental illness. You can use your voice — you have a say in what goes on in this city. 

If you do choose to do any one of these things, then from the bottom of my heart, I thank you.   

Richard Young has been a part of Megaphone for seven years, first as a vendor. He is now a member of The Shift peer newsroom as well. He volunteers at Agape Church in Burnaby and is also a “Chinatown ambassador” as part of the Chinatown Community Stewardship Program, fostering a more harmonious community in and around Chinatown.  

Published in Megaphone magazine on July 4, 2025