Maté tells the story of “Bruce,” a cardiovascular surgeon in Oregon who was arrested while about to commence surgery for writing prescriptions for addictive drugs for himself. This anecdote leads Maté to ask why a successful doctor with a wife and children would risk everything for his addiction. Maté looks to answer this question by assessing two dominant myths about addiction. First, he assesses the “bad choices” view, especially popular in the 1970s and 80s in America, which stated that drug use and addiction are the result of poor or even immoral choices on the part of the individuals. Such a view not only unfairly blames addicts for their plight but is psychologically and biologically erroneous. Given the neurological strength of addiction, users do not “choose” to remain addicted. As Maté says, citing a recent study, “repeated drug use leads to long-lasting changes in the brain that undermine voluntary control” (214). Thus, repeated drug use undermines the very capacity to resist using.

There is little choice involved either in the initial act of using. For, as Maté explains, individuals come to drugs predisposed to use based on traumatic experiences in their lives.