Setting

In the Realm of Hungry Ghosts is primarily set in Vancouver's Downtown Eastside, a neighborhood notorious for its high concentration of drug addiction and poverty. Dr. Gabor Maté draws from his experiences as a staff physician at the Portland Hotel, a residence and harm reduction facility in this area, where he worked for more than seven years. The book vividly depicts the harsh realities of life for individuals struggling with severe addiction in an urban environment.

While a specific date is not stated, the book's content suggests it covers Dr. Maté's experiences and observations from the late 1990s through the early 2000s. This era coincides with growing debates around harm reduction strategies and drug policy reform in Canada and internationally. The setting reflects a time of increasing awareness about the complex nature of addiction and the need for more compassionate, evidence-based approaches to treatment.

Beyond the microcosm of Vancouver's Downtown Eastside, Dr. Maté extends his analysis to broader societal issues. He explores how addiction manifests across different socioeconomic strata and geographic locations, from urban centers to suburban communities. This wider perspective allows readers to understand addiction as a pervasive issue that transcends the boundaries of any single neighborhood or demographic group.

Characters

• Dr. Gabor Maté: The author and narrator, a physician working with drug addicts in Vancouver's Downtown Eastside. He shares his experiences and insights on addiction.

• Serena: A longtime heroin addict and one of Dr. Maté's patients. Her story illustrates the complex nature of addiction and trauma.

• Celia: Another of Dr. Maté's patients, struggling with crack cocaine addiction. Her experiences highlight the challenges of overcoming addiction.

• Dean: A patient with a history of childhood abuse and drug addiction. His story demonstrates the link between trauma and substance use.

• Penny: A former sex worker and drug addict who becomes an advocate for harm reduction strategies.

• Dr. Maté's family members: Brief mentions of the author's wife, children, and parents provide context for his personal experiences with compulsive behaviors.

Quick facts

• In the Realm of Hungry Ghosts was published in 2008 after Dr. Gabor Maté had worked for over seven years with drug addicts in Vancouver's Downtown Eastside.

• The book's title refers to the Buddhist concept of “hungry ghosts”—beings driven by insatiable craving and addiction.

• In the Realm of Hungry Ghosts won the 2009 Hubert Evans Prize for Literary Non-Fiction.

• Dr. Maté draws on his own experiences with addiction, including his self-proclaimed addiction to buying classical music.

• In the Realm of Hungry Ghosts argues that addiction is rooted in childhood trauma rather than moral failing or choice.

• The book presents controversial views on drug policy, advocating for decriminalization and safe injection sites.

• Dr. Maté uses composite characters to protect his patients' privacy while telling their stories.

• The book combines scientific research, case studies, and Maté's personal reflections.

• In the Realm of Hungry Ghosts has been translated into more than 25 languages.

• The audiobook version is narrated by Daniel Maté, the author's son.

About the Author

Dr. Gabor Maté is a renowned Canadian physician, author, and speaker who has made significant contributions to the fields of addiction, stress, and childhood development. Born in Hungary in 1944, he survived the Nazi genocide before emigrating to Canada in 1957. Dr. Maté's personal history has profoundly influenced his compassionate approach to medicine and his understanding of trauma's impact on health.

After a career as a family practitioner and palliative care physician, Dr. Maté turned his focus to addiction treatment, working with patients in Vancouver's Downtown Eastside. His experiences in this challenging environment have informed his writings and lectures, offering unique insights into the nature of addiction and its relationship to societal factors.

Dr. Maté is the author of several bestselling books, including In the Realm of Hungry Ghosts: Close Encounters with Addiction, When the Body Says No: The Cost of Hidden Stress, and Scattered Minds: The Origins and Healing of Attention Deficit Disorder. His works have been translated into more than 30 languages, reflecting the global relevance of his ideas on the connection between mind and body health.

As a public figure, Dr. Maté has been a vocal advocate for progressive drug policies and harm reduction strategies. His defense of supervised injection sites and criticism of punitive approaches to addiction have sparked national debates in Canada. Dr. Maté continues to be a sought-after speaker, known for his ability to blend personal anecdotes, scientific research, and social commentary in his presentations on health and society.