Confessions of an English Opium-Eater (1821) is an autobiographical book by Thomas De Quincey. Maté quotes from the book throughout In the Realm of Hungry Ghosts, showing parallels between De Quincey’s addiction and childhood, his own compulsions, and the situations of his patients.

De Quincey writes, “What was it that did in reality make me an opium eater? Misery, blank desolation, abiding darkness” (6). The misery and desolation he refers to are equivalent to the intolerable voids that Maté sees in his addicted patients. De Quincey’s insights are relevant to modern day addicts, healthcare professionals, and policy makers who are involved with drug laws.

As early as 1821, there is an articulate record of the escape that drugs can provide. Maté says that drugs “provide a route to feeling alive again, if only temporarily” (39). He then quotes De Quincey’s description of opium’s ability “to stimulate the capacities of enjoyment” (39). 

The Buddhist wheel contains six realms. When combined, they comprise the entirety of human existence. Every aspect of human existence finds representation within one of the six realms. The realm of hungry ghosts is the realm of the addict. Maté describes its inhabitants as:

creatures with scrawny necks, small mouths, emaciated limbs, and large, bloated, empty bellies.