The work of the PHS appears innovative to its supporters and naïve to its detractors. Part of Maté’s project is to encourage the view that addicts are often a product of childhood trauma. Next, their status of “addicts” becomes more pronounced as society views them with fear, contempt, or both, pushing them to the fringes in the process.

The circumstances that lead to a heightened susceptibility to addiction are already outliers, relative to the non-addicted populace. Addicts are already outsiders in the sense that their pasts do not typically mirror those of the non-addicted. The pain caused by societal ostracism is yet another source of misery to numb with substances.

Society pays lip service to the idea that addicts are people who have made bad choices, and who need help. However, society places addicts viewed as dangerous, subhuman criminals outside the margins of proper society despite claiming an interest in helping them. Even Maté admits that sometimes he feels contempt for his clients. 

Maté uses his own compulsions and obsessive thought loops to examine parallels between him and the substance addicts he treats. His self-scrutiny teaches him the value of self-awareness for those who struggle with addiction. Drugs fill what the title of Chapter 20, “A Void I’ll Do Anything to Avoid,” speaks to.