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The reviewer Phillip Smith seems ignorant of what a genetic predisposition means, and explains. Genetics actually explain the very question you ask:

"Unlike the NIDA people, with what I consider to be their neuro-bio-pharmacological determinism and reductionism, Maté goes a step further. He points out, accurately enough, that no matter what substance we're talking about, only a fraction of users, typically between 10% and 20%, become addicts. The 'chronic relapsing brain disease' model may have some utility, but it fails to explain why some people are susceptible to addiction in the first place and others are not."

As Avram Goldstein has suggested, a person with a genetic predisposition may be trying to correct an imbalance of brain chemistry. And with some addicts, their drug of choice may be doing that, albeit with some severe side effects. This can explain why many users don't become addicts, while many other people do.

It also explains why -- contrary to Gabor Mate -- addicts don't typically get hooked on the first type of drug they encounter. Some opioid addicts, for example, are not at all likely to get hooked on speed, despite considerable exposure. (Though enough exposure, with enough frequency and higher enough doses, will lead to anyone getting hooked on the major hard drugs: opioids, esp heroin; cocaine, esp crack; speed, esp crystal meth; and alcohol.)

Genetic predispositions also can explain why most people with traumatic backgrounds do NOT become addicts. True, childhood trauma especially increases one's risk of drug addiction tremendously. But it doesn't guarantee addiction.

I sense that the reviewer, and many other fans of the environmental explanations for addiction, think that any other explanation justifies the drug war. It does not. Indeed, it was the environmental explanations which were used to justify the drug war to begin with, using language very very much like that found in Gabor Mate's book --- painting a dark and dismal pictures of poor ghettos filled with people of color.

It's also a very inaccurate portrayal. For decades, the typical American addict -- including crack and heroin addicts -- has been white. The poor inner city neighborhoods of color are where these drugs are typically retailed, that's all -- at least in cities where such neighorhoods border on white areas and can be easily accessed by whites. And even then, it's typically on the edges of those neighborhoods. (But the wholesale business is often outside the inner-city neighborhoods of color. *This* is why the sentencing distinctions between crack and powder cocaine is so unfair and racially biased.)

The bogeyman of people like Gabor Mate, Johann Hari and Bruce Alexander is Avram Goldstein, who designed some of the first rat studies and was a pioneer in addiction science, and was one of the first outspoken advocates for harm reduction and even for experiments with legal prescriptions of heroin for addicts. He also went on to help pioneer methadone maintenance (which by far the most effective treatment for heroin addiction, provided the dosage is high enough, and people stay in treatment long enough).

Finally, if you actually read the newsletters from NIDA, you'd know that specific genes have been identified for predispositions to different drug addictions, including nicotine addiction. There is no real scientific debate over this matter. Gabor Mate is the equivalent of a climate-change denialist. And his arguments against genetic explanations greatly exaggerate and misidentify what is meant by genetic predisposition. Indeed he likes to use the word "cause" instead of "predispose" when characterizing the genetic explanations of addiction. And he refers to old studies, prior to our ability to examine DNA itself.

One last note: Just because the drug war is a gov't policy and practice, and NIDA is a govt agency, doesn't mean that NIDA is serving the interests of the drug warriors. American government is NOT monolithic. Not surprisingly, people who grew up under the Reagan-Bush-Clinton era seem to think that govt is one big monolithic bad guy. It's not. I suggest you subscribe to the NIDA newsletters and periodicals. You might be surprised at what you'll learn.

FYI: I'm a recovering heroin addict, and alcohol abuser, with 20+ years of continuous clean and sober time. It required no spiritual awakening. It just required methadone for 10+ years, until the cravings disappeared (methadone dampens them down, and if they can then be ignored, they are not reinforced, and eventually, after many years, disappear). I also score extremely low on the trauma questionnaire that Mate is so fond of. Indeed, I really couldn't have asked for a much better childhood, and I received a great education, including graduate school. (Btw, methadone stopped my interest in drinking too, and there's a neurological reason for this but I'll spare you. I'll just say that there's every indication to suggest that I have a genetic predisposition, esp given how I went through drug after drug in years of experimentation until I found what it seemed I was looking for...)