Addiction and Neuroanthropology: Querer mas y mas

Daniel H. Lende

Colombian Study: Colombian perspective of addiction versus the perspective of the United States, the world’s largest consumer of drugs

According to the Colombians studied in Dr. Lende’s study, drug abuse involved wanting more and more (querer mas y mas), cravings, desire, and urges. Drug use was seen as a range from a small vice (everyone has some sort of vice) to the worst case scenario mode of putting individuals directly onto the street. The latter is  a complete violation of Colombian social norms because of the overarching desire for drugs more than the value of desire to be with family and friends. Drugs, especially cocaine (referred to as la droga), have the potential to violate one of the most entrenched values of Colombian culture–protecting the well-being of loved ones. When the desire for drugs outweighs the values, it becomes a problem, a habit that becomes hard to control. Otherwise, drug usage is not harshly judged unless it becomes a big enough problem that it dictates the individual.

In the United States, perspectives of drug use include viewing use as a moral failing, or a pathology. Americans have the tendency to compare drug use to either a biological pathology (chemical imbalances caused by drug use, “reward deficiency syndrome”) or a reflection of an individual’s self-control . The American perspective of drug use is Puritanistic, relating drug use to the “immoral” desire of too much pleasure.  According to the American perspective, the disruption of the hard-wired pleasure circuits already within the brain can be “hijacked” by this “immoral” drug usage.

By comparing these two starkly different views, Dr. Lende was able to collage emic and etic perspectives and the connection between behavior and experience, creating an ethnographic, neurological revelation regarding addiction:

Addiction is a problem of involvement, not just pleasure or of the self.

So, how does neuroanthropology play a role in all of this? 

Lende identified two core components of addiction and addictive behavior directly from individuals experienced to study: users report compulsive desires and urges for drugs, leading to relapse or excess; users also identified drug use as an escape from the doldrums and stresses of every day life. Furthermore, Lende identified that sociocultural dynamics affect an individual’s cues and habits that create compulsive or destructive ends. According to the DSM, criteria for substance abuse requires the specific pharmacological structure and mechanism of the drug, whether or not individuals demonstrate tolerance or withdrawal, continued use despite negative effects, and using increasingly higher dosages to achieve greater effects. The problem, which the neuroanthropological view seeks to tackle, peaks when many drugs produce no physiological adaptations. How does one measure the extent of substance abuse according to the DSM’s guidelines if no physiological symptoms are expressed? Causation for addiction must be reviewed, according to Lende, in order to go beyond focusing on withdrawal. According to Lende:

“A full explanation for addiction is not to be found in deviations from rational choice, leaving out community dynamics, social meanings, and other important aspects of substance abuse. Morevoer, this approach also treats addiction as solely an individual problem, in particular, by assuming that addiction is a brain disease that limits the mind’s ability to lead a rational life. “

The aforementioned approach of treating addiction as a disease foregoes answering WHY. What drove this individual to substance abuse? Why did can it become so destructive for particular individuals? These questions, according to Lende, need to be examined in order to garner a full understanding of addiction.

Neuroscience and Addiction

Addiction is a complex process that incorporates many different parts of the brain, rather than just a few isolated sections. Motor, sensory, and bodily regulation must be integrated together before addiction can occur. It begins from the basal parts of the brain (regulation, activation of bodily functions), runs through the limbic system (emotions, evaluation of stimuli), up through the frontal cortices (higher-order cognition). As Lende put it, they have to do with what to do, when to do, and how much to do.

Wanting More and More: The Neuroanthropology of Involvement

Incentive salience, or the determination of which incentives for reward are most important (salient) to an individual, was proposed in a 1993 study as the core psychobiological process that is most affected in continued substance abuse. The biochemical mediator for incentive salience is the dopaminergic system. In Lende’s studies in Colombia, he found that using incentive salience as a model for a scale depicting experience turned out to be a good predictor of addicted status. Asking real people about their real experiences with drug use, Lende sought to better understand their want for drugs and how they would get drugs, and how they felt before actually getting the drugs. In the end, he found that the “want” actually corresponded to experiences during the drug use rather than before or after, and that meaning and social context played a role in the experience.

Incentive Salience and Addiction: Mediation, Environment, and Anthropology 

According to Lende, incentive salience is a much more focused means of examining drug usage. Incentive salience merely reflects a few aspects of addiction (remember, addiction is highly complex and dynamic), and does provide good insight into addiction, but does not fully explain it. Incentive salience gives researchers an insight into the neurological processes of decision making, and the means of seeking out rewards. It also links together cues and rewards through motivation and action.

Incentive salience, however, is not the same thing as conscious desire. As Lende puts it:

That urge for pizza people get, that sense that they want it now, and that they just have to have it–that is incentive salience.

Well, now I want some pizza. Thanks, Dr. Lende.

Anyways, a good way to garner information regarding incentive salience has to do with ethnographical research. In his Colombia study, Lende asked participants to describe a “typical day”. His results”

  • Heavy drug users described a sequence of feeling ambivalent towards drug use, a marked decision to use, and then the action of seeking out whatever drug they use. In addition, these people reported a stronger urgency and desire to use once the decision to use had been made. They reported that they felt the want for more and more (querer mas y mas) in the moment. Not before, not after, but in the moment that the drug use was happening.

^^^that’s incentive salience

The salience experienced by Colombian users, however, occurred when using that drug transformed their lives. It took them away from day to day life experiences, the monotonous, and created a  viaje (journey) to the sublime. Well, who wouldn’t want that?

According to Lende, “signals for salience depend on the presence of cues, the structure of environments, and present and past states. In other words, when behavioral options are salient, animals will pursue them–that is what incentive salience does.”

This incentive salience can be applied in two ways:

1. Involvement: the creation of a feeling of belonging or involvement in cultural meaning schema

2. Transition: Signaling transitions between activities, shifting involvement from what matters throughout the day

 

Yet, how does this explain habitual use? Incentive salience alone just doesn’t cut it. Habits play a role in the same neurological processes that incentive salience does. When the want for more and more (querer mas y mas) becomes a cultural commodity, partnering alongside feelings of belonging and transcendence from the mundane, that may lead people to wanting to repeat that experience. Repetition over continual, extended periods of time can create a habit. A habit (referenced in the text, Gaybriel 2008, p.363) is defined as:

“learned, repetitive, sequential, context-triggered behaviors which are performed not in relation to the current or future goal but rather in relation to a previous goal and the antecedent behavior that most successfully led to achieving that goal.”

Lende goes on to describe the interworkings of habits and culture, pointing out that the neuroanthropological approach sheds light into the social and biological aspects of drug use. In the end, the neuroanthropological approach helps better understand the complexity and dynamics of addiction.

11 thoughts on “Addiction and Neuroanthropology: Querer mas y mas”

  1. This article resonated with my own experience with addicted drug users. It is one of the saddest things to see someone so bright with potential become consumed by addiction. While some Americans might view drug use as a hedonistic form of pleasure, those who have truly encountered addicts are more familiar with querer mas y mas.

  2. I really commend Lende on this research, what a tough research sight! I also agree that the issues of salience and habit play a huge role in most behaviors, not just “drug” use. However, I think it is somewhat misleading to lump all substances into the “drug” category and speak of them in a homogeneous manner. It has been shown that addiction patterns are very different for different substances, with synthetic opiates and cocaine/crack/meth being much more addictive than marijuana and psychedelics. Lende at one point mentions crack cigarettes, I would be interested to know if this was the main substance of addiction or if there were others also.

  3. I think this is really interesting. I agree with Lende that substance abuse is more than just a physiological issue, but rather something that should be evaluated from many different perspectives. I have always thought that addiction was a problem that should not only be limited to substance abuse, as Lende suggests. It can be easy to get addicted to a myriad of things other than drugs.

  4. Could the same be said about any kind of addiction, for instance food addiction? I believe food is the new drug that’s taking over, and it’s legal!

  5. Great review — I had the same thought reading the pizza line.
    I really thought this article was interesting in terms of how the environment and experience can shape salience signaling. The example of the rats deprived of good mothering that more quickly responded to reward cues is fascinating to me. Is this how it works in humans, as well? This phenomenon of less parental involvement as a cause of heightened reactions to possible rewards can reshape the way that people deal with drug addiction and drug abuse prevention.

  6. Great article review, it is so much more than a physiological response . I’ve had experience with people trying to recover from a wide range of drugs and this study further explains how those deeper in the “rabbit hole” can understand the wanting of more and more. This can also be applied to a wide range or things. I had this one person we were seeing who was trying to get off the use of hard drugs, his addiction then moved from craving them to wanting sex more and more changing his habit.

  7. We, at least here in the U.S. T tend to think of drug use as something like a disease affecting those with a lax moral compass and a weak will. Personally when looking at the context for habitual drug use simple escapism never arrives at the forefront of my mind. The drug use itself is the deviation from the cultural norm, it is the misstep. When considering the social context of drug use the common thought is “they must have come from a bad family” or “they weren’t raised right”. The fact idea that drug use itself may not always be the deviation is novel. In Colombian culture, drug use is another action that requires a confluence of events to constitute a deviation. The wanting more is an inherent aspect of drugs that demonizes it in U.S. culture and the journey is simply an effect, not the problem. That is a fascinating distinction.

  8. I really enjoyed our discussion about this in class. I think smoking in particular is interesting to look at when it come to addiction because it is something that is often done in a social situation. I don’t consider myself a smoker because I do not smoke regularly, but the only time that I will is when I’m surrounded by others that are smoking. I went to New Orleans with some of my friends and while we were out at the bars, one of my friends and I picked up smoking because it’s part of the atmosphere. To me, the idea of being addicted to smoking is something that I don’t think that I could ever be, but I can definitely see how it happens. I do think that there is some neurological reasons behind addiction. Smoking in particular is very relaxing, so I can see that having neurological effects with the chemicals in the brain.

  9. I have been having trouble finding many of my old comments, but I know I commented on this one because I remember referring to incentive salience, that feeling of just having to have it. I feel as though this is a two fold issue. There is the conditioning for wanting that thing, in this case the drug, and its reward, that to me is the psychological aspect. The neruo here neurochemical, laying somewhere with augmented receptors and your brain chemically, physically, driving you to something.

  10. I think this model is very good, and can even be applied to more things besides just craving drugs. For my research proposal, I compared drug addiction to football addiction. I believed that similar affective and neurological pathways plagued both desires. Whether it is the desire to get high off of drugs or to get high off of sports, the same dopamine reward pathways operate. In particular, I believed that playing football competitively can prime individuals to abuse substances through neurological and social factors, as well as the actual environment of a high performance sport. I think everyone has something that they want more and more. Some people just take their craving to a different intensity.

  11. After re-reading this I think some of these ideas could be used to look at the way we treat addiction in this country. While the moral failing and individual focus for addiction may work for some, there may be a better model based on cultural ideas and belief. It seems like societal thought is shifting away from the belief that addiction is a moral failing on the individual part, albeit slowly, and more a combination of several factors. As it changes hopefully treatment can allow people the ability to see addiction in a new light and treat it in a way that is more effective.

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