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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.