In Chapter 13 of The Encultured Brain, Daniel Lende discusses drug use and addiction and the importance of cultural contexts associated with those drug-related behaviors. Lende uses his ethnographic research on adolescents and drug use that he conducted in Colombia to demonstrate the complexities of addiction and habitual actions. The author begins this chapter by immediately separating Colombian views of drug usage and the United States’ views of drug usage. According to Lende, the people of Colombia view the use of drugs not as a problem of pleasure, rather problems of “social violations” and their actual nature of being (Lende pg. 339). In contrast, Americans view drug-related problems, such as addiction, as strictly medical related issues, such as disorders and diseases, or an absence of morality. Ironically, the United States’ incomplete view of addiction mostly stems from the Diagnostic and Statistical Manual, which provides criteria in order to diagnose substance abuse. This contrast between two different cultures that Lende presents sets up nicely a deeper discussion about ways to combine neuroscience with anthropology in order to more fully understand drug addictions in the context of culture and the human experience.
Lende presents a neuroanthropological theory of addiction containing two key components. One component of Lende’s theory includes a “compulsive desire for drugs” (Lende pg. 340). The second component of Lende’s proposed theory deals with the fact that drug use becomes habituated. Using drugs becomes an automatic behavior due to repeating actions over a period of time, which the author explains how this mechanism of shifting to automaticity occurs later on in the chapter. Lende’s integrative theory of addiction stresses the importance of not just neurobiological research, but also the inclusion of subjective aspects that can be a result of anthropological research.
Chapter 13 provides much evidence that discredits the outdated views of addiction. For example, Lende counters the idea that addiction does not involve a single chemical imbalance or a single network in the brain. Because the brain is highly connected, most networks within the brain are active during a multitude of events. The brain structures that we view as components of a remote neural circuit might be, in fact, key pieces to completely different neural circuits as well. This suggests that the idea of addiction is extremely complex and requires a more intricate understanding of not only the brain itself, but how human experiences shape it.
An important term used in Chapter 13 is “incentive salience”. Incentive salience is the process of deciding which cues or incentives for a potential reward are important enough to an individual in a certain context. As Robinson and Berridge (1993) point out, incentive salience plays a key role in addiction, and helps guide to the understanding that addiction is not simply a “problem of pleasure” (Lende pg. 343).
Lende uses the idea of incentive salience with his research on adolescents and addiction in Colombia as a way to combine more of the specific anthropological aspects of addiction with the neurobiological side of addiction (i.e. “wanting phase,” “liking phase,” and “learning phase”). The potential mechanisms by which the reward system works are beyond the scope of this review, although they are detailed in Lende’s chapter. However, as mentioned above, “wanting”, “liking”, and “learning” are crucial in reward-based behaviors and incentive salience, as Lende finds, is what links those pieces together. Incentive salience is almost like the “glue” of those aspects regarding addiction. But what exactly is the “glue” of incentive salience? Lende explains how important a person’s complete cultural experience, which includes socioeconomic and environmental factors, is to their experience of incentive salience and thus addiction.
This chapter shows just how complex addiction really is. In order to get the most out of this chapter, Lende demands that every aspect of addiction be considered with context. Habits, for example, exist only through the light of context. The underlying goal of habits is to guide a person through a series of actions to achieve something based on a previous context (Lende pg. 352).
Lende concludes Chapter 13 with the term “chunking” and how intertwined it is with habitual behavior. Through learning, one is able to create a model, or an idea of what the best way to accomplish something would be, and once that model is in place, a transition to automaticity takes place. Specifically, a “cache” system, that contains inflexible sequences of actions that can be executed quickly, takes over and the learned behavior is engrained into a habit, and eventually an addiction is formed.