, otherwise known as
delirium tremens Biopsychosocial Model While regarded
biomedically as a
neuropsychological disorder, addiction is multi-layered, with
biological, psychological, social,
cultural, and
spiritual (biopsychosocial–cultural–spiritual) elements. A biopsychosocial–cultural–spiritual approach fosters the crossing of
disciplinary boundaries, and promotes
holistic considerations of addiction. A biopsychosocial–cultural–spiritual approach considers, for example, how physical environments influence experiences, habits, and patterns of addiction.
Ethnographic engagements and developments in fields of knowledge have contributed to biopsychosocial–cultural–spiritual understandings of addiction, including the work of
Philippe Bourgois, whose
fieldwork with street-level drug dealers in
East Harlem highlights correlations between drug use and structural
oppression in the United States.
Biological Factors Some biological influences of the biopsychosocial model include genetic heritability, neuroadaptations in reward circuitry, and changes in neurotransmitter systems. Some examples of neurotransmitters that are affected include: dopamine, GABA, and glutamate. Chronic substance exposure seems to produce long-term changes in the mesolimbic dopamine system These biological factors contribute to things like the initial vulnerability and the development of drug-seeking behaviors. It does this by altering factors like reward sensitivity, stress reactivity, and executive control systems. Conditioning based models show that environmental cues can acquire motivational significance and potentially trigger craving and relapse, even after periods of long abstinence. This is mainly due to the interaction with neurodevelopmental stress pathways. Together, these levels of analysis highlight addiction as a complex and dynamic condition emerging from the interaction of several aspects including: neurobiological processes, individual psychological traits, and broader social environments. Heath undertook ethnographic research and
fieldwork with the
Camba people of
Bolivia from June 1956 to August 1957. Heath observed that adult members of society drank 'large quantities of
rum and became intoxicated for several contiguous days at least twice a month'. Heath's observations and
interactions reflected that this form of
social behavior, the habitual heavy consumption of alcohol, was encouraged and valued, enforcing social bonds in the Camba community. As reports of drug use rapidly increased, the cultural model found application in anthropological research exploring western drug
subculture practices. These findings challenge popular narratives of
immorality and
deviance, conceptualizing substance abuse as a social
phenomenon. The prevailing culture can influence drug-taking behaviors, along with the physical and psychological effects of the drug. To
marginalized individuals, drug subcultures can provide social connection,
symbolic meaning, and socially constructed purpose that they may feel is unattainable through conventional means. The subcultural model demonstrates the complexities of addiction, highlighting the need for an integrated approach. It contends that a
biosocial approach is required to achieve a holistic understanding of addiction.
Critical medical anthropology model Emerging in the early 1980s, the critical medical anthropology model was introduced, and as Merrill Singer offers 'was applied quickly to the analysis of drug use'. Where the cultural model of the 1950s looked at the social body, the critical medical anthropology model revealed the
body politic, considering drug use and addiction within the context of macro level structures including larger political systems,
economic inequalities, and the institutional power held over social processes. Highly relevant to addiction, the three issues emphasized in the model are: •
Self-medication • The social production of suffering • The political economy (
Licit and Illicit Drugs) These three key points highlight how drugs may come to be used to self-medicate the
psychological trauma of socio-political disparity and
injustice, intertwining with
licit and illicit drug market politics. Social suffering, "the misery among those on the weaker end of power relations in terms of physical health, mental health and lived experience", is used by anthropologists to analyze how individuals may have personal problems caused by political and economic power. From the perspective of critical medical anthropology, heavy drug use and addiction are consequences of such larger-scale unequal distributions of power. The three models developed here – the cultural model, the subcultural model, and the Critical Medical Anthropology Model – display how addiction is not an experience to be considered only biomedically. Through consideration of addiction alongside the biological, psychological, social, cultural, and spiritual (biopsychosocial–spiritual) elements which influence its experience, a holistic and comprehensive understanding can be built. == Social learning models ==