Wanting to Craving: Understanding Compulsive Involvement with Drugs

By Daniel Lende

A long-time research project of mine has been to understand how adolescents get hooked on drugs. Querer más y más, as they say in Colombia, to want more and more. When people get addicted – whatever the substance may be – they often report urges, cravings, and obsessive thinking as a primary force in why they keep using or relapse. Knowing the consequences often doesn’t matter, especially in those moments when that desire feels hot as a knife.

The easiest analogy for me to help people understand this type of desire is to ask people to think about that one time they really craved something to eat. Yes, that time, when you just had to have it. Most people have experienced this one time or another. With substance abuse, craving like this often becomes an unpredictable constant, something that comes on in the morning or while walking by a favorite bar or seeing a friend who has that gleam in his eye and a crooked smile on his face.

So here is what I found in Colombia, reported in a 2005 Ethos article entitled Wanting and Drug Use: A Biocultural Approach to Addiction (click for the full paper: Lende Wanting pdf). The abstract goes:

The integration of neurobiology into ethnographic research represents one fruitful way of doing biocultural research. Based on animal research, incentive salience has been proposed as the proximate function of the mesolimbic dopamine system, the main brain system implicated in drug abuse (Robinson and Berridge 2001). The research presented here examines incentive salience as the mediator of the wanting and seeking seen in drug abuse. Based on field work with adolescents at a school and a drug treatment center in Bogotá, Colombia, this article addresses: 1) the development of a scale to measure the amount of incentive salience felt for drugs and drug use; 2) the results from a risk-factor survey that examined the role of incentive salience and other risk factors in addiction; and 3) the ethnographic results from in-depth interviews with Colombian adolescents examining dimensions of salience in the reported experiences of drug use. Incentive salience proved to be a significant predictor of addicted status in logistic regression analysis of data from 267 adolescents. Ethnographic results indicated that incentive salience applies both to drug seeking and drug use, and confirmed the importance of wanting, a sense of engagement, and shifts in attention as central dimensions of experiences related to drug use.

Several years later, I like to highlight several things about this research. First, different domains of subjective involvement can be linked to dopamine –wanting more and more, the sense of an urge or push to use (often not a conscious desire), and the heightened focus on places and actions and times that lead to using. The scale I developed showed good internal consistency, adding support that these three senses of compulsive involvement are linked. If you want to know more about the scale, I have done a separate post detailing the compulsive involvement scale in both Spanish and English versions.

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Richard Thaler Speaks at RSA

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Richard Thaler, an economist at the University of Chicago, co-wrote the book Nudge: Improving Decisions about Health, Wealth and Happiness with the legal scholar Cass Sunstein. Here Thaler presents his views about decision making, policy and goverment before an audience at the RSA – often called the Royal Society of Arts.

For those of you looking to read something shorter, Thalen and Sunstein give an overview of their book in this LA Times article Designing Better Choices. They also have a scholarly article Libertarian Paternalism Is Not an Oxymoron. And for the truly devoted, you can check out their website Nudges.

Thalen is a behavioral economist, and thus sees the notion of perfect rationality and idealized cost/benefit decision making as irrational. We are human, flawed and imperfect; more importantly, our “choice architectures” are significantly shaped by features of the environment, such as what captures our attention or simply following the default option like the rest of the herd. Hence the nudge, those small features in the environment that we can shape in specific directions while still letting people make their own decisions.

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Habits to Help

Val Curtis
Val Curtis

Warning: Habits May Be Good For You highlights the anthropologist Val Curtis’ work to synthesize anthropology, public health, and consumer behavior. She has a simple problem, how to teach children in sub-Saharan Africa to habitually wash their hands, thus lowering significantly the risk of many diseases. As Charles Duhigg writes, Curtis turned to consumer-goods companies for insight into her work.

She knew that over the past decade, many companies had perfected the art of creating automatic behaviors — habits — among consumers. These habits have helped companies earn billions of dollars when customers eat snacks, apply lotions and wipe counters almost without thinking, often in response to a carefully designed set of daily cues.

“There are fundamental public health problems, like hand washing with soap, that remain killers only because we can’t figure out how to change people’s habits,” Dr. Curtis said. “We wanted to learn from private industry how to create new behaviors that happen automatically.”

The companies that Dr. Curtis turned to — Procter & Gamble, Colgate-Palmolive and Unilever — had invested hundreds of millions of dollars finding the subtle cues in consumers’ lives that corporations could use to introduce new routines.

If you look hard enough, you’ll find that many of the products we use every day — chewing gums, skin moisturizers, disinfecting wipes, air fresheners, water purifiers, health snacks, antiperspirants, colognes, teeth whiteners, fabric softeners, vitamins — are results of manufactured habits. A century ago, few people regularly brushed their teeth multiple times a day. Today, because of canny advertising and public health campaigns, many Americans habitually give their pearly whites a cavity-preventing scrub twice a day, often with Colgate, Crest or one of the other brands advertising that no morning is complete without a minty-fresh mouth…

“Our products succeed when they become part of daily or weekly patterns,” said Carol Berning, a consumer psychologist who recently retired from Procter & Gamble, the company that sold $76 billion of Tide, Crest and other products last year. “Creating positive habits is a huge part of improving our consumers’ lives, and it’s essential to making new products commercially viable.”

Habits

Habitual behavior is one topic that concerns brain science, psychology, economics and anthropology, each with disciplinary specific ways of trying to explain these everyday patterns. However, most of those explanations have two flaws: some variety of rationality as the way to understand habits, and some causal force (e.g., genetics, reward, subjective utility, culture) as forming the pattern. But things are not quite so simple, as “Habits May Be Good For You” shows:

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The Everyday Brain and Our Everyday Life

Earlier this week I wrote about Jean-Pierre Changeux and Gerald Edelman, drawing on the New York Review of Books essay by Israel Rosenfield and Edward Ziff, How The Mind Works: Revelations. As I blogged then, “In the end I was still left with a ‘So what?’ Their hints at subjective psychology, the acting brain, and relational representation remained the side dishes, rather than the main course. I’ll deal with that main course later this week.” It’s Saturday, so I better keep to that promise.

Let me begin by just giving you the essay excerpts.

In general, every recollection refers not only to the remembered event or person or object but to the person who is remembering. The very essence of memory is subjective, not mechanical, reproduction; and essential to that subjective psychology is that every remembered image of a person, place, idea or object invariably contains, whether explicitly or implicitly, a basic reference to the person who is remembering.

The “rigid divide,” [Giacomo] Rizzolatti and Corrado Sinigaglia write in their new book, Mirrors in the Brain, “between perceptive, motor, and cognitive processes, is to a great extent artificial; not only does perception appear to be embedded in the dynamics of action, becoming much more composite than used to be thought in the past, but the acting brain is also and above all a brain that understands.”

For Edelman, then, memory is not a “small scale model of external reality,” but a dynamic process that enables us to repeat a mental or physical act: the key conclusion is that whatever its form, memory itself is a [property of a system]. It cannot be equated exclusively with circuitry, with synaptic changes, with biochemistry, with value constraints, or with behavioral dynamics. Instead, it is the dynamic result of the interactions of all these factors acting together.

Together, subjective psychology, an acting and embedded brain, and representation and action that are dynamic and relational present us with a new starting point when we talk about the intersections of neuroscience and psychology with anthropology. Starting with their conclusions, making it the beginning of something better, that would have been a really exciting essay for me to read.

As I wrote a couple days ago, Howard Gardner does get us closer to this new individuality. “Gardner brings a refreshingly unique take, neither the individual of science, bounded and rational, or the individual of philosophy and art, lone thinker and creative genius. Nervous system, individual experience, and subjective interpretation move us into a radically different domain—an individuality that lies firmly in the continua Gardner describes.”

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Wednesday Round Up #15

Anthropology

Clifford Geertz, Very Bad News
The late great American anthropologist takes on Jared Diamond’s book Collapse: How Societies Choose to Fail or Succeed

Erik Davis, BBC Documentary: Tales from the Jungle: Malinowski
YouTube videos of the BBC documentary on one of the founders of modern anthropology, Bronislaw Malinowski

Integral Praxis, Investigating Global Health
Nice video and links on Paul Farmer’s work

John Hawks, Numbers, Amazon-Style
Numbers: universal phenomenon or cultural invention? Looks like Western linearity is acquired. Nice summary of a Science article by Stanislas Dehaene et al. that goes from the Mundurucu in Brazil to neural mapping

Ian Kuijt, The Regeneration of Life: Neolithic Structures of Symbolic Remembering and Forgetting
The abstract for a new Current Anthropology paper on archaeology and the “social construction of identity and memory… expressed through public ritual”

Terry Eagleton, Culture Conundrum
Civilization vs. barbarism? Why civilization needs (popular) culture

Keith Axline, Inside the Architecture of Authority
Photographer Richard Ross shows institutions in their concrete power

Social Fiction, On Ethnographic Surrealism
Gives us a pdf link to James Clifford’s classic paper, plus a cool image and plenty of playfulness

Mark Dingemanse, Under the Spell of Ideophones
Ghanian newspapers, vivid sensory language, and the uses of persuasion

Liam Stack, In Egypt, “Dramatic” Push For Women’s Voices
Anthropology and drama combine: An Egyptian women’s troupe takes on stereotypes Muslim and Western

Elitism in the US

En Tequila Es Verdad, Carnival of the Elitist Bastards #1
Just what it says! A blog carnival celebrating experts, smart people, and other bad-ass riff-raff

John Pieret, Be All The Bastard You Can Be
“Our elitisim is not exclusionary. We welcome everyone to join.”

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Wednesday Round Up #9

Tit-for-Tat, Game Theory and the Like

Michael Shermer, The Doping Dilemma
The rationality of doping—through game theory

Jim Rilling et al., The Neural Correlates of the Affective Response to Unreciprocated Cooperation
Anterior insula, left hippocampus, and left lingual gyrus light up when you are getting screwed (pdf)

Jim Rilling et al., A Neural Basis for Social Cooperation
Cooperating in the Prisoner’s Dilemma game lights up the reward centers! (pdf)

Jake Young, The Ruthlessness ‘Gene’ –or- Four Caveats in Interpreting Behavioral Genetics Studies
The Dictator Game, genes and mechanism, and media sensationalism

Ken Binmore, Review of Axelrod’s The Complexity of Cooperation
The tit-for-tat strategy is over-rated

Wendy Grossman, New Tack Win’s Prisoner’s Dilemma
Social recognition and team play wins hands-down…

Tully, Arrow’s Impossibility Theorem
Social choice theory, ranked preferences, and the failure of individual-based theories

Research Digest Blog, How Group Cooperation Varies Between Cultures
“students from less democratic countries like Saudi Arabia, Oman and Belarus tended to punish not only free-loaders, but also cooperative players, with the result that cooperation in their groups plummeted”

Joseph Henrich et al., Costly Punishment Across Human Societies
Pdf of the 2006 Science paper on the cross-cultural propensity to punish cheaters based on ultimatum and third-party punishment games

Mark Gimein, The Eligible-Bachelor Paradox
“How economics and game theory explain the shortage of available, appealing men”—grab hold of a good one and don’t let go…

Aging: Evolution and More

Neuroscientifically Challenged, Trying to Make Evolutionary Sense of Menopause
Good summary of previous debates, plus coverage of a new theory: avoiding female reproductive competition

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