The Influence of Society and Culture in Addiction

What is Culture?

The learned and shared pattern of values and beliefs of a group of people is known as culture. According to the Center for Advanced Research on Language Acquisition, culture is a shared pattern of behaviors and interactions, cognitive constructs, as well as understanding learned by socialization. What we eat and wear, the music we listen to, what we consider wrong or right, etc. Are all largely determined by culture. As a result, a group of people are likely to behave in a certain way and are vulnerable to a certain outcome because of culture.

Substance use disorder does not discriminate based on culture, as anyone from anywhere is susceptible. Cultural identity and values either make an individual more or less vulnerable to substance use disorder.

Note: in this discussion about culture and addiction, it goes beyond ethnic or linguistic groups. It factors in ‘interest groups’ or ‘interest communities’ such as a university setting where binge drinking is usually common. Therefore, culture is very flexible and people should be allowed to define their cultures based on interests and purposes.

What are the Cultural Factors that Influence Addiction?

It is next to impossible to list every factor from all the cultures in the world that is able to influence substance use, hence some common cultural factors with significant impacts on addiction are discussed below:

1. Acculturation

People who acculturate to a new ‘home’ after immigration are at a higher risk of substance abuse than people who still have a connection to their home cultures after immigration. This is because adjusting to a new culture, especially one that is very different, is often very overwhelming. Hence, having the leverage of remaining connected to the home culture makes it easier.

Also, the new culture may have strong connections with substance use, which a new member may not handle rightly, hence a higher risk of addiction.

2. Individualistic Versus Collectivist Culture

Some cultures are very individualistic, such that independence is ‘preached’ at every opportunity. There is little or no interdependence in the societal structure. So, people often bear their burdens alone, leaving them more vulnerable to vices like addiction. Collectivist cultures, on the other hand, promote shared responsibilities and dependence in societal structures. This culture protects people because they are not alone in their pain. Other members of the society offer as much help as possible; hence, they are less vulnerable to vices like addiction. However, the downside is if any member of the society has addiction issues, it’s easier for another member to develop similar issues because of the same connection.

3. Cultural and Generational Trauma

Trauma is one of the most common risk factors for addiction because people often turn to substance use for relief. Therefore, cultural and generational trauma increases the risk of addiction.

4. Use of Substances in Social or Spiritual Events

Some cultures are highly spiritual or religious and use some substances such as tobacco, peyote, and ayahuasca, in their ‘act of worship’. Individuals in these groups are regularly exposed to these substances and may view them entirely differently. Hence, they have a higher risk of abusing them and leading to addiction than people from subcultures where there is discouragement of substance use based on religious beliefs. The same thing goes for cultures where substance use forms an essential part of their social events.

5. Role of Extended Family

Extended families that operate like collectivist cultures offer similar protection for members. For example, young people in the family are more likely to receive better supervision, hence reducing their chances of developing addiction due to factors like peer pressure.

What is the Role of Culture in Addiction Treatment?

Every phase of the treatment of addiction is impacted by culture. For instance, culture plays key roles in whether an individual seeks treatment or not and how much trust individuals are likely to have in professionals treating addiction. As a result, mental health professionals consider striving for cultural competence in therapy pertinent. In fact, cultural humility is recommended by some experts.

Cultural humility entails understanding and accepting that, no matter how hard you try, you are not likely to fully comprehend all that is to know about someone else’s culture. Therefore, professionals ask questions and learn about the cultural identities and values of clients from the clients. 

For effective treatment of addiction, mental health professionals must not make assumptions about the cultural beliefs and values of clients based on stereotypes and ethnocentric values. This allows professionals to make appropriate recommendations based on the needs of each client.

For some clients, a full recovery from addiction goes beyond recovering from the symptoms of substance use disorder alone. It also involves re-connection to cultural identity, which may include recommitting to religious or spiritual activities. If addiction treatment is culturally responsive, more people will complete their treatment and ultimately achieve a full recovery.

According to the Diagnostic and Statistical Manual of Mental Disorders, treatment providers are urged to consider the areas below when screening and assessing mental health conditions, including substance use disorders:

• The cultural identity: the values and beliefs of the person
• The cultural explanation: some clients think their addiction is a punishment from a god
• The cultural factors between the client and the treatment provider: how clients will relate with treatment experts is greatly influenced by what they know about their culture. Therefore, experts should know how their cultures impact those of their clients, if there’s any impact.
• Cultural factors associated with the client’s environment and functioning.
• The overall cultural assessment