Is Substance

Abuse
Culturally
Bound?
Vedika Basu
 Historical Roots of Substance Consumption

Many cultures around the world have used substances like alcohol, psychedelic
mushrooms or hashish for medicinal, spiritual or social purposes.

For example, a psychedelic mushroom, known as Amanita muscaria has been

used ceremonially in Asia for 4,000 years or more. (Crocq 2007)

It was in the 1900s with the spread of Christianity that consumption of

substances began to be viewed in a negative light.
 Colonialism and Substance Abuse
Colonialisation gravely affects the patterns of substance use for people of
differenct cultures.

For example, the American Indians and Alaska Natives people used alcohol
sparingly and only during specific ceremonies before colonisation. (Crocq 2007)

However, after the advent of colonisation, these cultures started using alcohol
more frequently and a higher number of alcohol misuse is still reported in these
communities.

Some AIAN elders believe that a disconnect from traditional culture has
contributed towards alcohol abuse.

Alcohol has become a big part of African culture due to colonisation. The African
slaves were paid for their effort with alcohol instead of money.
There are different cultural and national standards for
substance use and abuse.

There are different cultural variations in attitudes toward

substance consumption, patterns of substance use,
accessibility of substances and prevelance of disorders
related to substance
 Cultural Differences in Accessibility of Substances

It is illegal to sell or purchase Marijuana in the United States, but it is legal under
some circumstances in Holland

The legal age of hard alcohol consumption in Maharashtra is 25 while in Russia it is

18 years.

You can buy a bottle of wine in a student cafeteria in France, but this is impossible to
do in a university like FLAME or Ashoka.

The accessibility of substances depends on the importance placed by the culture and
the attitudes towards substance consumption.
There is no universal criterion that would
distinguish normal from abnormal drinking
Even though Europe makes up just 15% of the population, it
consumes 50% of the alcohol on Earth.

Spanish and Greek respondents indicate that drinking is an

essential part of their culture, while France and Portugal are the
top consumers.

It is very common for children as young as 15 to start drinking

alcohol in France. Many can have a glass of wine with their
breakfast in Italy or have a beer in the middle of work in Germany.
While they drink often, they also drink in small quantities and
usually with a meal. The alcohol they drink seem to have digestive
purposes or enhance the taste of the meal.
 Have the Europeans Evolved to Drink More?

A report by the Journal of Neuropharmacology states that Europe is programmed to

consume more alcohol and fatty foods than those in the East. (O'Neil 2011)

Scientists found a stronger genetic switch in Europeans as compared to the Asians.

They hypothesised that Europeans historically needed more fatty foods and alcohol
to survive the cold harsh winters. Consequently, their gene switch evolved to favour
alcohol and fatty foods more today.

As Asians have a weeker gene switch, they are less inclined to choose fatty foods and
alcohol genetically.
 Biological Factors and Substance Consumption

In most Asian countries, the overall prevalence of alcohol consumption is relatively

low.

East Asian populations have a "protective mechanism" against alcohol abuse.

It was found that approximately 50% of Korean, Japanese, and Chinese individuals
lack aldehyde dehydrogenase in their blood which eliminates the first breakdown
product of alcohol.

As a result, they get a flushed face and palpitations when the consume alcohol, and
hence are not as likely to drink in large amounts.
The Journal of the American Medical Association reported that cells of
Africans who smoke absorb more nicotine than do the cells of White or
Hispanic smokers. The frequency or level of smoking did not matter.

This is why Africans or African-Americans tend to suffer from tobacco-related

diseases such as lung cancer and why they have more trouble quitting the
habit.
 Acculturation and Substance Abuse

Research by Borges et al (2011) showed that Hispanic people who migrate to the
U.S. as children have a higher chance of substance use disorder compared to those
who migrate as adolescents or adults, but an overall lower chance than Hispanic
people born in the U.S.
This because these children lose their connect with their home culture.

Alcohol related disorders are also associated with lower educational levels,
lower socio-economic status and higher rates of unemployment. However, it is
difficult to say what is cause and what is effect.
Psychodiagnostic
Biases
The cultural background of the professional can
influence his perception of different behaviours.

Doctors can misdiagnose particular diseases due to

cross-cultural differences in the perception, attribution
and expression of signs of disease.
 Bias in Diagnosis
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1. Mental health professionals should notice the importance of social

distance between their patients and themselves across different
cultural groupings. Even the way we observe abnormality may be
affected by our own social status. For example, it was suggested that
substantial differences in psychiatric symptoms between low and high
status groups in the Austro-Hungarian Army in 1914 were influenced
by the fact that most psychiatric observers belonged to high status
nationality.
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2. Therapist's beliefs your recording to upload.
expectations Make sure tothem
can predispose copy to "see"
psychopathology thewherever
link to yourthey
recording
look. and share it with others.
For example: If the patient arrives early for his appointment, then he's
anxious. If he arrives late, then he's hostile and if he is on time then he is
compulsive.
This non critical thinking alerts us to the dangers inherent in
maintaining schemas that allow and even encourage any human
behaviour to be subsumed under on or another of pathological
categories.
3. Skepticism about the applicability of Western diagnostic criteria in
other cultures and vice versa.
They insist that distress is experienced and manifested in many
culture-specific ways.

Different cultures may either encourage or discourage the reporting

of psychological or physiological components of the stress response

In addition, in some cultures persistent nightmares are viewed as a

spiritual and supernatural phenomenon, whereas others observe
nightmares as indicators of mental or physical disturbance (DSM-IV,
p. 581).
Some existing culture-specific disorders are difficult to interpret in terms of
other national classifications.

A neurological weakness, typically diagnosed in China, includessymptoms of

weakness, fatigue, tiredness, headaches, and gastrointestinal complaints

The Western diagnostic assessments of patients with this disorder varied with
different diagnostic procedures employed. It could be anxiety disorder,
depressive disorder, or bipolar disorder
Culture-bound syndromes challenge any universal categorization because
of the culturally specific content of the disorders

But no matter how you describe a problem, it would manifest as a

maladaptive and distressful symptom, as inability to cope with stressful
situations.

The key to success in diagnostic practices is to identify distress and

maladaptive symptoms correctly and in their cultural context.
 References
Marc-Antoine Crocq (2007) Historical and cultural aspects of man's relationship with
addictive drugs, Dialogues in Clinical Neuroscience, 9:4, 355-361, DOI:
10.31887/DCNS.2007.9.4/macrocq

Moggach, A. (n.d.). Drinking Culture: Europe. Retrieved 2022, from

https://signetbranding.com/news/drinking-culture-europe/

O'Neil, C. (2011). Europeans 'evolved' to drink more. Independent. Retrieved 2022, from
https://www.independent.co.uk/news/science/europeans-evolved-to-drink-more-
2313665.html

Borges G, Breslau J, Orozco R, Tancredi DJ, Anderson H, Aguilar-Gaxiola S, Mora ME. A cross-
national study on Mexico-US migration, substance use and substance use disorders. Drug
Alcohol Depend. 2011 Aug 1;117(1):16-23. doi: 10.1016/j.drugalcdep.2010.12.022. Epub 2011
Feb 5. PMID: 21296509; PMCID: PMC3110586.