Graduation Year

2023

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Anthropology

Major Professor

Daniel H. Lende, Ph.D.

Committee Member

Elizabeth Miller, Ph.D.

Committee Member

Heide Castañeda, Ph.D.

Committee Member

Jason DeCaro, Ph.D.

Committee Member

Geoffrey Potts, Ph.D.

Keywords

Drug Use, Harm Reduction, Neuroanthropology, United States

Abstract

Substance use triggers are largely understood to be embedded in drug use contexts and to be a major precipitator of relapse. Yet, the relationship between triggers and future instances of drug use is not quite clear– particularly in understanding the nuances of when triggers are “triggering” and when they are not. Additionally, there is little ethnographic work that explores how individuals interact with triggers in contexts related to substance use, particularly during periods of active use. This project employs ethnographic and survey research methods to interrogate substance use triggers in the harm reduction context. In doing so, it answers the three main questions. How do people who inject drugs in local harm reduction programs come to know triggers? What is the “harm reduction context,” and what is the “local”? And what are the local neurologies of substance use triggers in harm reduction? The answers to these questions come from 13 months of fieldwork with 130 people who inject drugs and participate in a syringe exchange program in the state of Florida, U.S. Through semi-structured interviews, observations, and a salience survey, this project found that people who inject drugs enact triggers differently in harm reduction than in other contexts such as substance use treatment or laboratory research on triggers. Interactions with triggers, this work suggests, are bound to local “sites.” De-centering the notion of a geographically bound field site, this work highlights how other “sitings,” namely the War on Drugs and Opioid Crisis, shape practices related to injection drug use and harm reduction. The harm reduction context, then, is not simply a physical space but in constant interaction with larger social, cultural, and political institutions that shape drug use. Ultimately, this work suggests that in harm reduction, triggers are at once very visible and conceptually irrelevant. In essence, triggers disappear. To understand this better, this work interrogates “wanting” in harm reduction which is part of a larger dynamic of tolerance, withdrawal, associative learning, and substance use maintenance. I suggest it is these dynamics that comprise the “neurologies” of triggers that are relevant to the harm reduction context. This work contributes to broader scholarship in anthropology that seeks to unsettle the divide between nature and culture. Employing a synthesis of the multiple ontologies and local neurologies approaches, this work highlights an ethnographic interrogation of biocultural processes and further suggests a need to account for specific and general biology, in addition to considerations of how to ground objects and practices locally. Ultimately, this work is one of the first applications of the local neurologies framework and provides a path forward for future researchers interested in studying the intersections of the brain and culture.

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