Cultural and societal influences on addiction patterns: A Sri lankan perspective

Global models of substance use disorder (SUD) often prioritize individual-level risk factors, overlooking the profound role of cultural and societal context. This study addresses this gap by investigating the unique socio-cultural determinants shaping addiction and recovery in Sri Lanka, a setting marked by its collectivist traditions and rapid social change. Social cohesion refers to the bonds, trust, and sense of solidarity that hold a community together. Its effect on addiction is paradoxical: it can be both a powerful protective factor and a significant risk factor. A qualitative study was conducted utilizing retrospective data from client records and in-depth, semi-structured interviews with current residents and staff of the Mithuru Mithuro rehabilitation center. Thematic analysis was employed to identify recurring cultural themes. Preliminary analysis revealed that addiction patterns are not merely clinical issues but are deeply embedded in the Sri Lankan socio-cultural fabric. The collectivist nature of society was found to provide a protective support network, yet simultaneously exerts intense stigma that drives substance use underground and delays treatment-seeking. Strong, and healthy social cohesion in its positive form, was shown to prevent addiction and aid recovery reducing the loneliness and alienation that often drive substance use. Also, social cohesion was found to offer emotional and practical help during times of stress, providing alternatives to drugs or alcohol as a coping mechanism. Community norms against substance use can be gently enforced through family pressure and social expectations, deterring initial experimentation. Furthermore, a supportive network which can provide everything from a place to live to help finding a job, were found to be critical for sustained recovery. However, when social cohesion became oppressive or was centered on deviant norms, it could directly foster addiction. In tightly-knit groups, the pressure to "fit in" can be immense. If the group's activities include substance use (e.g., binge drinking with coworkers, drug use in a specific subculture), refusal to participate could lead to social exclusion. Cohesion within a drug-using peer group was a primary driver of sustained addiction. The bonds formed within this "using community" was found to be incredibly strong, creating a powerful alternative social world that competes with mainstream society. Recovery often involves substituting addictive behaviors with religious rituals (e.g., Buddhist meditation). The Sri Lankan experience, as seen through the lens of Mithuru Mithuro, demonstrates that effective addiction treatment must be culturally congruent. A one-size-fits-all clinical approach is insufficient. Interventions must leverage protective cultural assets, such as family involvement and spiritual practices, while actively mitigating the detrimental effects of stigma. These findings underscore the critical need for culturally grounded public health strategies in non-Western contexts.

To be updated shortly..