Overview
Actor-Network Theory (ANT) is a social theory that posits that social phenomena are the result of a network relationships between interacting entities rather than dividing the world into a material reality and a social reality.
For instance, a conventional biomedical perspective of addiction might frame the problem as beginning with exposure to substances, escalating to chronic use that changes brain chemistry and tolerance levels, developing into a dependence or addiction, and leading to drug-seeking behavior with its associated consequences.
A more ANT-centric perspective steps back from a linear cause-and-effect chain to instead examine the network of relationships from which a substance use disorder emerges. We might end up with a non-linear list:
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a pharmaceutical company oriented towards profitability as a result of shareholder, managerial, and worker interests manufactures and markets an addictive substance after a series of clinical trials, regulatory approval processes, and patent applications
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a public policy agenda supports private insurance companies as a way to fund healthcare protocols that involve processing prescriptions to the products of a pharmaceutial company
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an insurance company decides which substances it will pay for and under which conditions through a combination of risk-analysis algorithms trained on healthcare data, documentation from Electronic Health Records, and contractual policies involving prior authorization
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a treatment facility or clinic hires from a competitive marketplace of medical professionals who have varying educational credentials and memberships with professional organizations whose outputs are regularly cited in private and public standards
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medical education institutes train physicians according to regulatory guidelines from accreditation organizations that examine the state of academia and research to derive guidelines and consolidate core materials for physician education
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a physician prescribes this addictive substance to patients according to diagnostic criteria and protocols, including pain scale assessments that negotiate between a patient’s expression of pain and a physician’s interpretation of pain
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a patient’s family has a history of health issues and substance use disorders, which a physician evaluates through their engagement with risk-related discourse and genetic research
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a patient suffers from major trauma that leads to a clinical encounter with a physician whose interpretation of the patient’s expression of pain leads to a prescription to an addictive substance
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a patient lacks culturally or religious compatible support networks around them, leading to increased isolation and the substance as their primary means to alleviate pain or suffering
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a patient’s neurochemistry changes to produce cravings and dependence that lead to job performance issues and unemployment at the discretion of an employer that might or might not be understanding of substance use disorders
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public intoxication laws criminalize the dependence for homeless individuals with substance use disorder, further marginalizing them while adding the traumas associated with the abuses of incarceration and increasing potential exposure to illicit addictive substances or those who can provide them
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political coalitions formed by middle and upper class communities reject proposals to fund social services through systemic reforms out of concern for their tax burdens and property values
So on and so forth. In a system like this, we can’t really isolate any single thing as the cause or even cleanly carve out a discrete set of causes. In fact, we can keep unpacking each phenomenon as the product of an even more granular network, like pointing out that the political coalitions are comprised of local politicians and property owners navigating the forces of housing and labor markets through digital media as information exchange platforms.
Each actor or agent influences how other actors and agent’s have the capacity and incentives to act. When we consider this model of social phenomena, it becomes increasingly hard to see addiction or substance use disorder as solely a health issue within an individual’s mind-body duality. I would argue that this guides us away from hyperindividualized, radically materialist perspectives of lived reality and towards concepts like interconnectedness and impermanence, which are found very commonly in the “Eastern” traditions” before being crudely adapted into “Western spirituality.”