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Drug Users Underestimate the Power of Cravings
> 2/19/2007 2:02:12 PM

A revealing new study points to chemical activity within the brain to suggest that, in the midst of an internal conflict between logic and the emotional desire for immediate gratification, many drug users both new and seasoned underestimate the difficulties of presented by addiction and its related symptoms: dependence, withdrawal, and intense physical and psychological cravings.

Carnegie Mellon University Professor and addiction expert George Loewenstein performed the eight-week study, small in scale but huge in terms of potential applications, that dealt with thirteen heroin users participating in a treatment and maintenance plan involving the opiate substitute bruprenorphine (BUP). Throughout the study, patients were presented with the option of accepting either a set sum of cash or an additional dose of the medication. 12 set cash totals, ranging from $1 to $100, were offered to the addicts, and they were asked to make the decision independently for each sum. Of course, as the numbers rose, participants were more likely to choose the cash; in the study's most important variable, half of the surveys took place directly before the patients received their dosage and the other half several minutes later, when their addictions had been momentarily satiated. In addition, the subjects were sometimes promised their reward on that same day, while other times they were told they would receive it five days later.

The most immediately significant results of the experiment showed that the addicts were twice as likely to choose additional portions of BUP if asked to make the choice before receiving their daily dose, when their cravings were at their most severe. This was true regardless of when they expected to receive the drugs. In what seems like a paradox, addicts considered the potential for long-term gain more carefully when already under the influence. When going through the cravings, they were willing to forego the future dose only when offered sums of $60 or more, but after being treated that figure dropped to $35. The following day, the pattern only repeated itself. The confusion inherent in rationalizing drug use, particularly to those unfamiliar with the extremes of withdrawal and desire, inevitably leads more people to try drugs they know to be extremely dangerous by thinking that they, unlike others, will not succumb to the symptoms of addiction. It also leaves addicts more likely to downplay their own use, sustaining the false belief that the pains of withdrawal will not be as severe the next day.

In an earlier, thematically related economics study by the same professor, researchers found that, when offered small sums of money that increased slightly over time, most participants chose to accept the immediate rewards rather than wait for larger sums. This experiment arose from the recent study of neuroeconomics, or the ways in which brain processes affect short and long-term investment decisions. By measuring the neural activity of the study's participants through Magnetic Resonance Imaging (MRI), researchers detected a chemical conflict between the disparate sections of the brain responsible for emotion and logic. The abstract reasoning portions of the brain registered activity in every instance, but the short-term variables also stimulated the brain's emotional center. While most people exhibited the rational desire to undergo a slightly longer wait for a larger sum, immediacy won out in short-term versions of the experiment:

For example, many people who [were] offered the choice of $10 today or $11 tomorrow [chose] to receive the lesser amount immediately. But if given a choice between $10 in one year or $11 in a year and a day, people often [chose] the higher, delayed amount.

In most decision-making processes, emotion trumps reason in the heat of the moment, even when dealing with such small amounts of money. When the variables involved are addictive and life threatening, even the most serious addicts underestimate the intensity of emotion stirred by withdrawal. The brain may mistake this initially overwhelming response for reason and foster an erroneous belief in the power of self-discipline and the relative worth of gratification. When driven by addiction, the mind often has greater trouble considering the future implications of each decision. The limits of the human brain can easily fail us in these situations as we make choices that we will sorely regret later. It is in this way that extremely intelligent people can fall into the continuing cycles of physical and psychological dependence, twin influences that wear down even the strongest among us over time.

Comments
While it is somewhat comforting to read that scientists are learning more about the hells of addiction - I feel no sense of purpose to the conclusion. I am an addict. I feel so tired, at 24, keeping this life together as best I can. I have been to 2 different recovery homes and one 'real' treatment center, having some success (and more disapointments)and recieving as much support as my family could ever possibly give. Thanks for confirming what I wish I never knew, that no amount of intelligence or logic will save somebody from this pain. And that puts me back to square one... How can I get some hope? It is sickening to recall the absolute sincere yearning (and effort) to be ok, and get confused as you retrace whatever it was that got you into that pit again. It is simple and complicated; I wonder how I can be 'normal'and find that fire inside to strive to be ok and know that it will be ok. For many it isn't and that is a cold fucking feeling. But the website is informative and it is way better than nothing, so thanks.

Posted by: Michelle 9/14/2007 12:55:57 PM