20 Jun Why People With Cocaine Addiction Don’t Change?

MedicalResearch.com Interview with:
Dr Karen Ersche PhD
University of Cambridge
Department of Psychiatry
Brain Mapping Unit
Herchel Smith Building
Cambridge UK

MedicalResearch.com: What is the background for this study?

Dr. Ersche: Cocaine addiction is a major public health problem that is associated with significant harm – not just for the individual, but also for their families and for society as a whole. Without medically proven pharmacological treatments, therapeutic interventions mainly rely on psychosocial approaches, but behaviour in people with cocaine addiction remains extremely difficult to change.

The impetus for this study was to find out why people with cocaine addiction are so resistant to change. One possibility would be that they have a strong tendency to develop habits, which means that they show patterns of behaviour that are not under direct voluntary control.

MedicalResearch.com: What are the main findings?

Dr. Ersche: We found that people with cocaine addiction are indeed more inclined to develop habits, but only when their behaviour is being rewarded. In this case, they readily switch into an autopilot mode and continue doing what they had been doing before, regardless of the consequences and whether or not it is still rewarding.

For behaviours that are not rewarded, but are motivated to avoid something bad happening, cocaine-addicted people do not show this increased tendency to develop habits. In fact, our data suggest that they are much less inclined than healthy people to make an effort to prevent something bad happening to them in the first place.

MedicalResearch.com: What should readers take away from your report?

Dr. Ersche: Our study has illustrated, under laboratory conditions, a behaviour profile for cocaine-addicted individuals that may strike a chord with people who interact with such individuals. Our findings go some way to explain this behaviour and seeming inability to change, which those interacting with cocaine users may have found so incomprehensible. With an increased propensity towards habit formation, people with cocaine addiction just function slightly differently from others. This knowledge could help to ease some of the frustration that the behaviour of people with cocaine addiction inflicts. Most importantly, however, our findings may inform therapeutic strategies, making them more effective.

In practical terms, this would mean acknowledging that approaches involving rewards in moderation are more effective than punitive ones. Importantly, simply warning cocaine users about the risks associated with their behaviour won’t be enough; cocaine-addicted people need to be actively protected from adversity, because they themselves will fail to avoid it.

Interventions may also be more effective if we find ways to build on cocaine users’ particular strength in developing habits. This could be achieved by training implementation of more desirable habits that could replace drug-taking habits.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ersche: Moving forwards from the findings of this study, I would like to better understand the mechanisms in the brain that underlie the behaviour profile of chronic cocaine users, and to use this knowledge to develop more effective treatments for cocaine addiction.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:
1. K. D. Ersche, C. M. Gillan, P. S. Jones, G. B. Williams, L. H. E. Ward, M. Luijten, S. de Wit, B. J. Sahakian, E. T. Bullmore, T. W. Robbins. Carrots and sticks fail to change behavior in cocaine addiction. Science, 2016; 352 (6292): 1468 DOI:10.1126/science.aaf3700

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on June 20, 2016 by Marie Benz MD FAAD