Addicts underestimate the power of their own craving

Sated drug addicts who have just had a hit, underestimate the influence their craving will have on them in the future, researchers have shown. The finding echoes similar research showing that when we're in a satisfied state we underestimate the motivational force of hunger, thirst and sexual desire.

For eight weeks, George Loewenstein and colleagues studied 13 abstinent heroin addicts who were supported by a carefully controlled regimen of the heroin substitute Buprenorphine. During that time the participants were asked to make a number of real choices regarding whether in five days' time (when their next dose of Buprenorphine would be overdue) they would rather receive various cash amounts versus an extra dose of Buprenorphine (on top of the one they would get anyway).

The participants were asked to make these decisions either straight before or straight after they'd received their latest due dose of Buprenorphine. Crucially, when the participants were currently in a satisfied state, they valued an extra dose of Buprenorphine five days later at just $35, compared to $60 when they were currently in a state of craving (these are median values).

During another stage of the study, participants chose between an immediate extra dose of Buprenorphine versus cash. In this case, participants in a state of craving actually valued an extra dose of Buprenorphine at $75.

“Our results suggest that addicts under-appreciate the effects of deprivation when they are not actually deprived”, the researchers said. This tendency to underestimate the power of craving could help explain why people start to take drugs which they've been warned will be highly addictive.
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Badger, G.J., Bickel, W.K., Giordano, L.A., Jacobs, E.A., Loewenstein, G. & Marsch, L. (2007). Altered states: The impact of immediate craving on the valuation of current and future opioids. Journal of Health Economics, In Press.

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