A neuroeconomic signature of opioid craving: How fluctuations in craving bias drug-related and nondrug-related value

Abstract

How does craving bias decisions to pursue drugs over other valuable, and healthier, alternatives in addiction? To address this question, we measured the in-the-moment economic decisions of people with opioid use disorder as they experienced craving, shortly after receiving their scheduled opioid maintenance medication and ~24 h later. We found that higher cravers had higher drug-related valuation, and that moments of higher craving within-person also led to higher drug-related valuation. When experiencing increased opioid craving, participants were willing to pay more for personalized consumer items and foods more closely related to their drug use, but not for alternative “nondrug-related” but equally desirable options. This selective increase in value with craving was greater when the drug-related options were offered in higher quantities and was separable from the effects of other fluctuating psychological states like negative mood. These findings suggest that craving narrows and focuses economic motivation toward the object of craving by selectively and multiplicatively amplifying perceived value along a “drug relatedness” dimension.

Ketogenic diet reduces a neurobiological craving signature in inpatients with alcohol use disorder

“…The NCS, along with other recent machine learning-based neural signatures of craving ( 36 ) represent an exciting new approach for tracking risk of relapse during recovery. The current findings suggest that the NCS may indeed be sensitive to substance use disorder intervention and the recovery process, complementing recent studies using decision-making behavior to predict craving fluctuations in an opioid use disorder sample ( 37 ). Although Koban et al ( 17 ) was published in a high impact journal, the Koban NCS has not been replicated or validated by other studies.…”

Ketogenic diet reduces a neurobiological craving signature in alcohol use disorder

“…The NCS, along with other recent machine learning-based neural signatures of craving (Garrison et al, 2023) represent an exciting new approach for tracking risk of relapse during recovery. The current findings suggest that the NCS may indeed be sensitive to substance use disorder intervention and the recovery process, complementing recent studies using decision-making behavior to predict craving fluctuations in an opioid use disorder sample (Biernacki et al, 2022). Future markers that combine imaging and behavioral markers may improve prediction further.…”

Patient Perceptions of Integrating Meditation-based Interventions in Office-based Opioid Treatment with Buprenorphine: A Mixed-methods Survey

“…5 Adults with opioid use disorder (OUD) evidence heightened drug cue reactivity and blunted responsiveness to natural rewards, underscoring the need for cognitive approaches that can strengthen self-regulation of addictive responses to drug cues and gradually enhance responsiveness to natural reward. 6 Meditation-based practices cultivate moment-by-moment nonjudgmental awareness of patients' thoughts, emotions, and sensations and aim to strengthen self-regulatory capacity. 7 Meditation-based interventions (MBIs) have shown promise in reducing perceived pain severity, stress, and anxiety and have enhanced treatment adherence, including to behavioral modifications.…”

“…Chronic substance use reorganizes the mesocorticolimbic dopamine system to enhance impulsivity and drug-induced rewards over delayed natural rewards 5 . Adults with opioid use disorder (OUD) evidence heightened drug cue reactivity and blunted responsiveness to natural rewards, underscoring the need for cognitive approaches that can strengthen self-regulation of addictive responses to drug cues and gradually enhance responsiveness to natural reward 6 …”