Behavioral economic analysis of cue‐elicited craving for alcohol

Abstract

Rationale Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug’s value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. Method Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. Findings Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (Omax), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized Pmax). Craving was significantly correlated with demand measures at levels ranging from .21 – .43. Conclusions These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving.

Economic demand predicts addiction-like behavior and therapeutic efficacy of oxytocin in the rat

“…Economic demand is associated with measures of addiction in humans for several drugs, such as lifetime years of cocaine, heroin, marijuana, and benzodiazepine use (15); severity of alcohol dependence (10,11,14) and craving (16); as well as severity of nicotine dependence (12,13) and craving (17). A model of economic demand was recently validated in cocaine-dependent participants (9), providing the means for ready, direct comparison of animal and human studies of addiction treatments.…”

“…They offer a structured quantitative method to model behavior that is mathematically identical across species (7)(8)(9), and accruing evidence indicates economic-based descriptors of human behavior may be particularly useful biomarkers of addiction severity (10)(11)(12)(13)(14). Notably, economic demand has been shown to correlate with lifetime years of cocaine, heroin, marijuana, and benzodiazepine use (15); severity of alcohol dependence (10,11,14) and craving (16); as well as severity of nicotine dependence (12,13) and craving (17). However, economic demand has not yet been established as a biomarker of addictionlike behavior in animals, an essential final step in linking animal and human studies of addiction through economic demand.…”

Dorsolateral prefrontal and orbitofrontal cortex interactions during self-control of cigarette craving

“…Behavioral economists propose that drug cues increase the marginal utility of the drug, favoring the decision to consume (3,5,6). Indeed, cue-induced craving reflects the subjective value of drug use (7) and predicts drug-seeking behaviors (8,9), but is also amenable to self-control (6,10). Cue-induced craving is affected by a variety of contexts and events that impact self-control, such as perceived drug availability (11)(12)(13)(14), expectancy (15), stress (16), or intention to seek treatment (17).…”

Smokers Report Greater Demand for Alcohol on a Behavioral Economic Purchase Task

“…In laboratory settings, demand curve analyses have been used to quantify drug consumption and levels of drug-reinforced responding as a function of price (e.g., lever presses required to obtain a drug dose) to measure differences in drug potency or the impact of environmental manipulations on demand (Higgins et al, 2004;Johnson and Bickel, 2006). Recently, time and cost-effi cient self-report demand curve measures have been developed and administered in clinical settings to measure individual differences in the incentive value of drugs (Jacobs and Bickel, 1999;MacKillop et al, 2010b;Murphy et al, 2009;Skidmore and Murphy, 2011).…”