Cocaine Users Less Likely to Anticipate Consequences of Actions

Posted on September 19th, 2015

Cocaine Users Less Likely to Anticipate Consequences of ActionsPeople affected by cocaine addiction may have an unusual inability to anticipate the personal and social costs of their addiction-related behavior, if recently reported findings from a group of American researchers are correct.

Powdered cocaine and “crack” cocaine are stimulant substances known for their ability to produce the longstanding chemical changes associated with drug addiction. As with other forms of addiction, one of the common symptoms of cocaine addiction is continued involvement in substance intake after experiencing serious personal or social harm related to that intake. In a study published in February 2015 in The Journal of Neuroscience, researchers from four U.S. institutions sought to determine if people dealing with cocaine addiction lose at least some of their ability to predict the harms associated with their drug-using behavior.

Cocaine Addiction

All cocaine starts out as powdered cocaine, a substance known chemically as cocaine hydrochloride. Powdered cocaine is turned into crack cocaine through further chemical processing. Whether consumed in powdered form or in the form of crack, cocaine travels through the bloodstream and reaches the brain, where it produces a sensation called euphoria by altering the chemical balance in a group of structures that researchers popularly refer to as the pleasure center. If the pleasure center is repeatedly exposed to cocaine, this brain area’s chemical balance will undergo long-term alterations that support the onset of physical cocaine dependence. Because crack use encourages relatively frequent cocaine intake, consumption of this form of the drug may support dependence/addiction more rapidly than consumption of powdered cocaine.

In addition to continued use of cocaine after exposure to seriously negative personal or social outcomes, potential symptoms of cocaine addiction include a recurring inability to set limits on cocaine intake, rising tolerance to the drug’s euphoric effects, the development of recurring urges for further cocaine use, cocaine consumption in clearly dangerous situations and the onset of withdrawal if the pleasure center’s supply of the drug drops below established minimum levels. An official diagnosis of cocaine addiction/abuse (a specific manifestation of a condition called stimulant use disorder) requires the presence of at least two out of 11 total symptoms.

Predicting Benefit and Harm

The most important chemical in the pleasure center is a substance called dopamine. Increases and decreases in the levels of this chemical essentially control the onset of euphoria and less intense forms of pleasurable feeling. In addition to guiding short-term behavior, euphoria and other forms of pleasure help guide long-term behaviors in all human beings. This is true because humans have a natural tendency to pursue pleasurable sensations and avoid unpleasant sensations. Over time, adults learn how to predict which actions will bring them pleasure or good fortune and which actions will bring them pain or misfortune. In turn, predictions of pleasurable or painful outcomes help any given person decide how to structure his or her daily habits and routines.

Cocaine Addiction and Harm Anticipation

In the study published in The Journal of Neuroscience, researchers from the Icahn School of Medicine at Mount Sinai, New York University, the State University of New York at Stony Brook and Nevada State College used a project involving 75 adults to help determine if people affected by cocaine addiction lose at least part of their ability to predict negative outcomes and anticipate future exposure to loss. One-third of the participants had diagnosable cases of cocaine-based stimulant use disorder (referred to as cocaine use disorder by the researchers) and had also recently consumed cocaine, while another third qualified for a stimulant use disorder diagnosis but had not recently used the drug. The remaining 25 participants acted as a comparison group unaffected by stimulant use disorder. With the help of a procedure called an EEG (which measures brain activity), the researchers assessed all of the participants’ ability to predict positive and negative outcomes while performing a series of lab-based tests.

When they compared the results for the three groups, the researchers concluded that both cocaine-consuming groups experienced unusual difficulties when trying to predict which situations would lead to negative outcomes. They also concluded that the cocaine users who had not recently consumed the drug had unusual difficulties when trying to predict which situations would lead to positive outcomes. The researchers believe that people affected by cocaine addiction may simply lose some of the ability to gauge the consequences of their actions. They also believe that continued cocaine intake in an addicted individual may be, in part, an unconscious and misguided attempt to correct the chemical brain imbalances caused by the drug in the first place.

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