HomeAddictionTraining the Brain to Think Ahead

From time-to-time, I will post articles such as this that highlight promising new research that supports recovery ideas and principles that appear in “Powerless No Longer.” This article, from “Medical News Today, addresses research into the disability of addicts to delay short-term gratification, even when they know that the long-term consequences of using are dire.

“The growing numbers of new cases of substance abuse disorders are perplexing. After all, the course of drug addiction so often ends badly. The negative consequences of drug abuse appear regularly on TV, from stories of celebrities behaving in socially inappropriate and self-destructive ways while intoxicated to dramatization of the rigors of drug withdrawal on “Intervention” and other reality shows.

Schools now educate students about the risks of addiction. While having a keen awareness of the negative long-term repercussions of substance use protects some people from developing addictions, others remain vulnerable.

One reason that education alone cannot prevent substance abuse is that people who are vulnerable to developing substance abuse disorders tend to exhibit a trait called “delay discounting”, which is the tendency to devalue rewards and punishments that occur in the future. Delay discounting may be paralleled by “reward myopia”, a tendency to opt for immediately rewarding stimuli, like drugs.

Thus, people vulnerable to addiction who know that drugs are harmful in the long run tend to devalue this information and to instead be drawn to the immediately rewarding effects of drugs.

Delay discounting is a cognitive function that involves circuits including the frontal cortex. It builds upon working memory, the brain’s “scratchpad”, i.e., a system for temporarily storing and managing information reasoning to guide behavior.

In a new article in Biological Psychiatry that studied this process, Warren Bickel and colleagues used an approach borrowed from the rehabilitation of individuals who have suffered a stroke or a traumatic brain injury. They had stimulant abusers repeatedly perform a working memory task, “exercising” their brains in a way that promoted the functional enhancement of the underlying cognitive circuits.

They found that this type of training improved working memory and also reduced their discounting of delayed rewards.

“The legal punishments and medical damages associated with the consumption of drugs of abuse may be meaningless to the addict in the moment when they have to choose whether or not to take their drug. Their mind is filled with the imagination of the pleasure to follow,” commented Dr. John Krystal, Editor of Biological Psychiatry. “We now see evidence that this myopic view of immediate pleasures and delayed punishments is not a fixed feature of addiction. Perhaps cognitive training is one tool that clinicians may employ to end the hijacking of imagination by drugs of abuse.”

Dr. Bickel agrees, adding that “although this research will need to be replicated and extended, we hope that it will provide a new target for treatment and a new method to intervene on the problem of addiction.”

Notes:

The article is “Remember the Future: Working Memory Training Decreases Delay Discounting Among Stimulant Addicts” by Warren K. Bickel, Richard Yi, Reid D. Landes, Paul F. Hill, and Carole Baxter. Bickel, Yi, and Hill are affiliated with the Department of Psychiatry, Center for Addiction Research, Little Rock, Arkansas. Landes is with the Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Baxter is from Recovery Centers of Arkansas, Little Rock, Arkansas. The article appears in Biological Psychiatry, Volume 69, Number 3 (February 1, 2011), published by Elsevier.”

In chapter five of “Powerless,” I will address this phenomenon, and one of the tools we use to help addicts overcome what the study calls “Delay Discounting,” a tool called a “Cost Benefit Analysis,” or CBA. Doing a CBA is simply weighing the advantages and disadvantages of using or not using in a formal cognitive manner designed to change and re-prioritize the thinking of the addict, so he simply comes to a different conclusion. This is part of the “cognitive training” mentioned in the article, and it’s good to see that studies are being done that will validate the efficacy of the tools I will be talking about.


Comments

Training the Brain to Think Ahead — 5 Comments

  1. Abuse, intoxication etc are “cool”. For example, I wanted to start smoking and drinking just to be like the big kids. They counted for much more in my picture of the world than boring old teachers, doctors and the rest of the establishment. Add to that the fact that I suffered from an undiagnosed psychiatric disorder then you have a recipe for chronic abuse.

    O.k. that’s personal experience, not research but how many others were like me?

    • In a word, millions were like you. I started smoking for the same reasons you did, and drinking to feel like “one of the guys,” for the first time in my life. What this article is addressing is the condition that results from continued use. Many High School and College students drink, use, and raise hell, but the majority “mature out of it.” Some don’t. They lose, or more accurately, never acquire the ability that most people have to put long-term goals ahead of short-term gratification. It’s one of the unfortunate things that happen to our brains as part of the mechanism of addiction, and adds to the denial that all addicts must overcome in order to recover.

  2. Delay discounting sounds to me like an idea worthy of investigation but does not really take into consideration the withdrawal a daily user has to deal with which is often the key for turning a user into an abuser. This withdrawal isn’t necessarily a body sensation or just feeling badly or the shakes or whatever. I think a fairly high percentage of addicts start off using to overcome anxiety or just a generalized fear of their environment. If the drug of choice relieves this anxiety, the anxiety returns when the chemical effects wear off and often times to a heightened degree. Someone who has suffered from panic attacks and the like will often do anything to relieve them-even commit suicide. Risk-reward is not a consideration and cognitive based treatment is a long stretch for an individual who is regulasly experiences anxiety on a daily basis

  3. That anxiety can be, and is addressed by cognitive therapy. First the addict needs to understand where it comes from, the dopamine system, affecting the self-preservation mechanism. Studies have repeatedly shown that when an addict firmly makes the decision that the consequences of using clearly outweigh the benefits of continuing to use, these withdrawal symptoms, along with their associated urges can be dealt with using cognitive techniques.

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