Abstract
Reinforcing properties of psychoactive substances are considered to be critically involved in the development and maintenance of substance dependence. While accumulating evidence suggests that the sensitivity to reinforcement values may generally be altered in chronic substance users, relatively little is known about the influence reinforcing feedback exerts on ongoing decision-making in these individuals. Decision-making was investigated using the Cambridge Risk Task, in which there is a conflict between an unlikely large reward option and a likely small reward option. Responses on a given trial were analyzed with respect to the outcome on the previous trial, providing a measure of the impact of prior feedback in modulating behavior. Five different groups were compared: (i) chronic amphetamine users, (ii) chronic opiate users in methadone maintenance treatment (MMT), (iii) chronic users of illicit heroin, (iv) ex-drug users who had been long-term amphetamine / opiate users but were abstinent from all drugs of abuse for at least 1 year and (v) matched controls without a history of illicit substance use. Contrary to our predictions, choice preference was modified in response to feedback only in opiate users enrolled in MMT. Following a loss, the MMT opiate group chose the likely small reward option significantly less frequently than controls and heroin users. Our results suggest that different opiates are associated with distinctive behavioral responses to feedback. These findings are discussed with respect to the different mechanisms of action of heroin and methadone.
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Acknowledgements
We would like to thank our volunteers without whom this study would not have been possible, particularly those who aided with recruitment, as well as the key workers Nick Schiller and Marion Martin and members of Narcotics Anonymous. We also thank Dr Robert Rogers for providing the Risk Task and Dr George Ploubidis for statistical advice. This work was funded by a Wellcome Trust Programme Grant (no. 019407) to Professors Trevor Robbins, Barry Everitt, Barbara Sahakian and, Dr Angela Roberts and carried out within the MRC Centre for Behavioural and Clinical Neuroscience. Karen Ersche was supported by the Fund for Addenbrooke's and Jonathan Roiser by the Medical Research Council. The authors declare that they have no conflict of interests.
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Ersche, K., Roiser, J., Clark, L. et al. Punishment Induces Risky Decision-Making in Methadone-Maintained Opiate Users but not in Heroin Users or Healthy Volunteers. Neuropsychopharmacol 30, 2115–2124 (2005). https://doi.org/10.1038/sj.npp.1300812
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DOI: https://doi.org/10.1038/sj.npp.1300812
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