Poor decision making is a hallmark of addiction. This is clear from the fact that addicts accept many risks and make great sacrifices in order to use drugs like cocaine despite the fleeting pleasure they get from this activity. However, long-term drug users are also prone to making poor choices in other areas of their life, like engaging in unprotected sex and reckless driving. This fits with a growing body of laboratory research showing that cocaine addicts process the costs and benefits of their actions differently than healthy non-users, and are specifically more likely to accept a small but immediate reward rather than wait for a large reward—a bias indicative of impulsive decision making (for review, see ref. [1]).

Determining the behavioral and neural mechanisms of impulsive decision making is an important goal of addiction research, and recent studies have shown that merely allowing rats to self-administer cocaine disrupts the way they make decisions about non-drug rewards [1], suggesting that repeated drug exposure leads to long-term alterations in the function of neural circuits that normally mediate adaptive decision making. In the current issue of Neuropsychopharmacology, Burton et al. [2] build on this body of work to investigate whether cocaine-induced changes in decision making are accompanied by changes in the way rewards are processed by the nucleus accumbens (NAc), a region that is strongly implicated in both decision making and cocaine addiction.

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