Novel Therapeutics for Addiction: Behavioral Economic and Neuroeconomic Approaches

Opinion statement Behavioral economic and neuroeconomic understandings of addiction offer both established and empirically supported treatments as well as a foundation from which promising new treatment options are emerging. Addiction must be understood and treated as a state of pathological overvaluation of the reinforcement of drug use fueled by an imbalance of the competing neurobehavioral decision systems that govern decision making (CNDS theory). The CNDS theory presents two systems, the executive and impulsive, which are dysregulated in reinforcer pathology by greater relative control of the impulsive, hedonic system, and lesser relative control of the executive, regulatory system. This leads to a reinforcer pathology where drug use is maladaptively overvalued in comparison to other reinforcers, leading to a chronic and often relapsing state of addiction. Some treatments which directly alter economic variables associated with drug use have already been empirically supported, including contingency management (which increases the short-term price of drug use) and drug agonist therapies (which decrease the short-term value of drug use compared to other reinforcers). New, promising treatments which bring the fundamental CNDS dysregulation of addiction into balance include episodic future thinking, which increases the temporal window over which the opportunity costs of drug use are integrated by engaging executive control, and TMS therapies which directly i...
Source: Current Treatment Options in Psychiatry - Category: Psychiatry Source Type: research