The Impact of Immediate Craving on the Valuation of Current and Future Opioids

Abstract

One of the mysteries of drug addiction is why people start to use drugs that are known to be addictive. Prior research has found that people generally under-predict the impact on their own future preferences of visceral states, such as hunger, thirst and fear that they are not currently experiencing. Based on this research, we hypothesized that people who are not currently craving a drug - even addicts who have experienced craving frequently in the past - will under-appreciate the impact of craving on their own future preferences. To test this prediction, we elicited the money value that addicts placed on an extra dose of the heroin substitute Buprenorphine, when they were either in a state of craving (right before receiving BUP) or in a drug-satiated state (right after receiving BUP). In the most important condition, the reward they ended up receiving - either money or BUP - would be delayed by 5 days. As would be predicted if addicts can't remember what craving is like when they aren't currently craving, addicts valued the extra dose of BUP to be received 5 days later more highly when they were craving than when they were satiated.

Keywords: Addiction, utility elicitation, decision making

JEL Classification: C91, D00