7 June 2017: Addiction states as dynamic changes in valuation

Anna Konova
Center for Neural Science
New York University

The symptoms of drug addiction imply alterations in decision processes. The integrative field of neuroeconomics, which borrows concepts and methods from economics, psychology, and neuroscience, has identified a “domain general” neural system encompassing the ventromedial prefrontal cortex and the striatum in the computation of subjective value – the basis of idiosyncratic preferences and choice. Indeed, the application of this framework to addiction in both humans and other animals has successfully captured many features of addiction. However, this work has generally considered addiction as a static entity, ignoring addiction’s most elusive (and perhaps most defining) feature – its stereotyped, cyclic nature at the level of the individual, characterized by alternating periods of abstinence and drug use. I will discuss ongoing work in which we aim to better understand two dynamic processes at the transition between abstinence and relapse to drug use: (1) a relatively slower process (in the order of weeks and months) related to risk preferences that tracks drug use vulnerability and which we have modeled with repeated assessments of economic choice behavior through the first months of treatment for opioid addiction; and (2) a faster process (in the order of minutes or hours) related to the motivational state of craving that tracks immediate vulnerability and which we have modeled as a specific, gain-control like shift in the value of the object of craving. Understanding these addiction states as dynamic changes in valuation, we hope, can help identify when additional therapeutic intervention is needed on a timescale that is clinically useful as well as motivate the development of new decision- and valuation-based interventions for breaking the cycle of addiction.