A psychological desire to use cocaine regularly is known as cocaine dependence. People addicted to cocaine make riskier decisions than healthy people
after losing a potential reward, suggested a study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.
In the study, senior author Martin Paulus of the Laureate Institute for
Brain Research in Tulsa, Oklahoma, and colleagues show that this
heightened sensitivity to loss displayed by the cocaine users correlated
with an exaggerated decrease in a part of the brain that processes
‘Altered neural processing of risk and reward drives people with cocaine use disorder to take further risks to regain a lost reward.’
The results suggest that altered neural processing of risk and
reward drives people with cocaine use disorder to take further risks to
regain a lost reward, helping researchers to understand why cocaine
users tend to make risky decisions despite the potential negative
"This paradoxical relationship between how someone acts in response
to a loss can give us clues for how to develop better interventions and
how to track the recovery of the brain from cocaine addiction," said
first author Joshua Gowin, of the University of California San Diego,
where the research was completed, and of the National Institute on
Alcohol Abuse and Alcoholism in Bethesda, Maryland.
In the study, 29 participants diagnosed with cocaine use disorder
and 40 healthy control participants performed a Risky Gains Task, in
which they could earn money by choosing between three monetary values -
the lowest value being the safest option and higher values being
riskier. Dr. Gowin and colleagues assessed differences in behavior and
neuroimaging between the groups.
As the potential monetary value increased, the control group showed a
proportional increase in activity of the ventral striatum, a brain
region important for processing reward, which was not observed in the
cocaine use disorder group. According to the authors, this suggests that
riskier behavior in people with cocaine use disorder is not motivated
"In an interesting parallel to their real life behavior, brain
activity and choice behavior during a gambling task used in this study
indicate an aberrant sensitivity to loss and a tendency to double down
and make risky choices," said Cameron Carter, Editor of Biological
Psychiatry: Cognitive Neuroscience and Neuroimaging. The two groups made
risky decisions at a similar frequency overall, but the effect was only
observed after participants had lost a gamble in a previous round.
Additionally, the study showed that lifetime cocaine use correlates
with activity of the anterior cingulate cortex during a risky decision,
which suggests a direct relationship between neural processing of risk
and substance use.
Because the data for the study were collected at a single time point
after people had already developed cocaine use disorder, it remains
unknown if the differences found in the study preceded cocaine use or
were caused by it. Future studies that follow people at high risk for
the disorder over time can help provide an answer to this question.