Carrots and sticks fail to change behavior in cocaine addiction

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Science  17 Jun 2016:
Vol. 352, Issue 6292, pp. 1468-1471
DOI: 10.1126/science.aaf3700

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Punishment doesn't work in cocaine addicts

Addiction is extremely difficult to treat, particularly cocaine use disorder. Animal experiments have led to the concept of drug addiction as abnormal goal-directed learning and habit formation. Ersche et al. found that overtraining with positive reinforcement such as rewards made cocaine-addicted patients less sensitive to the outcome of their actions. In contrast, overtraining on a punishment paradigm had no effect. Thus, habits may determine the behavior of cocaine users.

Science, this issue p. 1468


Cocaine addiction is a major public health problem that is particularly difficult to treat. Without medically proven pharmacological treatments, interventions to change the maladaptive behavior of addicted individuals mainly rely on psychosocial approaches. Here we report on impairments in cocaine-addicted patients to act purposefully toward a given goal and on the influence of extended training on their behavior. When patients were rewarded for their behavior, prolonged training improved their response rate toward the goal but simultaneously rendered them insensitive to the consequences of their actions. By contrast, overtraining of avoidance behavior had no effect on patient performance. Our findings illustrate the ineffectiveness of punitive approaches and highlight the potential for interventions that focus on improving goal-directed behavior and implementing more desirable habits to replace habitual drug-taking.

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