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The role of anticipation in drug addiction and reward

Authors Jędras P, Jones A, Field M

Received 27 September 2013

Accepted for publication 24 October 2013

Published 16 December 2013 Volume 2014:3 Pages 1—10


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Paweł Jędras, Andrew Jones, Matt Field

Department of Psychological Sciences, University of Liverpool, Liverpool, UK

Abstract: Addiction is a chronically relapsing disorder, and substance users frequently relapse when they encounter opportunities to use drugs. In this paper, we review evidence regarding the psychological response to anticipation of imminent drug availability, its neural substrates, and its relationship to other phenomena implicated in addiction. Naturalistic and laboratory studies indicate that drug anticipation increases cue-provoked craving and attentional biases for drug-related cues. As predicted by existing theoretical models, these effects reflect hyper-valuation of drugs that are perceived as available for consumption, which is linked to activation of the dorsolateral prefrontal cortex that, in turn, innervates subcortical regions associated with reward processing. Drug expectancy is necessary for the formation of conditioned responses to drug-related cues and it modulates the strength of conditioned responses. Furthermore, the role of impulsivity in addiction can be understood in terms of its interaction with the response to imminent drug availability. These results have a number of implications for the treatment of addiction, ranging from government policies that restrict the perceived availability of drugs to novel biological and psychological interventions that could blunt the response to signals of drug availability.

Keywords: attentional bias, availability, conditioning, cue-reactivity, expectancy, substance use disorders

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