Study Provides New Insight Into Drug-Related Decisions

There are many factors that can increase the risk of developing a substance abuse problem. Family history, social networks and socioeconomic factors are all important influences in whether individuals will choose to initiate and continue drug use. However, none of these factors carry any guarantee that a person will use drugs.

Predicting initiation of drug use and addiction is a science based on individualized variables for each person. Despite the many issues that can predict an increased risk of drug use, there are specific processes in the brain that, in the end, decide whether a person will begin using drugs.

Recently, a new study provided important information that will help experts better understand how the brain makes decisions about drug use. The study was conducted by researchers at the University of Maryland School of Medicine and is published in the online version of the journal Science.

The research provides evidence that one area of the brain plays a critical role in decisions that are made in the spur of the moment. The section of the brain is located in the orbitofrontal cortex, and the study shows that this same part of the brain is not involved when individuals make decisions based on prior knowledge or experience.

The study’s findings are a major breakthrough because they provide critical information about the neurobiological processes related to decision-making and particularly give insight into decisions that lead to substance abuse. Previously, it had been believed that both types of decisions occurred in the same part of the brain.

The orbitofrontal cortex was assumed to be responsible for "value-based" decisions, such as when a person chooses an alternative based on weighing possible outcomes and options.

With the information gained by the study, there is new understanding that the area of the brain is involved only when the decision’s outcomes must be computed hurriedly. If the value of the decision has been stored or pre-weighed, the orbitofrontal cortex is not involved with the decision.

The study shows that when there is orbitofrontal cortex damage, it may be difficult for a person to make a quick, unprecedented decision. According to lead author Joshua Jones, Ph.D., the person may not be able to see the extended consequences of the decision and may regress to habitual behaviors.

This may explain the habitual decisions made by those with a substance addiction, with addicts gravitating to the choice that gives them immediate satisfaction, rather than considering how their decision may impact them later. Because drugs, and particularly cocaine, can do damage to the orbitofrontal cortex, this provides helpful new insight for understanding why addicts continue to make decisions that consistently result in negative consequences.

The authors note that future research will include exploration of whether changes in the brain resulting from drug use are causing continued addiction.