Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-19T10:19:07.521Z Has data issue: false hasContentIssue false
  • English
  • Français

Behavioral preference for viewing drug v. pleasant images predicts current and future opioid misuse among chronic pain patients

Published online by Cambridge University Press:  15 April 2019

Scott J. Moeller ,
Adam W. Hanley  and
Eric L. Garland
Scott J. Moeller
Affiliation:
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
Adam W. Hanley
Affiliation:
University of Utah Center on Mindfulness and Integrative Health Intervention Development, Salt Lake City, UT College of Social Work, University of Utah, Salt Lake City, UT
Eric L. Garland*
Affiliation:
University of Utah Center on Mindfulness and Integrative Health Intervention Development, Salt Lake City, UT College of Social Work, University of Utah, Salt Lake City, UT
*
Author for correspondence: Eric L. Garland, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The USA is currently enduring an opioid crisis. Identifying cost-effective, easy-to-implement behavioral measures that predict treatment outcomes in opioid misusers is a crucial scientific, therapeutic, and epidemiological goal.

Methods

The current study used a mixed cross-sectional and longitudinal design to test whether a behavioral choice task, previously validated in stimulant users, was associated with increased opioid misuse severity at baseline, and whether it predicted change in opioid misuse severity at follow-up. At baseline, data from 100 prescription opioid-treated chronic pain patients were analyzed; at follow-up, data were analyzed in 34 of these participants who were non-misusers at baseline. During the choice task, participants chose under probabilistic contingencies whether to view opioid-related images in comparison with affectively pleasant, unpleasant, and neutral images. Following previous procedures, we also assessed insight into choice behavior, operationalized as whether (yes/no) participants correctly self-reported the image category they chose most often.

Results

At baseline, the higher choice for viewing opioid images in direct comparison with pleasant images was associated with opioid misuse and impaired insight into choice behavior; the combination of these produced especially elevated opioid-related choice behavior. In longitudinal analyses of individuals who were initially non-misusers, higher baseline opioid v. pleasant choice behavior predicted more opioid misuse behaviors at follow-up.

Conclusions

These results indicate that greater relative allocation of behavior toward opioid stimuli and away from stimuli depicting natural reinforcement is associated with concurrent opioid misuse and portends vulnerability toward future misuse. The choice task may provide important medical information to guide opioid-prescribing practices.

Keywords

Allostasischoice behaviorchronic paininsightopioid misuserewardtreatment outcome
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 4 , March 2020 , pp. 644 - 652
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahmed, SH (2010) Validation crisis in animal models of drug addiction: beyond non-disordered drug use toward drug addiction. Neuroscience & Biobehavioral Reviews 35, 172–184.CrossRefGoogle ScholarPubMed
Ahn, WY and Vassileva, J (2016) Machine-learning identifies substance-specific behavioral markers for opiate and stimulant dependence. Drug and Alcohol Dependence 161, 247–257.CrossRefGoogle ScholarPubMed
Amador, XF, Strauss, DH, Yale, S, Flaum, M, Endicott, J and Gorman, J (1993) Assessment of insight in psychosis. American Journal of Psychiatry 150, 873–879.Google ScholarPubMed
Anderson, BA, Faulkner, ML, Rilee, JJ, Yantis, S and Marvel, CL (2013) Attentional bias for nondrug reward is magnified in addiction. Experimental and Clinical Psychopharmacology 21, 499–506.CrossRefGoogle ScholarPubMed
Badiani, A, Belin, D, Epstein, D, Calu, D and Shaham, Y (2011) Opiate versus psychostimulant addiction: the differences do matter. Nature Reviews Neuroscience 12, 685–700.CrossRefGoogle ScholarPubMed
Banks, ML, Hutsell, BA, Schwienteck, KL and Negus, SS (2015) Use of preclinical drug vs. food choice procedures to evaluate candidate medications for cocaine addiction. Current Treatment Options in Psychiatry 2, 136–150.CrossRefGoogle ScholarPubMed
Blume, AW, Schmaling, KB and Marlatt, GA (2005) Memory, executive cognitive function, and readiness to change drinking behavior. Addictive Behaviors 30, 301–314.CrossRefGoogle ScholarPubMed
Butler, SF, Budman, SH, Fernandez, KC, Houle, B, Benoit, C, Katz, N and Jamison, RN (2007) Development and validation of the Current Opioid Misuse Measure. Pain 130, 144–156.CrossRefGoogle ScholarPubMed
Castine, BR, Albein-Urios, N, Lozano-Rojas, O, Martinez-Gonzalez, JM, Hohwy, J and Verdejo-Garcia, A (2019) Self-awareness deficits associated with lower treatment motivation in cocaine addiction. The American Journal of Drug and Alcohol Abuse 45, 108–114.CrossRefGoogle ScholarPubMed
Clark, JM, Cao, Y and Krause, JS (2017) Risk of pain medication misuse after spinal cord injury: the role of substance use, personality, and depression. Journal of Pain 18, 166–177.CrossRefGoogle ScholarPubMed
Cleeland, CS and Ryan, KM (1994) Pain Assessment: Global use of the Brief Pain Inventory. Academy of Medicine, Singapore: Annals.Google ScholarPubMed
David, AS, Bedford, N, Wiffen, B and Gilleen, J (2012) Failures of metacognition and lack of insight in neuropsychiatric disorders. Philosophical Transactions of the Royal Society of London B Biological Sciences 367, 1379–1390.CrossRefGoogle ScholarPubMed
Dean, AC, Kohno, M, Morales, AM, Ghahremani, DG and London, ED (2015) Denial in methamphetamine users: associations with cognition and functional connectivity in brain. Drug and Alcohol Dependence 151, 84–91.CrossRefGoogle ScholarPubMed
Donny, EC, Bigelow, GE and Walsh, SL (2004) Assessing the initiation of cocaine self-administration in humans during abstinence: effects of dose, alternative reinforcement, and priming. Psychopharmacology (Berl) 172, 316–323.CrossRefGoogle ScholarPubMed
Evans, CJ and Cahill, CM (2016) Neurobiology of opioid dependence in creating addiction vulnerability. F1000Research 5.CrossRefGoogle ScholarPubMed
Garland, EL and Howard, MO (2014) Opioid attentional bias and cue-elicited craving predict future risk of prescription opioid misuse among chronic pain patients. Drug and Alcohol Dependence 144, 283–287.CrossRefGoogle ScholarPubMed
Garland, EL, Froeliger, B, Zeidan, F, Partin, K and Howard, MO (2013 a) The downward spiral of chronic pain, prescription opioid misuse, and addiction: cognitive, affective, and neuropsychopharmacologic pathways. Neuroscience & Biobehavioral Reviews 37, 2597–2607.CrossRefGoogle ScholarPubMed
Garland, EL, Froeliger, BE, Passik, SD and Howard, MO (2013 b) Attentional bias for prescription opioid cues among opioid dependent chronic pain patients. Journal of Behavioral Medicine 36, 611–620.CrossRefGoogle ScholarPubMed
Garland, EL, Manusov, EG, Froeliger, B, Kelly, A, Williams, JM and Howard, MO (2014) Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial. Journal of Consulting and Clinical Psychology 82, 448–459.CrossRefGoogle ScholarPubMed
Garland, EL, Froeliger, B and Howard, MO (2015 a) Allostatic dysregulation of natural reward processing in prescription opioid misuse: autonomic and attentional evidence. Biological Psychology 105, 124–129.CrossRefGoogle ScholarPubMed
Garland, EL, Hanley, AW, Thomas, EA, Knoll, P and Ferraro, J (2015 b) Low dispositional mindfulness predicts self-medication of negative emotion with prescription opioids. Journal of Addiction Medicine 9, 61–67.CrossRefGoogle ScholarPubMed
Garland, EL, Howard, MO, Zubieta, JK and Froeliger, B (2017) Restructuring hedonic dysregulation in chronic pain and prescription opioid misuse: effects of mindfulness-oriented recovery enhancement on responsiveness to drug cues and natural rewards. Psychotherapy & Psychosomatics 86, 111–112.CrossRefGoogle ScholarPubMed
Goldstein, RZ, Craig, AD, Bechara, A, Garavan, H, Childress, AR, Paulus, MP and Volkow, ND (2009) The neurocircuitry of impaired insight in drug addiction. Trends in Cognitive Sciences 13, 372–380.CrossRefGoogle ScholarPubMed
Greenwald, AG, Poehlman, TA, Uhlmann, EL and Banaji, MR (2009) Understanding and using the implicit association test: iII. meta-analysis of predictive validity. Journal of Personality and Social Psychology 97, 17–41.CrossRefGoogle ScholarPubMed
Hardy, L and Hogarth, L (2017) A novel concurrent pictorial choice model of mood-induced relapse in hazardous drinkers. Experimental and Clinical Psychopharmacology 25, 448–455.CrossRefGoogle ScholarPubMed
Hedegaard, H, Warner, M and Miniño, AM (2018) Drug overdose deaths in the United States, 1999–2017 (pp. 1–8). US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.Google Scholar
Hogarth, L and Chase, HW (2011) Parallel goal-directed and habitual control of human drug-seeking: implications for dependence vulnerability. Journal of Experimental Psychology: Animal Behavior Processes 37, 261–276.Google ScholarPubMed
Hogarth, L and Hardy, L (2018) Depressive statements prime goal-directed alcohol-seeking in individuals who report drinking to cope with negative affect. Psychopharmacology (Berl) 235, 269–279.CrossRefGoogle ScholarPubMed
Hogarth, L, Mathew, AR and Hitsman, B (2017) Current major depression is associated with greater sensitivity to the motivational effect of both negative mood induction and abstinence on tobacco-seeking behavior. Drug and Alcohol Dependence 176, 1–6.CrossRefGoogle ScholarPubMed
Kaye, AD, Jones, MR, Kaye, AM, Ripoll, JG, Galan, V, Beakley, BD, Calixto, F, Bolden, JL, Urman, RD and Manchikanti, L (2017) Prescription opioid abuse in chronic pain: an updated review of opioid abuse predictors and strategies to curb opioid abuse: part 1. Pain Physician 20, S93–s109.CrossRefGoogle ScholarPubMed
Keefe, RS, Poe, M, Walker, TM, Kang, JW and Harvey, PD (2006) The Schizophrenia Cognition Rating Scale: an interview-based assessment and its relationship to cognition, real-world functioning, and functional capacity. American Journal of Psychiatry 163, 426–432.CrossRefGoogle ScholarPubMed
Kornor, H and Nordvik, H (2007) Five-factor model personality traits in opioid dependence. BMC Psychiatry 7, 37.CrossRefGoogle ScholarPubMed
Lang, PJ, Bradley, MM and Cuthbert, BN (2008) International Affective Picture System (IAPS): Affective Ratings of Pictures and Instruction Manual. Technical Report A-8. Gainsville, FL: University of Florida.Google Scholar
Lawn, W, Freeman, TP, Hindocha, C, Mokrysz, C, Das, RK, Morgan, CJ and Curran, HV (2015) The effects of nicotine dependence and acute abstinence on the processing of drug and non-drug rewards. Psychopharmacology (Berl) 232, 2503–2517.CrossRefGoogle ScholarPubMed
Le Berre, AP, Vabret, F, Cauvin, C, Pinon, K, Allain, P, Pitel, AL, Eustache, F and Beaunieux, H (2012) Cognitive barriers to readiness to change in alcohol-dependent patients. Alcoholism: Clinical and Experimental Research 36, 1542–1549.CrossRefGoogle ScholarPubMed
Lenoir, M, Augier, E, Vouillac, C and Ahmed, SH (2013) A choice-based screening method for compulsive drug users in rats. Current Protocols in Neuroscience 64, 9–44.CrossRefGoogle Scholar
Lindgren, KP, Neighbors, C, Teachman, BA, Baldwin, SA, Norris, J, Kaysen, D, Gasser, ML and Wiers, RW (2016) Implicit alcohol associations, especially drinking identity, predict drinking over time. Health Psychology 35, 908–918.CrossRefGoogle ScholarPubMed
Lindgren, KP, Neighbors, C, Gasser, ML, Ramirez, JJ and Cvencek, D (2017) A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse. American Journal of Drug and Alcohol Abuse 43, 237–246.CrossRefGoogle ScholarPubMed
Lysaker, PH, Pattison, ML, Leonhardt, BL, Phelps, S and Vohs, JL (2018) Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry 17, 12–23.CrossRefGoogle ScholarPubMed
Meltzer, EC, Rybin, D, Saitz, R, Samet, JH, Schwartz, SL, Butler, SF and Liebschutz, JM (2011) Identifying prescription opioid use disorder in primary care: diagnostic characteristics of the Current Opioid Misuse Measure (COMM). Pain 152, 397–402.CrossRefGoogle Scholar
Moeller, SJ and Goldstein, RZ (2014) Impaired self-awareness in human addiction: deficient attribution of personal relevance. Trends in Cognitive Sciences 18, 635–641.CrossRefGoogle ScholarPubMed
Moeller, SJ and Stoops, WW (2015) Cocaine choice procedures in animals, humans, and treatment-seekers: can we bridge the divide? Pharmacology Biochemistry and Behavior 138, 133–141.CrossRefGoogle ScholarPubMed
Moeller, SJ, Maloney, T, Parvaz, MA, Dunning, JP, Alia-Klein, N, Woicik, PA, Hajcak, G, Telang, F, Wang, GJ, Volkow, ND and Goldstein, RZ (2009) Enhanced choice for viewing cocaine pictures in cocaine addiction. Biological Psychiatry 66, 169–176.CrossRefGoogle ScholarPubMed
Moeller, SJ, Maloney, T, Parvaz, MA, Alia-Klein, N, Woicik, PA, Telang, F, Wang, GJ, Volkow, ND and Goldstein, RZ (2010) Impaired insight in cocaine addiction: laboratory evidence and effects on cocaine-seeking behaviour. Brain 133, 1484–1493.CrossRefGoogle ScholarPubMed
Moeller, SJ, Hajcak, G, Parvaz, MA, Dunning, JP, Volkow, ND and Goldstein, RZ (2012) Psychophysiological prediction of choice: relevance to insight and drug addiction. Brain 135, 3481–3494.CrossRefGoogle ScholarPubMed
Moeller, SJ, Beebe-Wang, N, Woicik, PA, Konova, AB, Maloney, T and Goldstein, RZ (2013 a) Choice to view cocaine images predicts concurrent and prospective drug use in cocaine addiction. Drug and Alcohol Dependence 130, 178–185.CrossRefGoogle ScholarPubMed
Moeller, SJ, Parvaz, MA, Shumay, E, Beebe-Wang, N, Konova, AB, Alia-Klein, N, Volkow, ND and Goldstein, RZ (2013 b) Gene x abstinence effects on drug cue reactivity in addiction: multimodal evidence. Journal of Neuroscience 33, 10027–10036.CrossRefGoogle ScholarPubMed
Moeller, SJ, Konova, AB, Parvaz, MA, Tomasi, D, Lane, RD, Fort, C and Goldstein, RZ (2014) Functional, structural, and emotional correlates of impaired insight in cocaine addiction. JAMA Psychiatry 71, 61–70.CrossRefGoogle ScholarPubMed
Moeller, SJ, Fleming, SM, Gan, G, Zilverstand, A, Malaker, P, dOleire Uquillas, F, Schneider, KE, Preston-Campbell, RN, Parvaz, MA, Maloney, T, Alia-Klein, N and Goldstein, RZ (2016) Metacognitive impairment in active cocaine use disorder is associated with individual differences in brain structure. European Neuropsychopharmacology 26, 653–662.CrossRefGoogle ScholarPubMed
Moeller, SJ, Okita, K, Robertson, CL, Ballard, ME, Konova, AB, Goldstein, RZ, Mandelkern, MA and London, ED (2018) Low striatal dopamine D2-type receptor availability is linked to simulated drug choice in methamphetamine users. Neuropsychopharmacology 43, 751–760.CrossRefGoogle ScholarPubMed
Nosek, BA, Hawkins, CB and Frazier, RS (2011) Implicit social cognition: from measures to mechanisms. Trends in Cognitive Sciences 15, 152–159.CrossRefGoogle ScholarPubMed
Pujol, J, Blanco-Hinojo, L, Batalla, A, Lopez-Sola, M, Harrison, BJ, Soriano-Mas, C, Crippa, JA, Fagundo, AB, Deus, J, de la Torre, R, Nogue, S, Farre, M, Torrens, M and Martin-Santos, R (2014) Functional connectivity alterations in brain networks relevant to self-awareness in chronic cannabis users. Journal of Psychiatric Research 51, 68–78.CrossRefGoogle ScholarPubMed
Reich, RR, Below, MC and Goldman, MS (2010) Explicit and implicit measures of expectancy and related alcohol cognitions: a meta-analytic comparison. Psychology of Addictive Behaviors 24, 13–25.CrossRefGoogle ScholarPubMed
Rudd, RA, Seth, P, David, F and Scholl, L (2016) Increases in drug and opioid-involved overdose deaths - United States, 2010–2015. MMWR Morbidity and Mortality Weekly Report 65, 1445–1452.CrossRefGoogle ScholarPubMed
Schmidt, TP, Pennington, DL, Cardoos, SL, Durazzo, TC and Meyerhoff, DJ (2017) Neurocognition and inhibitory control in polysubstance use disorders: Comparison with alcohol use disorders and changes with abstinence. Journal of Clinical and Experimental Neuropsychology 39, 22–34.CrossRefGoogle ScholarPubMed
van der Meer, L, Costafreda, S, Aleman, A and David, AS (2010) Self-reflection and the brain: a theoretical review and meta-analysis of neuroimaging studies with implications for schizophrenia. Neuroscience & Biobehavioral Reviews 34, 935–946.CrossRefGoogle Scholar
Volz-Sidiropoulou, E, Boecker, M and Gauggel, S (2016) The positive illusory bias in children and adolescents with ADHD: further evidence. Journal of Attention Disorders 20, 178–186.CrossRefGoogle ScholarPubMed
Vowles, KE, McEntee, ML, Julnes, PS, Frohe, T, Ney, JP and van der Goes, DN (2015) Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain 156, 569–576.CrossRefGoogle ScholarPubMed
Wasan, AD, Michna, E, Edwards, RR, Katz, JN, Nedeljkovic, SS, Dolman, AJ, Janfaza, D, Isaac, Z and Jamison, RN (2015) Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain. Anesthesiology 123, 861–872.CrossRefGoogle ScholarPubMed
Wu, SM, Compton, P, Bolus, R, Schieffer, B, Pham, Q, Baria, A, Van Vort, W, Davis, F, Shekelle, P and Naliboff, BD (2006) The addiction behaviors checklist: validation of a new clinician-based measure of inappropriate opioid use in chronic pain. Journal of Pain and Symptom Management 32, 342–351.CrossRefGoogle ScholarPubMed
Zilverstand, A, Huang, AS, Alia-Klein, N and Goldstein, RZ (2018) Neuroimaging impaired response inhibition and salience attribution in human drug addiction: a systematic review. Neuron 98, 886–903.CrossRefGoogle ScholarPubMed