The University of Arkansas for Medical Sciences issued the following news release:

Why do people who know the dangers of a drug like Heroin still use it the first time?

A team of researchers that included University of Arkansas for Medical Sciences (UAMS) addiction expert Warren Bickel, Ph.D., suggest that some people underestimate the drug's addictive power and have an unrealistic view on how easy it will be to quit, leading them to "tempt fate" by experimenting with that drug.

In the study, published in the January issue of the Journal of Health Economics and now available online, the researchers based their hypothesis on observations of longtime drug users who under-appreciated the effects of future drug deprivation when they were not actually deprived.

In a novel experiment, the researchers found that Heroin users, who were being treated with a Heroin substitute medication, valued that substitute more right before they received it than afterward. If the addicts cannot appreciate the intensity of drug craving when they are not currently experiencing it, wrote the researchers, it seems unlikely that those who have never experienced craving could predict it as a motivational force.

In the eight-week study, 13 Heroin addicts being treated with the maintenance drug buprenorphone (BUP) were asked to choose at different times between varying amounts of money or an extra dose of the drug. The addicts were shown to want the extra dose nearly twice as much just before receiving a normal dose, when drug cravings were strongest, than right after receiving the dose - even if they knew it could be days before an extra dose would be available again.

Bickel said the study could improve addiction treatment by offering insight on why people use drugs they know are addictive and why it is difficult to quit using the drug.

"Individuals who are in treatment may think that they will be OK out of treatment. However, if they underestimate the power of drugs, they may be surprised that they relapse," said Bickel, professor and the Wilbur D. Mills Chair of Alcoholism and Drug Abuse Prevention for the Department of Psychiatry in the UAMS College of Medicine. "Similarly, adolescents may think that they can try drugs without ill consequence. But they may underestimate how powerful a drug is and therefore expose themselves to the drug."

The study was co-authored by Gary J. Badger of the Biometry Facility at the University of Vermont, Louis A. Giordano of the Department of Psychiatry at Duke University, Eric A. Jacobs of the Department of Psychology at Southern Illinois University and George Loewenstein of the Department of Social and Decision Sciences at Carnegie Mellon University.

During the study, the participants were shown a list of 12 amounts of money ranging from $0 to $100. They were asked to indicate for each amount whether they would prefer to receive that much money or an additional dose of BUP. They were also told that one of the 12 choices they made would randomly be chosen to count.

The participants were asked to make choices when their cravings were highest, right before they received their normal dose. They were also asked to make the choices right after receiving their normal treatment, when the cravings were lowest.

In addition, half the time, the participants made a choice that would occur the same day while the other half of the time they were told they would not receive the choice for five days.

The researchers assumed that addicts understood the intensity of their drug cravings and their choices would not be affected by whether or not they had just received treatment.

The results showed the opposite, as the median money amount preferred to an extra dose of BUP was greater when the subjects were drug deprived, whether the dose was to be delivered immediately or after five days compared to when they their cravings were satiated.

When participants were drug deprived, they valued an immediate extra dose at $75, but valued the same dose at $50 when they were not deprived. More importantly, according to the researchers, when the subjects were deprived they valued an extra dose five days later at $60, but only valued it at $35 when they were not deprived.

"The research suggests that to prevent a relapse of drug use, we need to anticipate this underestimating of the motivational force of drugs," Bickel said. "We need to develop treatments that promote a more correct estimate of the threat."