The Behavioral Economics of Substance Use Disorders: Reinforcement pathologies and their repair

Below:  Mean (±1 standard error of the mean) hypothetical consumption values across 17 different prices for alcohol purchases associated with three next-day responsibility conditions: (diamonds) no next-day responsibilities, (squares) next-day class, and (triangles) next-day test. From Skidmore JR, Murphy JG. 2011. The effect of drink price and next-day responsibilities on college student drinking: a behavioral economic analysis. Psychol. Addict. Behav. 25:57–68..

The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.

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