How Positive Are Addictions, and Does Coffee Taste Good?

I smoked a cigarette for the first time when I was 15 years old. Looking back, I’m actually surprised I held off that long – so many factors in my environment supported it. Both of my parents smoked regularly; most of my friends. Cigarettes were cheap – maybe $2 a pack, and they were easy to come by. At the time smoking was still permitted in many public spaces, including at the restaurant where I worked. Smoking was everywhere.

I can’t say that smoking that first cigarettes was enjoyable… in fact, it was quite the opposite. Maybe you’ve never smoked before, but perhaps have had coffee? Alcohol? As I type this it’s hard to imagine how coffee used to be so off-putting that to endure it I had to flood it with sugar and cream. Luckily, my memory serves me, and plenty of other people’s anecdotes support this – early experiences with drugs or alcohol are not particularly pleasant. There’s a reason you don’t see many beginning drinkers opt for whiskey neat, instead choosing apple Pucker or hard lemonade. It’s only after experience and acclimation that the mocha can be faded out and suddenly you find yourself ordering a martini (hold the vermouth).

So – if many drugs have inherently aversive properties, wouldn’t we expect substance use and abuse to be rare?

While this seems intuitive, researchers have found some straight-forward explanations as to why substance use – casual or otherwise – is actually quite common. This is NOT to say that drug abuse is straight-forward or simple – either to treat or circumvent, unfortunately (more on these points in upcoming blogs). However, there are rational reasons why people can overlook common aversive properties such as taste or from method of drug delivery (e.g., needle injection) and willingly – eagerly – self-administer drugs. It largely boils down to – maybe you guessed it – reinforcement. Both positive and negative reinforcement can come into play, resulting in what can amount to such a terrifically valued habit that is impossible to ignore, hard to simply kick, and challenging to surmount with alternative reinforcers.

Now, I feel the need to pause and note that this post is aiming to provide a broad overview of behavior maintained by drug substances – to lay some groundwork for more intricate variables to be discussed in future blogs. Each person has unique factors (including genetic) influencing their behavior that cannot be ignored. And – in fact, behavior analysts focus IN on unique individual variables when working clinically. While I’ll delve into these other variables at a later time point, I first want to spend some time discussing how a simple understanding of reinforcement can help explain not only initial attempts at trying out drugs but also continued use and potential abuse.

Let’s talk first about positive reinforcement, as it is often a primary influence in the initiation of substance use. As noted above, sweet substances are commonly added to orally consumed drugs to enhance their appeal. That Frappuccino or piña colada actually tastes pretty good! However, some other compounds which produce physiological effects may also contain sugar yet there isn’t a black market for gummy vitamins… clearly something else is also at play here.

By definition, drugs produce physiological changes in the body. Sometimes these changes produce effects that are perceived as desirable and can lead to an increase in seeking out and consuming these substances – a positive reinforcement effect. The subjective feelings differ based on the substance, but reinforcing drugs are commonly described as producing some type of euphoria, relaxation, relief from pain, alertness, energy, or enhanced sensation. Of course, not everyone will always find the same drugs to be enjoyable, but there are some types of drugs that are generally found to be reinforcing when examined under several human and nonhuman research paradigms (commonly drug self-administration or examining how much someone will pay or work for access to a unit of a drug). As several researchers have noted, understanding substance abuse as a pattern of behavior that is reinforced by drugs has contributed greatly to our ability to interpret and treat it (Panlilio & Goldberg, 2007).

Moreover, early encounters with drugs often occur in a broader context involving friends and social events. If you combine this enjoyable context with the positive physiological effects of the drug, any potential aversive properties can be overcome fairly easily. The smoke isn’t THAT terrible, that beer doesn’t taste THAT bad… or, at least, it can be tolerated because everyone is having fun! In a technical sense, this stems from classical conditioning and is called counterconditioning – if you pair something offensive with enough other positives, the off-putting substance can become positively valued. Pretty soon, that pale ale is far from offensive and you may even test your limits by tasting several different varieties. Flights of beer are popular, no? Once the value of the substance is high enough – either from enough social pairings or positive physiological effects – we might find ourselves interested in trying them without so much support. You can fade out the friends, take away the sugar in your coffee because you’re counting calories – whatever it may be. And you might find this fading process to be pretty easy! The physiological effects are still there to support you, without the prior crutch.

So – these positive drug effects, combined with potential social aspects, can lure us into having a daily coffee or tea or beer at 5 o’clock or whatever it may be. Does this provide a thorough understanding of how substance use can arise and be maintained? Are people just “junkies” who can’t stray from the junk? Where is the will-power and why can’t people simply choose to abstain? While people use drugs to achieve positive reinforcing effects, this is only one part of a more complex picture. Stay tuned, because in the next post we’ll discuss how negative reinforcement contributes heavily to an addict’s continued use of drugs and why it can be so darn difficult to break the cycle.