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Protracted Drug Use Impairs Decision Making

The behavior of chronic drug users often seems erratic and even dangerous to the observer. This is because their decision-making abilities – a complex process that involves the integration of emotional information with higher level cognitive processing – have likely been compromised by their substance use. This study examines linkages between decision-making impairments and frontal lobe dysfunction.

Researchers used functional neuroimaging to compare four groups during performance of the Cambridge Risk Task (which presents an unlikely high-reward option as well as a likely low-reward option). The groups were: chronic amphetamine users, chronic opiate users, ex-drug users abstinent for at least one year, and matched “controls,” healthy individuals without drug issues.

Results indicate that both current and prior amphetamine and opiate abuse may disrupt the ability of the prefrontal cortex to properly regulate the decision-making process. During the risk task, control participants showed relatively greater activation in the right dorsolateral prefrontal cortex, whereas participants with current, or even a prior history of drug use showed relatively greater activation in the left orbitofrontal cortex. This different brain activation observed in both the current and former drug users may reflect long-lasting changes in brain function caused by chronic drug use, or it may reflect a pre-existing abnormality that could have been exacerbated by chronic drug use.

(Ersche, KD, Fletcher, PC, Lewis, SJG, Clark, L, Stocks-Gee, G, London, M, Deakin, JB, Robbins, TW, Sahakian, BJ: Abnormal frontal activations related to decision-making in current and former amphetamine and opiate dependent individuals. Psychopharmacology 180:612-623, 2005.)

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