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Cocaine Users Lack Empathy, Are Less Social Than Non-Users

New research on cocaine users has revealed that they don’t have the same responses to social cues as non-users, deriving less “reward” from social interactions. Cocaine is the second most popular illicit drug (after marijuana) in the U.S., and many users will graduate from casual use to lasting addiction. The impairments to social interaction found in this research could be an explanation of why social consequences of addiction (such as lost friends or ruined relationships with loved ones) may not be sufficient encouragement to stop using the drug, and has important implications for treatment.

The Study

The researchers aimed to build upon the existing knowledge of cocaine users’ social impairment by performing two separate experiments. In the first experiment, a group of 80 cocaine users were compared against 63 control (non-using) participants based on how they interacted with a virtual character. The experiment was focused on joint attention, in which we derive neurological rewards when somebody focuses his or her attention on the same object as we do, or vice-versa. When people demonstrate “joint attention,” it establishes a social bond (more so than if both looked at different objects), and psychologists believe it reflects our ability to feel empathy with others. In the first experiment, the participants’ eye movements were tracked, and this same device controlled the eye-gaze behavior of the virtual companion, enabling researchers to have the character look at the same object as the participant or a different one. The participants’ pupil sizes were taken as an objective measure of emotional processing, and they also ranked the different conditions according to how pleasurable they perceived them to be.

The second test used the same basic type of experiment, but instead of using pupil size as a measure of emotional response, 16 participants from each group were scanned using an fMRI (functional magnetic resonance imaging) machine. This enabled researchers to see if differences in emotional processing in cocaine users were accompanied by reduced activation of key “reward” areas in the brain.

Cocaine Users Experience “Blunted” Social Rewards

Cocaine users didn’t emotionally engage in the social interaction as much as the control group, which was confirmed by a less significant response from their pupils during the experiment. In addition, they differentiated between the joint attention and non-joint attention less than the control group, but both groups ranked the joint attention as being more pleasurable. In the second test, researchers were able to confirm that the social interaction produced less activation in the medial orbitofrontal cortex (an important brain region for the processing of rewards) of cocaine users compared to the healthy controls.

The researchers asked the participants questions about the size of their social networks, and this correlated with the brain activation in reward centers. In other words, the cocaine users had fewer friends, and this appears to be related to their diminished processing of social rewards. The lack of emotional engagement in the joint attention experiments also suggests that cocaine users find it more difficult to see things from another’s perspective and may feel less empathy than the healthy controls.

The Implications for Treatment

One of the most interesting implications of these findings is related to the consequences of addiction. Often, problems in social relationships that emerge as a result of drug or alcohol use are huge motivators for people to make a change and get healthy again. However, in cocaine users, this may have a limited effect because of their diminished ability to empathize with others. In addition, they may lose contact with good, supportive friends who would be more likely to help them overcome their issues. This loss of friends in itself may drive the user even deeper into addiction.

For treatment providers, the research suggests a shift in focus may have many benefits. For example, spending time with cocaine dependent individuals and helping them learn to do things like think from the perspective of another person may have significant benefits during and after treatment. The researchers suggest this as an approach, in addition to training in general social skills and empathetic thinking.


This research fills in some important details about the behavior and motivations of cocaine abusers, and will therefore be very instructive for treatment providers and users themselves. Understanding the physiological and psychological differences in drug users enables treatment to be better tailored to those in need of it; it is hoped that the findings of this study will help to improve the outcomes of cocaine abusers both in and after rehabilitation. For users to be able to recognize their reduced interest in social activity as a consequence of drug abuse and not just a quirk of their personality may also be beneficial if it motivates them to overcome addiction and connect with others in social situations.


Posted on February 11th, 2014
Posted in Abused Drugs

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