Why Do Certain People Recover from Addiction More Easily Than Others?
Addiction specialists and other health professionals are well aware that not all people who enter addiction recovery programs experience the same rate of improvement or ultimately successfully halt their substance intake. In a study published in March 2014 in the journal Clinical Psychological Science, researchers from the U.S. and Great Britain explored one of the potential explanations for the differences in treatment outcomes among affected individuals. These researchers concluded that a paradoxical phenomenon, called rate dependence, may actually give people more heavily impacted by addiction a treatment advantage over their less heavily impacted counterparts.
Addiction is the term used to describe a combination of physical dependence on the effects of a substance and an accompanying constellation of symptoms that seriously reduce a dependent person’s ability to maintain mental and physical well-being and carry out the tasks needed to live a functional, self-reliant lifestyle. Specific symptoms that indicate the presence of an addiction include strong urges to keep using a particular substance, an inability to set and adhere to limits on substance intake, decreasing responsiveness to the effects of a given amount of a substance, the development of withdrawal symptoms when established substance intake needs are not met and the creation of a daily routine that heavily favors substance-related activities. In the U.S., all diagnosable forms of substance addiction and damaging substance abuse are considered together under a single heading called substance use disorder. Doctors designate the substance in question when making a diagnosis for each individual; in this way, the umbrella term substance use disorder becomes alcohol use disorder, opioid use disorder, etc.
Not all people impacted by substance addiction are affected to the same extent. In fact, the substance use disorder definition allows doctors to make a diagnosis in individuals with as many as 11 related symptoms and as few as two. One of the classic problems found in people heavily impacted by addiction is loss of the ability to consider the future negative outcomes of their actions and an accompanying tendency to place greater importance on impulsive activities (like substance intake) that produce rapid short-term rewards. Addiction specialists and researchers refer to this amplified preference for immediate reward as delay discounting.
Rate Dependence and Addiction Recovery
In the study published in Clinical Psychological Science, researchers from the Virginia Tech University Carilion Research Institute, the University of Minnesota, the University of Arkansas for Medical Sciences and University College London tested the impact of a phenomenon called rate dependence on the odds that any given person in recovery from substance addiction will have a successful treatment outcome. The principles of rate dependence hold that people who don’t respond well to the initial stages of treatment sometimes experience greater longer-term benefits from that treatment than people who do initially respond well. All told, the study included 222 individuals affected by an addiction to the opioid narcotic heroin, nicotine or some form of stimulant drug or medication. The researchers roughly divided these individuals into two groups: those heavily impacted by impaired impulse control and a preference for short-term rewards and those who retained a substantial ability to predict the negative outcomes of their actions.
When they compared the treatment outcomes of the two groups, the researchers found that those individuals who expressed concern about the consequences of their addiction actually experienced fewer treatment benefits than those individuals who had more or less lost their ability to think beyond their short-term mental and physical surroundings. Specifically, they concluded that the participating addicts most heavily involved in short-term thinking reduced their substance intake during treatment to a greater extent than the participating addicts who continued to contemplate the future. One of the treatments that apparently helped the short-term-oriented addicts the most was a training process that helped them improve a critical form of short-term memory called working memory.
Significance and Considerations
The authors of the study published in Clinical Psychological Science believe they are the first researchers to identify the potential positive impact of impaired short-term thinking and impulse control on the outcomes of substance addiction treatment. They also believe that, in the future, treatment programs may be able to provide highly targeted treatments for their clients/patients by administering fairly simple tests specifically designed to identify recovering addicts unusually affected by short-term thinking and a corresponding loss of control over impulsive behavior.