400 CHAPTER 9
Reward craving
The desire for the gratifying effects of using a
substance.
Relief craving
The desire for the temporary emotional relief
that can arise from using a substance.
correlation does not imply causation. It is possible that those who are at risk for de-
veloping substance abuse (perhaps because of a family history) may be more likely
to seek out peers who are substance users. For instance, consider that people who
have a high need for social approval are more likely to model their peers’ behavior.
So, it is possible that if peers abuse drugs, those desperate for social approval are
more likely to use or abuse drugs than are people who resist peer pressure and do
not respond strongly to peer approval (Caudill & Kong, 2001).
In any event, observational learning is an established fact. And it is possible that
by watching others—such as parents or peers, for instance—children and young
adults learn to expect drugs to produce certain kinds of experiences, even if they
do not use substances as a coping strategy (Brown et al., 1999; Colder et al., 1997;
Zamboanga et al., 2005). For instance, when the Beatles began smoking cigarettes
during their early teens, they did so in part because such behavior was modeled by
their parents and their community; in addition, they probably developed the expec-
tation that smoking would be fun and might make them appear more attractive to
girls. These positive expectancies, developed through observational learning, may
have led them to continue to smoke, even if smoking was initially unpleasant.Operant Conditioning
Operant conditioning exerts its infl uence on stimulant use and abuse (and substance
use, abuse, and dependence more generally) in several ways. First, if stimulant use
is followed by pleasant consequences, those consequences act as positive reinforce-
ment (which leads to recurrent use). Research on the dopamine reward system
shows that aspects of this type of learning have neurological underpinnings. In fact,
the dopamine reward system begins to be activated with the expectation of a drug’s
positive effects (that is, the expectation of reinforcement), which leads to reward
craving—the desire for the gratifying effects of using a substance (Verheul, van den
Brink, & Geerlings, 1999). Reward craving occurs even if recent experiences of
drug use have not been positive.
Second, stimulant use and abuse can independently lead to negative
reinforcement— alleviating a negative state, thereby producing a desirable experi-
ence (remember that negative reinforcement is not the same as punishment). In fact,
such negatively reinforcing effects contribute to substance abuse among people try-
ing to manage the psychological aftereffects of physical or emotional abuse (Bean,
1992; Catanzaro & Laurent, 2004; Ireland & Widom, 1994; Stewart, 1996); in
particular, using drugs may (temporarily) distract them from painful memories or
their present circumstances, and hence be reinforcing.
Drug use may provide transient relief from negative states, but persistently
using substances as the means of gaining such relief (as the coping strategy)—which
may have been learned, in part, through observing how other people cope—doesn’t
generally work, despite the fact that while the drug is in the system it may seem to
the person that it helps. Substance use may temporarily make a person less aware of
or make him or her care less about life’s diffi culties, but it doesn’t make those dif-
fi culties go away. When the substance wears off, the person is in the same situation,
if not worse off because of the consequences of the substance use (e.g., “crashing”
after the high wears off or missing a deadline because of being high). These continu-
ing life challenges in turn require more coping, and the person can enter a down-
ward spiral. If substance use becomes the dominant coping strategy, it inevitably
becomes substance abuse and possibly dependence.
The temporary emotional relief provided by substance use can create cravings for
the drug when an individual experiences negative emotions; this type of craving is some-
times referred to as relief craving (Verheul, van den Brink, & Geerings, 1999). Both
reward craving and relief craving can cause substance-dependent people to use drugs
compulsively, even when they would like to quit. Thus, cravings are thought to play a
primary role in maintaining substance dependence (Torrens & Martín-Santos, 2000).
A third way that operant conditioning contributes to substance abuse and
dependence also involves negative reinforcement, but in this case because using theP SNP SN