The Behavioral Economics of Substance Use Disorders: Reinforcement Pathologies and Their Repair

Bickel, Warren K.; Johnson, Matthew W.; Koffarnus, Mikhail N.; MacKillop, James; Murphy, James G.

doi:10.1146/annurev-clinpsy-032813-153724

Cited by 655Substance Abuse Treatment and OutcomesDecision-Making and Behavioral EconomicsGambling Behavior and Treatments

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The Behavioral Economics of Substance Use Disorders: Reinforcement Pathologies and Their Repair

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Bickel, Warren K., Johnson, Matthew W., Koffarnus, Mikhail N., MacKillop, James, Murphy, James G.·2014·Annual Review of Clinical Psychology

DOI 10.1146/annurev-clinpsy-032813-153724PMC PMC4501268

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Abstract

The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.

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The concept of reinforcer pathology is a recent development in the field of the behavioral economics of addiction specifically focused on how the window of time over which reinforcers are integrated can determine the relative valuation of alcohol and drugs versus other prosocial reinforcers, such as relationships and employment.
“The concept of reinforcer pathology is a recent development in the field of the behavioral economics of addiction specifically focused on how the window of time over which reinforcers are integrated can determine the relative valuation of alcohol and drugs versus other prosocial reinforcers, such as relationships and employment [22–24].”
From Addiction Biomarkers: Dimensional Approaches to Understanding Addiction (2018) · cites this paper as [23]

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Authors: Bickel, W. K., Johnson, M. W., Koffarnus, M. N., MacKillop, J., & Murphy, J. G.
Affiliations: Virginia Tech (US)
Johns Hopkins University (US)
University of Georgia (US)
University of Memphis (US)
ORCID: Bickel, Warren K.
Johnson, Matthew W.
Koffarnus, Mikhail N.
MacKillop, James
Murphy, James G.
Venue: Annual Review of Clinical Psychology
Publisher: Annual Reviews
Published: 2014-03-28
Volume: 10
Issue: 1
Pages: 641-677
ISSN: 1548-5943 (ISSN-L)
1548-5951
DOI: 10.1146/annurev-clinpsy-032813-153724
PMC: PMC4501268
OpenAlex: W2152023371
Cited by: 655
References: 287
Citations by year: 2026: 32 · 2025: 40 · 2024: 45 · 2023: 59 · 2022: 60 · 2021: 59 · 2020: 126 · 2019: 69 · 2018: 40 · 2017: 49 · 2016: 32 · 2015: 33 · 2014: 11
FWCI: 5.56
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Annual Review of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (R01AA021529)
National Institute on Drug Abuse (R21DA032717, R01DA024080, R01DA032363, R01DA030241, R01DA034755)
National Cancer Institute (U19CA157345)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords: substance use disorders, behavioral economics, delay discounting, impulsivity, reinforcement learning, addiction treatment, endogenous and exogenous factors
MeSH terms: Choice Behavior, Humans, Motivation, Reinforcement, Psychology, Substance-Related Disorders, Economics, Behavioral

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The Behavioral Economics of Substance Use Disorders: Reinforcement Pathologies and Their Repair

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