Testing the Reinforcer Pathology Theory: A New Insight into Novel Targets for Drug Addiction

Despite decades of effort in developing evidence-based treatments, drug addiction remains one of the most problematic and enduring public health crises. Developing a new generation of theoretically-derived interventions constitutes an important clinical and scientific gap that, if addressed, may open innovative treatment opportunities. Based on the Reinforcer Pathology theory, altering the temporal window over which reinforcers are integrated (i.e., measured by delay discounting) would alter drug valuation and consumption. The first investigation—in 2 separate studies— test the Reinforcer Pathology theory by examining the effect of expanding and constricting the temporal window of integration using two mating narratives (long-term and short-term relationships, respectively) on cigarette valuation among cigarette smokers. The second investigation, test the Reinforcer Pathology theory by assessing the effect of remotely delivered Episodic Future Thinking (EFT) narratives (expands the temporal window) on real-world alcohol consumption among individuals with alcohol use disorder (AUD). Together, these investigations supported the Reinforcer Pathology theory and demonstrated its relevance for understanding and intervening in addiction. The current findings provide scientific justification to further investigate Reinforcer Pathology based interventions that expand the temporal window to change drug valuation and consumption. The construction of multi-component treatments that incorporate Reinforcer Pathology based interventions to systematically alter the temporal window may provide a novel intervention to reduce alcohol consumption.