Bernheim and Rangel (2004) on Cues and Addiction

B. Douglas Bernheim and Antonio Rangel, “Addiction and Cue-Triggered Decision Processes [pdf].” American Economic Review 94(5): 1558–1590, 2004.

• Three premises: (1) use among addicts is frequently a mistake; (2) experience sensitizes users to environmental cues that trigger mistaken usage; (3) addicts understand their susceptibility to cue-triggered mistakes. 

• Addictive substances interfere with how the brain forecasts near-term hedonic rewards, leading to the cue-conditioned problems. 

• Upon exposure to cues, you might enter a “hot” mode, in which you consume the substance irrespective of preferences. Sensitivity to cues depends on past consumption. “Wanting” a drug is not the same as “liking” the drug; see Robinson and Berridge (1993, 2001).

• Some patterns of addictive behavior that the model is consistent with: (1) unsuccessful attempts to quit and recidivism even though the short-term, painful withdrawal costs have already been incurred; (2) cue-triggered recidivism; (3) self-described mistakes, even in the act of consuming; (4) precommitment strategies; and (5) the use of behavioral and cognitive therapy. 

• The model involves a consumer who enters each period in a cold state, but who can choose among different lifestyles for that period; each lifestyle has a different prospect of presenting cues, and hence of being forced to mistakenly consume the drug.