When country music legend George Jones sang of his alcoholism, “I’m living and dying by the choices I made,” he probably didn’t realize there would be an entire field of scientific research devoted to that very idea. A recent article in Psychology of Addictive Behaviors offers a value based decision making (VBDM) take on recovery from addiction. Field et al. describe a correlation between value judgements and success in recovery from addiction. From this behavioral economics perspective, addiction progresses when “substances increase in value (hypervaluation) whereas alternative, substance-free reinforcers decrease in value (hypovaluation);” naturally, the authors posit that recovery progresses as the inverse occurs.
Singular value-signals that come from making a choice between two competing goals (ex. the choice to use drugs versus spending time parenting one’s children) build over time into a pattern of behavior, or evidence accumulation (EA). Relying on neuroscience as well as VBDM to explain preferential biases in substance abuse cases, this research suggests these biases and patterns can be overcome through treatment. The article claims that successful methods of treating addiction function to decrease the perceived rewards of using and increase the perceived rewards of sustained recovery. Effective treatment makes it easier for the client to make healthy choices.
As the authors note, many models for addiction treatment can be successful in correcting the skewed value-signals that result from long term substance use which cause addicts to continue to choose drugs. Cognitive behavioral therapy, motivational interviewing, and twelve step programs are mentioned as examples of therapies that provide opportunities for increased valuation of substance free activities. Field et al. describe opportunities for increased efficacy in all addiction treatment fields by tracking substance-use EA suppression and substance-free EA potentiation through a behavioral economics lens. At New Paradigm Recovery, we may assume it’s obvious that for sustained recovery, it’s not enough to fear relapse, that one must build a positive desire for a new way of life. However obvious this may seem, the VBDM model of recovery offers potential to gather and track data in new ways and support clients in their building of new value systems in an organized and discrete manner.
The authors also address the importance “of the availability of substance free rewards in an individual’s environment, which can exert substantial influence on substance use independent of any decision making process.” The holistic philosophy at New Paradigm Recovery incorporates family counseling, and dual-diagnosis and trauma treatment in our recovery treatment program to address multiple areas of each client’s life, encouraging wellness at home, at work, and in leisure. By considering environmental factors like access to positive substance-free stimuli, we contribute to our clients’ potential for success, encouraging healthy decision making patterns for lasting recovery.
Addiction treatment programs may benefit by considering these decision making factors with greater attention. While this research has many opportunities for further exploration, it poses significant questions about how treatment professionals can present clients with opportunities for greater rewards from recovery and help change the thought patterns that make using seem like a rewarding option, especially in early recovery.
At New Paradigm Recovery, we know that it is not enough to fear relapse; one must build a desire for a new way of life and learn to value life without drugs and alcohol. This truth about lasting recovery from addiction is bolstered by the VBDM research. As noted in the research and supported by our experience, cognitive behavioral therapy (CBT), motivational interviewing (MI), and twelve step programs are examples of therapies that can be successful in adjusting the skewed value-signals that result from long term alcohol and substance use, which cause clients to continue to drink or use drugs. The VBDM model of recovery offers the potential to gather and track information in new ways, and support clients in building new value systems in a discrete and intensive manner. Our goal at New Paradigm Recovery is to equip our clients and families with the tools and support essential for lasting recovery. Supporting positive substance-free values and encouraging the hope for a brighter future are crucial to that work.
Field, M., Heather, N., Murphy, J. G., Stafford, T., Tucker, J. A., & Witkiewitz, K. (2020). Recovery from addiction: Behavioral economics and value-based decision making. Psychology of Addictive Behaviors, 34(1), 182–193. https://doi.org/10.1037/adb0000518
By Mari Zabel
