Drug Abuse and Behavioral Disinhibition

J.C. Verster et al. (eds.), Drug Abuse and Addiction in Medical Illness: Causes, Consequences and Treatment, DOI 10.1007/978-1-4614-3375-0_2, © Springer Science+Business Media, LLC 2012 Learning Objectives Personality disorders and externalizing disorders • that are characterized by impulsive or poorly controlled behaviors are considered risk factors for developing drug abuse disorders. Impulsivity and disinhibition are well recognized in • diagnostic classi fi cations of drug abuse disorders. A basic behavioral characteristic underlying impul• sivity and disinhibition appears to be a de fi cit in the ability to inhibit inappropriate actions. CNS depressant drugs, such as alcohol and some • psychostimulant drugs, can produce acute impairments of inhibitory control. Long-term chronic abusers of drugs display sus• tained de fi cits of inhibitory control which could re fl ect the neural insult owing to prolonged drug exposure. Abstract Traditional models of drug abuse emphasize the drug’s rewarding effects as reinforcing drug use to the point of physical dependence and addiction. However, the past several years have seen an increased focus on the role of cognitive disturbances both as temporary acute reactions to drugs and as enduring impairments owing to prolonged chronic drug abuse. This chapter focuses on impairments of impulse control and reviews several lines of research that point to the role of impaired control in the development and maintenance of drug abuse disorders. The sections describe how the concept of impaired control is embedded in diagnostic classi fi cations of alcohol abuse disorders and how impaired control characterizes constructs, such as impulsivity and disinhibition, which are key aspects of personalities and psychopathologies commonly associated with drug abuse. Cognitive approaches to the concept of impaired self-control are also examined with the aim of identifying how speci fi c impairments in the ability to inhibit an action can contribute to drug abuse, and possibly emerge as a consequence of prolonged drug abuse. The chapter concludes by highlighting areas for further research, such as gaining a better understanding of the role of de fi cient inhibitory control in drug abuse for more effective treatment development. Drug Abuse and Behavioral Disinhibition