Author(s): Roy A Wise and George F Koob
What is the defining property of addiction? We dust off a several-decades-long debate about the relative importance of two forms of reinforcement—positive reinforcement, subjectively linked to drug-induced euphoria, and negative reinforcement, subjectively linked to the alleviation of pain—both of which figure importantly in addiction theory; each of these forms has dominated addiction theory in its time. We agree that addiction begins with the formation of habits through positive reinforcement and that drug-opposite physiological responses often establish the conditions for negative reinforcement to come into play at a time when tolerance, in the form of increasing reward thresholds, appears to develop into positive reinforcement. Wise’s work has tended to focus on positive-reinforcement mechanisms that are important for establishing drug-seeking habits and reinstating them quickly after periods of abstinence, whereas Koob’s work has tended to focus on the negative-reinforcement mechanisms that become most obvious in the late stages of sustained addiction. While we tend to agree with each other about the early and late stages of addiction, we hold different views as to (i) the point between early and late at which the diagnosis of ‘addiction’ should be invoked, (ii) the relative importance of positive and negative reinforcement leading up to this transition, and (iii) the degree to which the specifics of negative reinforcement can be generalized across the range of addictive agents.
Our inaugural Circumspectives
is entitled “The development and maintenance of drug addiction
”, authored by Roy A. Wise and George F. Koob (2014). The authors are eminent addiction researchers who have had a tremendous influence on the field, through both their research and generative spirits. For decades they have had a rather famous scientific disagreement, centered on their opposing views about what motivates addictive behavior. Dr. Wise is a proponent of the idea that the positive (rewarding) effects of abused drugs are most important, whereas Dr. Koob’s theory is that it is the aversive effects of drug withdrawal (the “Dark Side”) that are critical.
We welcome your thoughts on this debate and, if you wish to share them, your own ideas for experiments that would help to resolve this debate and push the field forward.
Bill Carlezon, Ph.D., on behalf of the Editors of NPP.