Role of Substance-Specific Subjective Effects in Predicting Drug of Choice and Substance Use Disorders

Substance use is an individual and societal burden. Although many people experiment with substances, only a small proportion ever becomes addicted. Several theories have postulated how and why individuals become addicted to substances; however, no theories have accounted for the roles an individual’s preference of substance-specific hedonic effects and drug of choice (DOC) play on addiction. To fill this gap in theories of addiction, it is proposed that preferred substance-specific hedonic effects are a key predictor of DOC and, in turn, the escalation from substance use experimentation to substance addiction. The current study tested the proposed association between hedonic effects, DOC, and addiction by first examining if elevations in scales designed to assess the enjoyment of substance-specific hedonic effects were associated with an increased probability of having a particular DOC. This study also investigated if those same scales were associated with a lifetime history of particular substance use disorders. Eighty-one treatment seeking individuals meeting criteria for a lifetime SUD and having experience with at least three different classes of substances were interviewed and given a battery of questionnaires assessing their enjoyment of substance-specific hedonic effects. Significant correlations were found between Caucasian race and having an opiate and stimulant substance use disorder, but not a depressant or hallucinogen substance use disorder. Marginally significant and non-significant effects in the expected direction provided some support for the hypotheses; however, no results were fully significant. Results provided some evidence for the extension of Koob’s (2008) hedonistic homeostatic dysregulation theory of addiction. Limitations include a lack of power to detect effects for some primary DOCs and SUDs and a relatively older aged sample.