Drug abuse and behavioral disinhibition

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 classifications 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 specific 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 deficient inhibitory control in drug abuse for more effective treatment development.