Acting with the future in mind is impaired in long-term opiate users

Abstract

These data provide important evidence suggesting that the functional aspect of episodic foresight is disrupted in long-term opiate users. While these deficits appear to have some links to impaired executive control, additional work is needed to gain a more complete understanding of the underlying cognitive and neural mechanisms involved. This, in turn, will have important implications for tailoring interventions with opiate users to maximise the likelihood of successful independent functioning.

Predictive mechanisms linking brain opioids to chronic pain vulnerability and resilience

“…Given the anatomical overlap between brain regions binding exogenous opioids and those undergoing neuroplasticity in chronic pain, an important consideration is whether opioid treatment for chronic pain is one potential driver of observed neuroplasticity. Evidence supporting this thesis is limited to studies of long‐term opiate users showing deficits in certain cognition functions, namely fear‐learning (Basden et al, ), prospective memory (Terrett et al, ) and episodic foresight (imagining the future) (Terrett et al, ), known to involve medial prefrontal interactions with basal ganglia (Peira et al, ) that undergo neuroplasticity in chronic pain (Baliki et al, ). While cause and effect (between opioid use and cognitive deficits) cannot be established from these studies, observations of changes in opioidergic and dopaminergic circuits and regions predicting chronic pain in the striatum (Baliki et al, ), point to the possibility that reinforcement‐related changes in both brain plasticity and behaviour in relation to opioid use and misuse may overlap with some of the observations of chronic pain neuroplasticity.…”

The History and Future of Human Prospection

“…The brake works by providing some of the motivational salience of a future reward before it arises (Pezzulo and Rigoli 2011;Viganò 2017;Kurth-Nelson, Bickel, and Redish 2012;Hoerl and McCormack 2016). In line with this perspective, researchers increasingly see impaired foresight as a risk factor for addiction and a barrier to recovery (Noël, Jaafari, and Bechara 2017;Bickel et al 2017;Terrett et al 2017). (For an interesting discussion about the relative role of the semantic and episodic systems in modifying intertemporal choices, see Hoerl & McCormack in STF [(2016)], Kwan et al [2015], and Palombo et al [2016].…”

The Emergence of Episodic Foresight and Its Consequences

“…The role of foresight in clinical conditions (e.g., anxiety, depression, schizophrenia) is increasingly attracting research attention . Impaired foresight is likely associated with many other behaviors, such as risk perception and drug abuse . Researchers in developmental psychology may want to consider findings in these fields.…”