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A concurrent pictorial drug choice task marks multiple risk factors in treatment-engaged smokers and drinkers

Concurrent choice tasks, where participants choose between a drug versus natural reward, predict dependence vulnerability in animals and humans. However, the sensitivity of concurrent choice tasks to multiple risk factors in treatment-engaged drug users has not been comprehensively tested. In experiment 1, 33 recently hospitalized smokers who were engaged with the smoking cessation service made forced choices between enlarging pictures of people smoking versus not smoking. In experiment 2, 48 drinkers who were engaged in an outpatient alcohol treatment service made forced choices between enlarging pictures of alcohol versus food. In these experiments, percent drug picture choice was significantly associated with dependence severity, craving, self-reported reasons for drug use (negative coping and cued craving), depression, anxiety, withdrawal intolerance, drug use frequency prior to treatment, and current abstinence status (coefficients ranged from r=0.39 to 0.66). The concurrent pictorial drug choice task is sensitive to multiple risk factors in clinical, treatment-engaged drug users, and may be used to identify individuals requiring more support, to test experimental treatment manipulations, and to translate to animal concurrent self-administration procedures.