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Journal of Addiction
Volume 2014, Article ID 189853, 14 pages
Research Article

Choosing Money over Drugs: The Neural Underpinnings of Difficult Choice in Chronic Cocaine Users

1Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
2Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA
3Addiction Recovery Research Center, Virginia Tech, Roanoke, VA 24016, USA
4Department of Psychology, Stanford University, Stanford, CA 94305, USA
5Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX 77030, USA

Received 31 March 2014; Revised 6 June 2014; Accepted 25 June 2014; Published 14 August 2014

Academic Editor: James Zacny

Copyright © 2014 Michael J. Wesley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Addiction is considered a disorder that drives individuals to choose drugs at the expense of healthier alternatives. However, chronic cocaine users (CCUs) who meet addiction criteria retain the ability to choose money in the presence of the opportunity to choose cocaine. The neural mechanisms that differentiate CCUs from non-cocaine using controls (Controls) while executing these preferred choices remain unknown. Thus, therapeutic strategies aimed at shifting preferences towards healthier alternatives remain somewhat uninformed. This study used BOLD neuroimaging to examine brain activity as fifty CCUs and Controls performed single- and cross-commodity intertemporal choice tasks for money and/or cocaine. Behavioral analyses revealed preferences for each commodity type. Imaging analyses revealed the brain activity that differentiated CCUs from Controls while choosing money over cocaine. We observed that CCUs devalued future commodities more than Controls. Choices for money as opposed to cocaine correlated with greater activity in dorsal striatum of CCUs, compared to Controls. In addition, choices for future money as opposed to immediate cocaine engaged the left dorsolateral prefrontal cortex (DLPFC) of CCUs more than Controls. These data suggest that the ability of CCUs to execute choices away from cocaine relies on activity in the dorsal striatum and left DLPFC.