Competing motivations: drug reinforcement vs non-drug reinforcement.

A behavioral pharmacological conceptualization of drug abuse is summarized, which views drug abuse as learned operant behavior that is reinforced by positive effects produced by drugs of abuse. In this view drug abuse may be better characterized as involving attraction rather than compulsion. Incentive-based treatments may be useful for overcoming and competing with the reinforcing effects of drugs of abuse. Illustrative examples of incentive-based treatments for drug abuse, and their results, are described. The efficacy of incentive-based treatments indicates that many substance abusers possess the necessary skills to achieve abstinence and suggests that motivational interventions alone may be sufficient in many cases. Areas for further research are discussed that relate to refining and developing incentive-based therapies and to improving their practical utility and public acceptability.