Brief measurement of non-drug reinforcement: association with alcohol demand and substance use

Drug use is inversely related with the availability of alternative, non-drug reinforcers. We recently demonstrated that brief single-item measures of past month non-drug reinforcement were associated with return to drug use and life satisfaction among people in substance use treatment. This study sought to extend the utility of these brief-to-collect measures to a general population and to determine associations with behavioral economic demand. Participants reporting current alcohol use were recruited using crowdsourcing methods (n = 380) and completed brief measures of non-drug enjoyability, availability, and relative frequency for their period of heaviest alcohol use and their current alcohol use. Alcohol demand was collected using hypothetical purchase tasks. Demand was significantly associated with relative frequency of drug use such that more proportional drug reinforcement was associated with higher demand intensity (Q0) and reduced price sensitivity (p’s < 0.001). Non-drug availability was associated with demand intensity during both time periods, but only with price sensitivity during the heaviest use period. Non-drug enjoyability only had a significant relationship with demand intensity during the heaviest use period. These findings further emphasize the inverse relationship between drug use and the availability, enjoyment, and engagement with non-drug activities. These data also highlight the validity of brief, easy to collect measures of non-drug reward making them ideal for use in the context of developing novel behavioral or pharmacological interventions for substance use disorder.