Negative Reinforcement and Substance Abuse: Using a Behavioral Conceptualization to Enhance Treatment‪.‬

Reinforcement history is a particularly potent predictor of future addictive behaviors. For the most part, researchers have studied the operant in order to understand and control positive reinforcement that maintains substance use behavior. However, negative reinforcement can be just as powerful in increasing the likelihood of substance use in the future, and some data suggest that negative (and not positive) reinforcement predicts increased difficulties associated with substance abuse over a person's lifetime. Negative reinforcement may be occurring if clients are avoiding withdrawal symptoms, escaping reality, self-medicating, or avoiding loss of using friends. In such cases, therapists may wish to use strategies such as response prevention, generating alternative activities, environmental interventions within the family and community, and emotion regulation and distress tolerance skills. **********