Regular substance use relates to cost sensitivity during cost-benefit decision-making in stable and volatile learning...

Research on substance use and decision-making relates reward sensitivity, cost insensitivity, and inconsistent use of cost information to greater substance use severity. However, little work tests how people compare rewards to costs within the same choice. Further, no work examines how the comparison of rewards to costs varies across different contexts. We administered a new cost-benefit variant of a probabilistic learning task to a diverse community sample with elevated rates of substance use (N = 130). Individuals with more years of regular substance use tended not to repeat safe choices particularly in contexts where doing so was advantageous, and repeated risky choices after they incurred losses regardless of context. Individuals with more years of regular substance use also showed reduced discrimination between loss magnitudes, selecting the risky choice even as loss magnitudes increased. Computational modeling parameters indicated that these individuals under-weighted losses, though this relationship weakened when accounting for age. Altogether, these results suggest that decreased sensitivity to cost information may characterize continued substance use despite incurring negative consequences.