NIDA now seems to have recognized that these ideas have only limited utility and has invited cognitive neuroscientists to participate in the hunt for a deeper understanding of drug abuse. The importance of cognition is illustrated by the fact that the overall pattern of U.S. drug use has remained constant for years. Although many people experience drugs, only a small number become addicted. Specifically, about 70 percent of Americans have tried illicit drugs, but less than 20 percent have used an illicit drug in the past year and only a few percent have done so in the past month. All of these facts suggest that simple learning and reinforcement concepts do not explain the drug experience.
Cognition is central to the pattern.
Education, alternative choices, and competing temptations all play a role in determining whether the user is seeking occasional reinforcement from drugs or heading for chronic use. At the same time, it is a challenge for cognitive neuroscience to understand why a significant number of people can't walk away from drug use. It is now clear that some people cannot stop taking drugs even after their body chemistry has been normalized after abstinence. They are easily set off and go back to destructive drug use. Some recidivists are mentally disturbed and are medicating themselves, and some may suffer from a genetic predisposition to drug use, but most recidivists have built up theories about why they do what they do.