Drug-abuse behavior may be maintained by reinforcement of the following types: (1) primary positive; (2) primary negative (a) by termination of withdrawal; (b) by reducing attention to, or discrimination of, aversive stimuli); (3) secondary positive (a) social and unrelated to drug effects; (b) social and related to drug effects; (c) chaining; and (4) secondary negative. Which type of reinforcement functions to maintain drug-abuse behavior appears to depend partly upon the class of drugs employed. The following drug classes are discussed in terms of the reinforcers maintaining their abuse: narcotics, stimulants, sedative-hypnotics and alcohol, hallucinogens and marijuana, and placebo. Different treatment modalities are aimed at different types of reinforcement. Using narcotic abuse as an example, methadone maintenance, detoxification, and traditional psychotherapy are discussed in terms of their effect on each of the types of reinforcement maintaining the drug habit.
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