Delay and Probability Discounting in Cocaine Use Disorder: Comprehensive Examination of Money, Cocaine, and Health Outcomes Using Gains and Losses at Multiple Magnitudes

Understanding factors associated with cocaine use disorder is important given its public health impact. One factor is delay discounting (devaluation of future consequences). Cocaine users have shown greater delay discounting of money rewards than non-cocaine users. But underexamined are factors known to affect discounting, such as the sign (reward vs. loss), magnitude (e.g., $10 vs. $1,000), and commodity (e.g., money vs. health) of the consequence. Also underexamined is probability discounting (devaluation of uncertain consequences). We conducted a comprehensive group-comparison study of discounting processes by comparing sign, magnitude, and commodity effects between demographically matched cocaine users (n = 23) and never users (n = 24) for delay discounting and sign and magnitude effects for probability discounting. Participants completed delay and probability discounting tasks spanning rewards and losses; money, cocaine, and health outcomes; and magnitudes of $10, $100, and $1,000. Four primary findings emerged when controlling for other drug use. First, cocaine users pervasively discounted delayed consequences more than never users regardless of sign, magnitude, or commodity, with the possible exception of delay discounting of $1,000 health equivalences. Second, both groups discounted delayed rewards more than losses, with a similar trend for probability discounting. Third, magnitude effects in cocaine users for delayed and probabilistic outcomes were similar to those previously observed in never users and other-drug users. Fourth, cocaine users discounted cocaine-related outcomes more than money and health, with variable results comparing money and health. These data suggest that the behavioral processes of delay and probability discounting are qualitatively similar for cocaine users and never users. However, quantitatively, cocaine users generally showed greater delay discounting and similar probability discounting compared with never users.