Drug use, decision-making and the blunders of Rob Ford

The embattled mayor of Toronto's bad decision-making has all the signs of problem drug and alcohol use, though it could just be incompetence

Toronto mayor Rob Ford has had a rough couple of months. He has recently confessed to using crack cocaine "in a drunken stupor", been caught on video making drunken death threats, and commented to reporters about his cunnilingus skills. He has also previously been charged with drink-driving, and admitted on separate occasions to buying illegal drugs and "smoking a lot of marijuana". Other allegations from former staff members include physical assault, making racist and sexist remarks, and sexual harassment.

Needless to say, the man has made some questionable choices recently. While Mayor Ford has vehemently denied all accusations of drug or alcohol dependence, this pattern of poor decision-making is reflective of impairments in self-control and impulsivity that are often seen in problem drug and alcohol users.

Anecdotally, examples of needle sharing, unsafe sex and driving under the influence are used to demonstrate instances of poor or risky decision-making that seem to be increased in heavy drug users.

However, examples such as these can be difficult to empirically measure. So scientists have created behavioural tasks that can be used to objectively quantify poor decision-making in an attempt to determine if such traits really are higher in dependent individuals.

Say someone (reliable) offers you a choice: you can either have £10 today, or you can have £20 if you wait another two weeks. Which would you choose, the small immediate payout or the larger delayed reward?

In this classic example of a delay-discounting task, individuals who are dependent on alcohol, cocaine or heroin consistently show a preference for the smaller sooner option, even though rationally you should wait for the later greater reward. This is indicative of an increase in impulsivity and difficulty with waiting, perhaps representative of the choice to use drugs now rather than enjoy a healthier life later on.

Another test of decision-making involves your penchant for risk. In a mock gambling task, participants can choose between four decks of cards and are instructed to make as much money as they can. Two of the decks give you a smaller payout but also have a smaller risk for loss, resulting in an overall gain, while the other two decks give out large rewards but can also hit you with heavy fines, resulting in an overall loss.

Dependent drug users again show impairment on the task, consistently going for those risky decks, even after punishments of up to £1,000. This tendency to consistently gamble on a risky option, hoping to get away with that big reward without experiencing the negative consequences, might help to explain the decision to continue using drugs even in the face of potential punishments, like getting arrested or losing your job.

Both of these tasks tap into a part of your brain that is involved in self-control and executive functioning. This area, the prefrontal cortex, is also a region that is known to be smaller in dependent drug users, and activation in this area is often impaired during performance of these tasks. These brain changes are largely thought to be the consequence of long-term drug use, although there is also evidence that differences in this area may predate heavy drug-taking in dependent individuals.

As for Mayor Ford, his gaffes do not appear to be one-off errors of judgment, but rather a pattern of faulty decision-making, consistently choosing to do or say the wrong thing.

However, it's important to keep in mind that there is no evidence that Mayor Ford is dependent on drugs or alcohol, and he claims to have only smoked crack once. Additionally, by no means does everyone who uses drugs become dependent upon them. In fact, it is estimated that only one in six individuals who try cocaine will ever develop an addiction.

Instead, his actions may be more indicative of his apparent "incompetence", rather than having anything to do with his drug use.

At least Mayor Ford is in good company. Marion Barry, the former mayor of Washington DC, was also caught using crack cocaine in a sting operation not so long ago, and he went on to be re-elected a couple years later.


Dana Smith

The GuardianTramp

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