The "trolley problem" and the moral decisions of drug users

Listening to my Inquiring Minds podcast today, the subject of morality was discussed, which led to talk of the example of the “trolley problem”:

To quote from Wikipedia:

“The general form of the problem is this: There is a runaway trolley barrelling down the railway tracks. Ahead, on the tracks, there are five people tied up and unable to move. The trolley is headed straight for them. You are standing some distance off in the train yard, next to a lever. If you pull this lever, the trolley will switch to a different set of tracks. Unfortunately, you notice that there is one person on the side track. You do not have the ability to operate the lever in a way that would cause the trolley to derail without loss of life (for example, holding the lever in an intermediate position so that the trolley goes between the two sets of tracks, or pulling the lever after the front wheels pass the switch, but before the rear wheels do). You have two options: (1) Do nothing, and the trolley kills the five people on the main track. (2) Pull the lever, diverting the trolley onto the side track where it will kill one person. Which is the correct choice?”

Now, the utilitarian view of morality predicts that people should choose to pull the lever killing only one person versus five. Generally, the studies suggest people often choose option #2, as would be predicted by the utilitarian theory. However, this result changes with slight variations in the scenario. For instance, when people are asked if they would push a person on a lever that would switch the tracks (instead of pulling the lever themselves as in scenario #2), far fewer people would choose to do so.

This trolley problem was recently investigated by Navarrete et al. (2012) ( using virtual reality and measuring their emotional reaction (at Michigan State University). Their results confirmed prior findings.

My question is how does drug use affects or be affected by our individual moral decision making. For instance, are people who are more utilitarian more likely to use legal and illegal drugs? Conversely, does using legal or illegal drugs make one more or less utilitarian? Since much drug use is a criminal act, and for many an immoral one, could this variation help explain why some people choose to use drugs?

This question has been studied most recently by Kornriech et al. (2013), Carmona-Perera et al. (2012), and Khemiri et al. (2012):

Polysubstance dependent patients display a more utilitarian profile in moral decision-making than alcohol-dependent patients, depressive patients and controls

Moral decision-making in polysubstance dependent individuals

Alcohol dependence associated with increased utilitarian moral judgment: a case control study


Bogus Pipeline: Use in studies of drug use and ethical issues

What is a ‘bogus pipeline’ method (BPL) used in social research? One vexing problem for researchers who collect self-report data is whether subjects are providing truthful responses. This can be especially problematic for questions that are sensitive or have a degree of ‘social desirability’.

According to Wikipedia, the BPL is a technique first used by psychology professor Harold Sigall, who wanted to study prejudice of whites towards blacks. The concern was whether reported declines in prejudice was really due to less racial prejudice, or if whites were reporting more socially desired answers. In order to reduce this potential bias, he had subject connected to a fake lie detector. Subjects were more likely to give honest answers to questions if they thought they are being monitored and their true answers would be revealed.


Here are some recent (and not so recent) articles on the use of BPL in studies of alcohol and drug use:

2009: Adolescent alcohol consumption: biomarkers PEth and FAEE in relation to interview and questionnaire data

2008: Enhancing self-report of adolescent smoking: the effects of bogus pipeline and anonymity

2003: “Start to stop”: results of a randomised controlled trial of a smoking cessation programme for teens

A paper by Aguinis and Handelsman (1997) provide an ethical critique of the BPL. To summarize, their criticism levels on several points: 1) Researchers using deception in studies typically mislead subjects by omission, rather than actively lying to them; 2) Subjects may feel coerced in revealing sensitive and potentially illegal information (such as illegal drug use); 3) Forcing subjects to confront uncomfortable truths about themselves (e.g., racist or prejudiced attitudes) may result in distress or harmful psychological consequences; 4) The authors point out that may BPL studies involve samples of children, who may be particularly vulnerable to psychological harm; 5) Subjects may feel coerced in revealing information they would have otherwise not wished to provide, and thus nullifying the freedom of avoiding the question by providing false information. The authors present arguments from two different perspectives in a dialogue format, which makes an interesting read. The full-text article is available via MSU libraries.

News: Are harmful effects of THC exposure transmittable to subsequent generations?

Science. 2014 Jan 3;343(6166):94-8. doi: 10.1126/science.1243985.
Pregnenolone can protect the brain from cannabis intoxication.
Vallée MVitiello SBellocchio LHébert-Chatelain EMonlezun SMartin-Garcia EKasanetz FBaillie GLPanin FCathala ARoullot-Lacarrière VFabre S,Hurst DPLynch DLShore DMDeroche-Gamonet VSpampinato URevest JMMaldonado RReggio PHRoss RAMarsicano GPiazza PV.

Recent attention has been focused on the long-term impact of cannabis exposure, for which experimental animal studies have validated causal relationships between neurobiological and behavioral alterations during the individual’s lifetime. Here, we show that adolescent exposure to Δ9-tetrahydrocannabinol (THC), the main psychoactive component of cannabis, results in behavioral and neurobiological abnormalities in the subsequent generation of rats as a consequence of parental germline exposure to the drug. Adult F1 offspring that were themselves unexposed to THC displayed increased work effort to self-administer heroin, with enhanced stereotyped behaviors during the period of acute heroin withdrawal. On the molecular level, parental THC exposure was associated with changes in the mRNA expression of cannabinoid, dopamine, and glutamatergic receptor genes in the striatum, a key component of the neuronal circuitry mediating compulsive behaviors and reward sensitivity. Specifically, decreased mRNA and protein levels, as well as NMDA receptor binding were observed in the dorsal striatum of adult offspring as a consequence of germline THC exposure. Electrophysiologically, plasticity was altered at excitatory synapses of the striatal circuitry that is known to mediate compulsive and goal-directed behaviors. These findings demonstrate that parental history of germline THC exposure affects the molecular characteristics of the striatum, can impact offspring phenotype, and could possibly confer enhanced risk for psychiatric disorders in the subsequent generation.

News: Pregnenolone may play in a role in feedback loop that reduces CB receptor activation

Synthesis of pregnenolone, an inactive steroid precursor, is stimulated by THC-activated cannabinoid receptors (CB). Pregnenolone, in turn, can act as an inhibitor of CB receptors. This negative feedback mechanism may limit the degree of CB receptor excitation and cannabis intoxication. This finding could lead to novel treatments for cannabis use disorders.

Reviewing Articles: Identifying the Genetic Predispositions for Cannabis Use Disorders

The Brisbane Longitudinal Twin Study: Pathways to Cannabis Use, Abuse, and Dependence Project – Current Status, Preliminary Results, and Future Directions
Authors: Gillespie, Henders, Davenport, et al. (2013)
Journal: Twin Research and Human Genetics
In this article, the authors describe their approach and preliminary findings from an ongoing longitudinal study of twin and non-twin siblings focused on the potential genetic loci of cannabis use disorders (CUDs). Very little is known about the specific genetic influences on the development of CUDs, with only two genome-wide association studies (GWAS) on the CUD phenotype having been completed to date (Agrawal et al., 2011; Verweij et al., 2012). 
To fill this gap, the authors initiated the Pathways to Cannabis Use, Abuse, and Dependence project using resources from the Brisbane Longitudinal Twin Study (BLTS), which was begun in 1992 to study the development of melanocytic naevi (i.e., “moles”). The BLTS has currently recruited approximately 3,000 subjects, composed of adolescent and young adult twins (monozygotic and dizygotic) and non-twin siblings, and sampled from primary and secondary schools in Brisbane, Australia. The sample is primarily of European-descent, with an average age of 22 years. A combination of computer assisted telephone interview (CATI) and online survey methods were used to collect data on cannabis and other substance use disorders conducted among those likely to have already passed through the peak periods of risk (ages 18-30). Other measures include longitudinal data on neuroticism and psychiatric symptoms, and cross-sectional (soon to be longitudinal) data on cognition, brain imaging, legal and illegal drug use, psychiatric diagnoses, and life events/social support. 
Around 60% of males and 49% of females in the sample had ever used cannabis, with similar proportion using nicotine, and nearly all (>98%) having had used alcohol. Over half of male cannabis users (58%) had a desire to stop or quit using cannabis, with a substantial proportion also endorsing using more than intended (48%) and craving (42%). Females experienced a similar pattern of features, though of reduced proportions. There was strong correlations between monozygotic twins for withdrawal (0.96) and craving (0.75) symptoms. There was substantial prevalence of depression and anxiety in the sample (27% and 18%, respectively). Future plans include modeling empirically based CUD phenotypes based on DSM-VI/V criteria, with subsequent tests for quantitative trait loci for CUD using GWA.