Sense of agency and addiction.

Agency is the sense that one has control over one's own actions and the consequences of those actions. A recent theory proposes that increases in agency disinhibit the dopamine system and thereby increase the number of tonically active dopamine neurons in the ventral tegmental area. The theory, called ADDS (Agency Disinhibits the Dopamine System), proposes a specific neural network that mediates these effects. ADDS successfully accounts for a variety of relevant neuroscience and behavioral results. Novel predictions are derived from ADDS about how the sense of agency impacts all aspects of drug addiction, including (1) the acquisition and maintenance of addictive behaviors; (2) cravings, compulsions, and relapse; and (3) treatment and recovery. ADDS predicts that increases in agency will increase the user's motivation to find and take drugs, and accelerate social drug taking. The theory also predicts that increases in agency will strengthen the antireward response that follows a drug high, and therefore exacerbate cravings and relapse. As a result, the theory predicts that treatment of substance-use disorders may be facilitated by appropriate changes to the client's sense of agency. The most therapeutic approach might be to elevate the client's agency at some times and weaken it at others.