21 December 2016
As detailed above, interoception is strongly related to reward, urge, and craving, and alliesthesia emphasizes that through interoceptive processing these constructs are dependent on the pre-existing internal state of the individual, which may undergo positive/negative alliesthetic changes. Thus, three components appear critical for how an individual responds to drugs: (1) the internal or homeostatic state as signaled via afferents converging to the insular cortex; (2) the cognitive state of the individual, which includes a “contextualized” representation of the interoceptive state (Shipp, 2005); and (3) the learned associations of the external stimulus (e.g. the drug of choice) with previous outcomes including predicted internal states. These components clearly differ across individuals who are initially exposed to drugs and those who have been taking drugs for years.

