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What is addiction? Substance-specific biases in human beliefs and LLMs

Creative Commons 'BY' version 4.0 license
Abstract

Understanding how individuals conceptualize addiction is an important approach to the study of substance use etiology. We asked participants in a large free-response study of of intuitive conceptualizations of addiction among alcohol and cannabis users and co-users to share their beliefs about the benefits and harms of alcohol and cannabis, and to explain in simple terms what it means to be addicted. Using a frontier language model (ChatGPT-4o) we extracted structured representations of people's beliefs and explanations, assessing the extent to which responses represented 11 clinically relevant diagnostic symptoms from the DSM-5 section on Substance Use Disorders. People's beliefs showed clear substance-specific biases, attributing more clinically relevant symptoms to alcohol than cannabis. A prompt-context manipulation that contextualized participants' substance-neutral explanations as relevant to either cannabis or alcohol revealed evidence sometimes for similar, and for other times opposite direction, substance-specific biases imposed by the ChatGPT annotation process itself.