Addiction scientists are trying to better understand cocaine use disorder:

Nearly 2 percent of the US population reported using cocaine in 2020, and the highly addictive substance is involved in nearly one in five overdose deaths, according to the Centers for Disease Control.

In Virginia, the number of cocaine-related overdoses has increased since 2013, with 968 fatal overdoses in 2022, according to preliminary data from the Virginia Department of Health, an increase of 20 percent over 2021. Of these, four out of five included fentanyl — prescription, illegal or analogous — strength driving force behind death.

Researchers at the Fralin Biomedical Research Institute at VTC are working to better understand cocaine use disorder and help reverse a national trend.

“Stimulants will return. Cocaine use and addiction have been on the rise for more than a decade, without strong treatment,” said Warren Bickel, a professor at the Fralin Biomedical Research Institute at VTC and director of the Addiction Recovery Research Center. “We need some new ideas.”

The study emphasizes the theory of reinforcing pathology, in which individuals place higher values ​​on immediate rewards – for example, for the way a substance makes them feel – and lower values ​​on future benefits. For the study, researchers will use cocaine contingency management by giving cash or something of value to people who meet their treatment goals.

“When people take drugs, we know they are giving up their jobs, relationships, families, even their lives, but when they receive a few dollars for a drug-free urine sample, they become strong. What explains that? Their temporal horizon. I give you money for a clean urine sample and immediately you spin it. Drugs are losing value,” said Bickel.

The Center for Addiction Recovery Research recruits adults who use cocaine for paid research studies on decision making. Participants will be asked to visit Roanoke’s lab 13 times over five weeks to undergo an MRI, report their cocaine use, perform a computerized assessment, and provide a urine sample. The research, which is not a treatment study, was supported by a grant of more than $700,000 from the National Institute on Drug Abuse, part of the National Institutes of Health.

“We’re asking people to participate for several weeks in a row, and we’re going to study whether addressing their short-term view of the future can be an additional key to treating them,” Bickel said. “It is beneficial to explore new ideas. A new intervention has been long overdue, and there’s growing evidence that it’s an idea whose time has come. This produces the effect we want to measure.”

Bickel is also the director of the institute’s Center for Health Behaviors Research, a professor of psychology at Virginia Tech’s College of Science, and a professor of psychiatry and behavioral medicine at the Virginia Tech Carilion School of Medicine. He was joined in the research by co-investigator Stephen M. LaConte, a professor at the Fralin Biomedical Research Institute.

LaConte says it’s important to work with colleagues dealing with substance use disorders and use brain imaging to study the effects of cocaine use and changes in the brain during interventions. “I thank the participants who have donated their time to come to (the institution) for our studies,” he said. “In addition to funding the science we do here, I also thank our state and federal agencies for their work to help reduce the stigma around addiction.”

Their goal is to positively impact public health by guiding innovative interventions that help reduce cocaine use.