Cocaine use in the United States has been on the rise in recent years, with nearly 2% of the population admitting to using the drug in 2020. The addictive substance is also becoming more deadly, with nearly 1 in 5 overdose deaths involving cocaine, according to the Centers for Disease Control. Virginia is no exception to this trend, with the number of cocaine-related overdoses steadily increasing since 2013. In 2022, preliminary data from the Virginia Department of Health shows that there were 968 fatal overdoses, a 20% increase from the previous year. Fentanyl, both prescription and illicit, played a role in 80% of those deaths.
Researchers at the Fralin Biomedical Research Institute at VTC are working to better understand cocaine use disorder and help reverse the national trend. Prof. Warren Bickel, a director at the institute’s Addiction Recovery Research Center, noted that stimulant drug use has been sweeping the country, but there has not been a robust treatment plan developed yet. “We need some new ideas,” Prof. Bickel said.
The Fralin Biomedical Research Institute is recruiting adults who use cocaine for a paid research study on decision-making. Participants will visit the Roanoke lab 13 times over five weeks to undergo MRIs, report their cocaine use, take computerized assessments, and provide urine samples. The study is supported by a grant of over $700,000 from the National Institute on Drug Abuse, part of the National Institutes of Health.
The theory of reinforcer pathology underpins the study, which explores how an individual values immediate reward, such as the way a substance makes them feel, over future benefits. The researchers will employ cocaine contingency management, where cash or something of value is provided to those who meet their treatment goals, to examine the power of temporal horizons.
“When people do drugs, we know they give up their jobs, relationships, family, even their lives, but when they receive several dollars for drug-free urine samples, they become powerful. What explains that? Their temporal horizon,” Bickel said. Bickel’s team wants to examine whether tackling the short-term view of the future could be a key to treating cocaine addiction.
“It is worthwhile to explore new ideas. New interventions are long overdue, and there is increasing evidence that this effort is an idea whose time has arrived. It is producing effects we want to measure,” Bickel said. The team aims to positively impact public health by guiding innovative interventions that help decrease cocaine consumption.
Co-investigator Stephen M. LaConte, an associate professor at the Fralin Biomedical Research Institute, said that it is critical to work alongside colleagues who are also addressing substance use disorders. “I am thankful to the participants who donate their time to come to the [institute] for our studies. Beyond funding the science that we do here, I am also grateful to our state and federal agencies for their work in helping to reduce the stigma surrounding addiction,” LaConte said.
The Fralin Biomedical Research Institute’s researchers hope their efforts will lead to more effective treatments for cocaine addiction and safeguard against the escalating number of cocaine-related overdose deaths across the United States.
