According to the Centres for Disease Control, cocaine use was reported by nearly 2 percent of the U.S. population in 2020, and the substance was associated with approximately one in five overdose deaths.
Preliminary data from the Virginia Department of Health reveals that the number of cocaine-related overdoses in Virginia has been steadily rising since 2013, with 968 fatal overdoses recorded in 2022, marking a 20 percent increase from the previous year. Among these cases, four out of five involved fentanyl, which includes prescription, illicit, or analogue forms and has been a significant contributing factor to these fatalities.
At the Fralin Biomedical Research Institute at VTC, researchers are engaged in efforts to enhance understanding of cocaine use disorder and contribute to reversing the prevailing national trend.
Warren Bickel, a professor at the Fralin Biomedical Research Institute at VTC and the director of the Addiction Recovery Research Centre, expressed concerns over the increasing prevalence of cocaine use and addiction. He highlighted the absence of effective treatment options and stressed the need for innovative ideas to address this issue.
The study emphasises the theory of reinforcer pathology, which suggests that individuals place a higher value on immediate rewards, such as the pleasurable sensations induced by substances, while assigning a lower value to future gains. As part of the study, researchers will implement cocaine contingency management, a strategy involving the provision of cash or valuable incentives to individuals who achieve their treatment goals.
Bickel explained that when people engage in drug use, they often sacrifice important aspects of their lives, such as jobs, relationships, and family. However, the offer of monetary rewards for drug-free urine samples holds significant sway, primarily due to the individuals’ temporal horizon. By receiving immediate compensation, the perceived value of drugs diminishes.
The Addiction Recovery Research Centre is currently seeking adults who use cocaine to participate in a paid research study focused on decision-making. Participants will be required to visit the Roanoke lab 13 times over a period of five weeks, during which they will undergo MRIs, report their cocaine use, complete computerised assessments, and provide urine samples. The research, supported by a grant exceeding $700,000 from the National Institute on Drug Abuse, which is part of the National Institutes of Health, does not involve treatment.
Bickel stated that the study aims to determine whether addressing participants’ short-term perspectives on the future can be an additional key factor in their treatment. He emphasised the significance of exploring new ideas and interventions, highlighting the long-overdue need for such advancements. Bickel expressed confidence that this endeavour, which is already yielding desired effects, is well-timed and deserving of careful evaluation.
In addition to his role as the director of the institute’s Centre for Health Behaviours Research, Warren Bickel holds positions as a psychology professor at Virginia Tech’s College of Science and a professor of psychiatry and behavioural medicine at the Virginia Tech Carilion School of Medicine. The study is a collaborative effort with co-investigator Stephen M. LaConte, an associate professor at the Fralin Biomedical Research Institute.
LaConte emphasised the importance of collaborating with colleagues working on substance use disorders and utilising brain imaging techniques to investigate the impact of cocaine use on the brain and its associated changes during the intervention. He expressed gratitude to the study participants for their generous contributions and acknowledged the support from state and federal agencies in combating the stigma surrounding addiction.
Their collective goal is to make a positive impact on public health by guiding the development of innovative interventions that effectively reduce cocaine consumption.