Does reducing the use of cocaine, but not abstaining from the substance entirely, produce health benefits? There's currently little research available that answers that question. William Stoops, Ph.D., professor in the University of Kentucky College of Medicine and director of regulatory knowledge and support for the UK Center for Clinical and Translational Science, has received a $2.9 million grant from the National Institute on Drug Abuse to find more answers.

Stoops hopes his research will contribute to the evolving knowledge of treatment for cocaine use disorder (CUD), a substance use disorder that currently has no well-established treatment methods. "Facilities treating cocaine use disorder are doing what they can, but there is no common practice," said Stoops. And while medications are available for other common substance use disorders including opioid use disorder and alcohol use disorder, no medication is available to treat CUD.

Another challenge is that under the current model, CUD treatment is considered “successful” only if a patient abstains entirely from using the substance. Stoops points out that while abstinence is the ideal outcome, such a “total” fix is not the same measure of success used in treating other chronic diseases.

"Abstinence may be too high of a bar to set.  We don’t do that with other chronic diseases — we focus more on reduction or management, like when treating someone for high blood pressure,” he said.

Stoops, along with interdisciplinary team members from the UK departments of behavioral science, psychiatry, internal medicine and psychology, hope to determine if reduced cocaine use confers health benefits to individuals with CUD. He hypothesizes that a reduction will lead to improved health, and abstinence will yield even more benefits.

The study will take place over five years and aims to enroll 200 participants (about 40 per year). Participants, who must be between 18 and 65 years old, will be asked to participate in a 12-week intervention during which they will need to be available three days a week for short visits. After the initial 12-week period, there will be long-term follow-up. The clinical component of the study will be conducted through the clinical services unit of the UK Center for Clinical and Translational Science.

In addition to helping people manage and treat their CUD, Stoops and the research team are also aware of the economic benefits to more people entering recovery.

"Substance use disorders in general, and CUD specifically are very expensive to the taxpayer. They lead to billions of dollars in lost productivity and health care costs each year," Stoops said. "Not having an effective, broadly-used treatment, combined with the lack of a strong evidence-base about whether reduced cocaine use can confer benefit, hampers our ability to help people with CUD."

If you are interested in participating in or learning more about the study you can find more information at clinicaltrials.gov.