Background and Aims Attentional bias has been demonstrated to a variety of substances. Evidence suggests that fixation time is a more direct measure of attentional bias than response time. The aims of this experiment were to demonstrate that fixation time during the visual probe task is a sensitive and stable measure of cocaine cue attentional bias in cocaine using adults compared to controls. Design A between-subject, repeated-measures experiment. Setting An outpatient research unit. Participants Fifteen cocaine using and fifteen non-cocaine-using adults recruited from the community. Measurements Participants completed a visual probe task with eye tracking and a modified Stroop during two experimental sessions. Findings A significant interaction between cue type and group (F = 13.5; P = 0.001) indicated that cocaine users, but not controls, displayed an attentional bias to cocaine-related images as measured by fixation time. There were no changes in the magnitude of attentional bias across sessions (F = 3.4; P = 0.08) and attentional bias correlated with self-reported lifetime cocaine use (r = 0.64, P = 0.01). Response time on the visual probe (F = 1.1; P = 0.3) as well as on the modified Stroop (F = 0.1; P = 0.72) failed to detect an attentional bias. Conclusions Fixation time on cocaine-related stimuli (propensity to remain focused on the stimulus) is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults.

Background Stimuli associated with cocaine use capture attention. Evidence suggests that fixation time measured on the visual probe task is a valid measure of cocaine cue attentional bias. The aim of this experiment was to demonstrate the test-retest reliability of cocaine cue attentional bias as measured by fixation time during the visual probe task. Methods In a within-subject, repeated-measures design, thirty-six non-treatment seeking cocaine-using adults completed a visual probe task with eye tracking. Results Participants displayed an attentional bias to cocaine-related images as measured by fixation time across two occasions (F (1, 35) = 56.5, p < 0.0001). A Pearson correlation indicated significant test-retest reliability for this effect (r = 0.51, p = 0.001). Response time failed to detect an attentional bias and test-retest reliability was low (r = 0.24, p = 0.16). Conclusion Fixation time during the visual probe task is a reliable measure of cocaine cue attentional bias in cocaine-using adults across time.

Highlights HEALing Communities Study is a parallel-group cluster randomized controlled trial. Communities That HEAL intervention’s goal is to reduce opioid overdose deaths. Structured consensus decision-making strategy guided study measure development. More than 80 study measure specifications and a common data model were developed. The study will provide methodology and longitudinal community data for research.

Rationale Opioid antagonists (e.g., naltrexone) and positive modulators of γ-aminobutyric-acidA (GABAA) receptors (e.g., alprazolam) modestly attenuate the abuse-related effects of stimulants like amphetamine. The use of higher doses to achieve greater efficacy is precluded by side effects. Combining naltrexone and alprazolam might safely maximize efficacy while avoiding the untoward effects of the constituent compounds. Objectives The present pilot study tested the hypothesis that acute pretreatment with the combination of naltrexone and alprazolam would not produce clinically problematic physiological effects or negative subjective effects and would reduce the positive subjective effects of d-amphetamine to a greater extent than the constituent drugs alone. Methods Eight nontreatment-seeking, stimulant-using individuals completed an outpatient experiment in which oral d-amphetamine (0, 15, and 30 mg) was administered following acute pretreatment with naltrexone (0 and 50 mg) and alprazolam (0 and 0.5 mg). Subjective effects, psychomotor task performance, and physiological measures were collected. Results Oral d-amphetamine produced prototypical physiological and stimulant-like positive subjective effects (e.g., VAS ratings of Active/Alert/Energetic, Good Effect, and High). Pretreatment with naltrexone, alprazolam, and their combination did not produce clinically problematic acute physiological effects or negative subjective effects. Naltrexone and alprazolam each significantly attenuated some of the subjective effects of d-amphetamine. The combination attenuated a greater number of subjective effects than the constituent drugs alone. Conclusions The present results support the continued evaluation of an opioid receptor antagonist combined with a GABAA-positive modulator using more clinically relevant experimental conditions like examining the effect of chronic dosing with these drugs on methamphetamine self-administration.

Impulsive sexual decision-making may underlie sexual risk-taking behavior that contributes to the disproportionately high prevalence of HIV infection among cocaine users. Delay-discounting procedures measure impulsive decision-making and may provide insight into the underlying mechanisms of sexual risk-taking behavior. The anxiolytic drug buspirone reduces delay discounting in rats and blunts the reinforcing effects of cocaine in some preclinical studies suggesting that it might have utility in the treatment of cocaine-use disorders. This study determined whether buspirone mitigates impulsive risky sexual decision-making in cocaine users on a sexual delay-discounting procedure. The effects of buspirone maintenance on the abuse-related and physiological effects of cocaine were also tested. Nine (N = 9) current cocaine users completed a repeated-measures, inpatient protocol in which sexual delay discounting was assessed following three days of maintenance on placebo and buspirone (30 mg/day) in counterbalanced order. The reinforcing, subject-rated, and physiological effects of placebo and intranasal cocaine (15 and 45 mg) were also assessed during buspirone and placebo maintenance. Buspirone increased the likelihood of condom use for hypothetical sexual partners that were categorized as most likely to have a sexually transmitted infection and least sexually desirable. Cocaine functioned as a reinforcer and increased positive subjective effects ratings, but buspirone maintenance did not impact these effects of cocaine. Buspirone was also safe and tolerable when combined with cocaine and may have blunted some its cardiovascular effects. The results from the sexual delay-discounting procedure indicate that buspirone may reduce preference for riskier sex in cocaine users.