Opioid Addiction
A large focus of our research is in opioid use disorder (OUD). In 2020, in the midst of the coronavirus pandemic, more than 93,000 people died from drug overdoses, a staggering number that is 30% higher than 2019 (National Center for Health Statistics). The opioid epidemic, in particular, continues to pervade and ravage the United States, accounting for approximately 68% of all drug overdose-related deaths. Although there are effective medications for OUD, adherence to treatment remains poor resulting in frequent relapse to drug use. An even more basic challenge is that many people with OUD and other forms of addiction do not seek out treatment in the first place, in part driven by low perceptions of need or a lack of faith in their ability to achieve sobriety.
In our research, we seek to understand the psychological and brain processes that may prevent people with OUD from seeking and engaging with drug treatment, when doing so could save their life and promote recovery. We use noninvasive brain imaging, especially functional MRI, to visualize the actively thinking brain while people are self-reflecting on their addiction and other kinds of behavior. We also use functional imaging and other biological assays to study basic stress mechanisms in OUD. Stress, which is a known trigger for drug use, is likely to thwart effective self-reflection and related attempts to exert self-control. We hope that a better understanding of the brain in these contexts will improve treatment outcomes among individuals with OUD and other drug addictions.
Insight
In common language, insight refers to the “aha” moment when something unclear suddenly becomes apparent. In psychiatry, insight refers to gaining and maintaining self-awareness that one has a mental illness, and that it requires treatment. It is a concept frequently associated with psychosis and dementia, but more recently has also emerged in the context of drug addiction. We study insight in OUD using newly developed functional MRI and behavioral tasks, with special emphasis on brain networks that are involved in self-reflection and self-awareness. Studying and understanding abnormalities in these brain networks can inform the development of new treatments that target the affected circuits to improve insight in drug addiction.
Metacognition
In common language, metacognition refers to “thinking about thinking.” In the scientific literature, metacognition refers to the ability to monitor one’s own thinking and behavior. Thus, metacognition is related to insight, but it is a broader concept that spans multiple domains beyond one’s addiction. We use functional MRI to understand metacognition in OUD, defined as the correspondence between task accuracy and task confidence.
More specifically, people have higher metacognition when they are highly confident in their performance when they give correct answers and when they are highly unconfident in their performance when they give incorrect answers. We study the brain circuits that underlie these processes, as well as their relationships to opioid use and severity.
Stress
Stress is a prominent trigger of drug use. However, the central and peripheral stress systems that are dysregulated in people who use opioids are not well-understood. We seek to improve our understanding of these systems with functional MRI as people with OUD are exposed to drug-related and stressful images. We also obtain laboratory assays of cortisol and alpha amylase during a laboratory stress challenge, and we link these stress markers to drug craving and functional imaging measures.
Smoking Addiction
We also have an ongoing project with cigarette smoking. Although there are effective treatments for smoking cessation, these treatments do not work for everyone. For people who continue to smoke, we need to develop new therapies that address the limitations of existing ones and expand the menu of options. We are therefore studying a neurotransmitter called acetylcholine, which is the main target for nicotine in the brain. To do this, we use positron emission tomography (PET), along with a radiotracer, to visualize acetylcholine transmission in the brain, with an eye toward identifying changes in this system among smokers.
Representative Publications
Moeller, S. J., Kundu, P., Bachi, K., Maloney, T., Malaker, P., Parvaz, M. A., Alia-Klein, N., London, E. D., & Goldstein, R. Z. (in press). Self-awareness of problematic drug use: a new fMRI task to assess underlying neurocircuitry. Drug and Alcohol Dependence. PMCID: PMC7170015.
Moeller, S. J., Platt, J. M., & Goodwin, R. D. (in press). Perception of treatment need among adults with substance use disorders: Longitudinal data from a representative sample of adults in the United States. Drug and Alcohol Dependence. PMCID: PMC7418940.
Moeller, S. J., Hanley, A. D., & Garland, E. L. (2020). Behavioral preference for viewing drug versus pleasant images predicts current and future opioid misuse among chronic pain patients. Psychological Medicine, 50(4), 644-652. PMCID: PMC7413318.
Moeller, S. J., Zilverstand, Z., Konova, A. B., Kundu, P., Parvaz, M. A., Preston-Campbell, R., Bachi, K., Alia-Klein, N., & Goldstein, R. Z. (2018). Neural correlates of drug-biased choice in currently-using and abstinent individuals with cocaine use disorder. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(5), 485-494. PMCID: PMC5944613.
Moeller, S. J., Okita, K., Robertson, C. L., Ballard, M. E., Johnson, M., Konova, A. B., Goldstein, R. Z., Mandelkern, M. A., & London E. D. (2018). Low striatal dopamine D2-type receptor availability is linked to simulated drug choice in methamphetamine users. Neuropsychopharmacology, 43(4), 751-760. PMCID: PMC5809782.
Parvaz, M. A., Moeller, S. J., & Goldstein, R. Z. (2016). Incubation of cue-induced craving in human cocaine addiction measured by EEG. JAMA Psychiatry, 73(11), 1127-1134. PMCID: PMC5206796.
Moeller, S. J., Fleming, S. M., Gan, G., Zilverstand, A., Malaker, P. d'Oleire Uquillas, F., Schneider, K. E., Preston-Campbell, R., Parvaz, M. A. Maloney, T., Alia-Klein, N., & Goldstein, R. Z. (2016). Metacognitive impairment in cocaine dependence is associated with individual differences in brain structure. European Neuropsychopharmacology, 26(4), 653-662. PMCID: PMC4805109.
Moeller, S. J., & Goldstein, R. Z. (2014). Impaired self-awareness in human addiction: Deficient attribution of personal relevance. Trends in Cognitive Sciences, 18(12), 635-641. PMCID: PMC4254155.
Moeller, S. J., Konova, A. B., Parvaz, M. A., Tomasi, D., Lane, R. D., Fort, C., & Goldstein, R. Z. (2014). Functional, structural, and emotional correlates of impaired insight in cocaine addiction. JAMA Psychiatry, 71(1), 61-70. PMCID: PMC4193926.
Moeller, S. J., Parvaz, M. A., Shumay, E., Beebe-Wang, N., Konova, A. B., Alia-Klein, N., Volkow, N. D., & Goldstein, R. Z. (2013). Gene × abstinence effects on drug cue reactivity in addiction: Multimodal evidence. Journal of Neuroscience, 33(24), 10027-10036. PMCID: PMC3682385.
Moeller, S. J., Hajcak, G., Parvaz, M. A., Dunning, J. P., Volkow, N. D., & Goldstein, R. Z. (2012). Psychophysiological prediction of choice: relevance to insight and drug addiction. Brain, 135(Pt 11), 3481-3494. PMCID: PMC3501972.
Moeller S. J., Maloney T., Parvaz M. A., Alia-Klein N., Woicik P. A., Telang F., Wang G-J., Volkow N. D., & Goldstein R. Z. (2010). Impaired insight in cocaine addiction: Laboratory evidence and effects on cocaine-seeking behavior. Brain, 133(5), 1484-1493. PMCID: PMC2912695.
Moeller, S. J., Maloney, T., Parvaz, M. A., Dunning, J. P., Alia-Klein, N., Woicik, P. A., Hajcak, G., Telang, F., Wang, G.-J., Volkow, N. D., & Goldstein, R. Z. (2009). Enhanced choice for viewing cocaine pictures in cocaine addiction. Biological Psychiatry, 66(2), 169-176. PMCID: PMC2742172.
For a full list of publications, click here.
PRIMARY MEMBERS
- Scott J. Moeller, PhD: Principal Investigator
- Pari Dhayagude, BS: Research Coordinator
- Olivia Orellano, BA: Research Coordinator
- Apurva Parikh, BA: Medical Student
- Shayne Thomas, BA: Research Coordinator
- Francesca Giammanco, LMSW; Patient Recruiter
- Sameera Abeykoon, PhD: Programmer/Analyst
- Melissa Thornton, BA: Programming Assistant
COLLABORATING LABS AT STONY BROOK
PARTICIPATION
We are looking for research volunteers with OUD and cigarette smokers, as well as people who do not use these substances, between the ages of 18 and 55, who speak English fluently. Functional MRI studies require that you be right-handed to participate. Compensation is provided, typically up to several hundred dollars. For more information and to find out if you qualify for our brain imaging studies, please contact:
Lab Email: sm.mmti.stonybrook@gmail.com
Lab Phone: 631-371-3096
Address: Renaissance School of Medicine (at Stony Brook University)
Health Sciences Center
101 Nicholls Road
Floor T10, Suite 087
Stony Brook, NY 11794
