More Information about the Study

Study Aims and Procedures

This study aims to develop a quantitative brain imaging metric that can help assess the current severity of an individual’s SUD and predict treatment outcome. The information we will learn may help us better understand the brain basis for addiction and treatment recovery. The target population of the main study includes physicians and other health professionals addicted to alcohol, opioids, or both, and consists of 2 main groups:

Group 1 Cross-Sectional: Long-term in-monitoring group who will participate in the cross-sectional study.  Cross-sectional participants will be enrolled in a PHP and have completed initial addiction treatment more than 2 months ago, but within the last 5 years. Eligible cross-sectional participants will undergo one imaging visit at the NIDA-IRP in Baltimore.

Group 2 Longitudinal: Early-in-treatment group who will participate in the longitudinal study. Longitudinal participants will still be in their initial phase of treatment, but near the end (1-2 months into treatment) at time of joining the study. Eligible longitudinal participants will undergo three imaging visits, several months apart, at the NIDA-IRP in Baltimore. 

Each imaging visit will take a full day (approximately 8-10 hours) and will generally require an overnight stay at an on-campus clinical research unit the evening prior to the study session. Both groups will also complete two online sessions, which include the screening consent process, administration of a structured psychiatric interview, a detailed history of substance use over lifetime and reviewing the study consent. All participants will also complete several self-administered questionnaires online (2-4 hours) at their convenience. 

ONLINE Addiction Phenotype Characterization arm: There is also an arm of this study, Addiction Phenotype Characterization arm, that is completed entirely online. The aim of this arm is to characterize addiction manifestations and any associated medical or psychiatric condition in health professionals. This arm is available to those who do not meet full criteria for the main imaging study (Groups 1 and 2 above), but who are enrolled in a PHP and have been diagnosed with a severe SUD. These participants will review the consent and complete the psychiatric interview and substance use timeline assessment via video chat (about 2-3 hours), and then complete several self-administered questionnaires online (2-4 hours) at their convenience.


Research Facilities at the NIDA-IRP, NRB

Imaging sessions take place at the Biomedical Research Center, located at the NIDA-IRP in Baltimore. We use a Siemens 3T MRI machine for imaging.

NIDA-IRP Biomedical Research Center in Baltimore, MD

Actual image of the 3T MRI scanner used in this study


For more information about the NIDA-IRP, visit

For more information about the Neuroimaging Research Branch of the NIDA-IRP, visit

Data Collection Process

Imaging: Those participating in the imaging arm will undergo two brain imaging sessions (at each study visit).This study uses a 3T MRI machine to take pictures of the brain. The following imaging modalities will be distributed over the two imaging sessions: a) High resolution MRI, b) Diffusion Tensor Imaging (DTI), c) Single voxel spectroscopy, d) Resting state fMRI, and e) Task activation fMRI [including tasks that probe network underlying reward sensitivity and cognitive flexibility, activation of error detection areas (such as the ACC), activation of the ventral striatum associated with positive and negative feedback, emotional processing (bilateral amygdala activity), and a task that assesses the effect of induced state of anxiety on the activation of the bed nucleus of stria terminal (BNST) and the central amygdala (CeA). If we are able to recruit the target of 350 participants that complete the imaging arm, we will have sufficient data to analyze how the brain circuitry is altered by addiction and how and when it heals.

*fMRI image courtesy of Courtesy Steve Smith, FMRIB
*MRS image courtesy of Allen D. Elster,

Addiction Phenotype Characterization: All study participants will complete a large set of instruments including a Timeline Follow Back (full lifetime), the Inventory of Drug Taking situations (IDTS), Obsessive Compulsive Drinking Scale, Penn Alcohol Craving Scale (PACS) and the Prescription Drug Use Questionnaire (PDUQ). Comorbid psychiatric conditions among the participants will be evaluated using a structured interview for psychiatric disorders (MINI+), the Beck Depression Inventory (BDI-II), the Snaith-Hamilton Pleasure Scale (SHAPS), the Beck Anxiety Inventory (BAI), Barratt Impulsivity Scale (BIS-11), the Adult ADHD self-report scale (ASRS), the Childhood Trauma Questionnaire (CTQ), the PTSD Checklist – Civilian Version (PCL-C), the Personality Disorder Questionnaire (PDQ-4) and the Toronto Alexithymia Scale. A full review of psychometric and personality testing performed during treatment will also add to a massive characterization database. 

Selected Publications by the NIDA Neuroimaging Research Branch

Abulseoud OA, Ross TJ, Nam HW, Caparelli EC, Tennekoon M, Schleyer B, Castillo J, Fedota J, Gu H, Yang Y, Stein E. Short-term nicotine deprivation alters dorsal anterior cingulate glutamate concentration and concomitant cingulate-cortical functional connectivity. Neuropsychopharmacology. 2020 Oct;45(11):1920-1930. doi:10.1038/s41386-020-0741-9. Epub 2020 Jun 19. PMID: 32559759; PMCID: PMC7608204.

Adinoff B, Gu H, Merrick C, McHugh M, Jeon-Slaughter H, Lu H, Yang Y, Stein EA. Basal Hippocampal Activity and Its Functional Connectivity Predicts Cocaine Relapse. Biol Psychiatry. 2015 Oct 1;78(7):496-504. doi:10.1016/j.biopsych.2014.12.027. Epub 2015 Jan 30. PMID: 25749098; PMCID: PMC5671769.

Garavan H, Pankiewicz J, Bloom A, Cho JK, Sperry L, Ross TJ, Salmeron BJ, Risinger R, Kelley D, Stein EA. Cue-induced cocaine craving: neuroanatomical specificity for drug users and drug stimuli. Am J Psychiatry. 2000 Nov;157(11):1789-98. doi:10.1176/appi.ajp.157.11.1789. PMID: 11058476.

Geng X, Hu Y, Gu H, Salmeron BJ, Adinoff B, Stein EA, Yang Y. Salience and default mode network dysregulation in chronic cocaine users predict treatment outcome. Brain. 2017 May 1;140(5):1513-1524. doi:10.1093/brain/awx036. PMID: 28334915; PMCID: PMC6075550.

Gu H, Salmeron BJ, Ross TJ, Geng X, Zhan W, Stein EA, Yang Y. Mesocorticolimbic circuits are impaired in chronic cocaine users as demonstrated by resting-state functional connectivity. Neuroimage. 2010 Nov 1;53(2):593-601. doi:10.1016/j.neuroimage.2010.06.066. Epub 2010 Jul 11. PMID: 20603217; PMCID: PMC2930044.

Kaufman JN, Ross TJ, Stein EA, Garavan H. Cingulate hypoactivity in cocaine users during a GO-NOGO task as revealed by event-related functional magnetic resonance imaging. J Neurosci. 2003 Aug 27;23(21):7839-43. doi:10.1523/JNEUROSCI.23-21-07839.2003. PMID: 12944513; PMCID: PMC6740597.

Liang X, He Y, Salmeron BJ, Gu H, Stein EA, Yang Y. Interactions between the salience and default-mode networks are disrupted in cocaine addiction. J Neurosci. 2015 May 27;35(21):8081-90. doi:10.1523/JNEUROSCI.3188-14.2015. PMID: 26019326; PMCID: PMC4444534.

McHugh MJ, Gu H, Yang Y, Adinoff B, Stein EA. Executive control network connectivity strength protects against relapse to cocaine use. Addict Biol. 2017 Nov;22(6):1790-1801. doi:10.1111/adb.12448. Epub 2016 Sep 7. PMID: 27600492.

Rose EJ, Salmeron BJ, Ross TJ, Waltz J, Schweitzer JB, Stein EA. Dissociable Effects of Cocaine Dependence on Reward Processes: The Role of Acute Cocaine and Craving. Neuropsychopharmacology. 2017 Feb;42(3):736-747. doi:10.1038/npp.2016.161. Epub 2016 Aug 19. PMID: 27545986; PMCID: PMC5240179.

Rose EJ, Salmeron BJ, Ross TJ, Waltz J, Schweitzer JB, McClure SM, Stein EA. Temporal difference error prediction signal dysregulation in cocaine dependence. Neuropsychopharmacology. 2014 Jun;39(7):1732-42. doi:10.1038/npp.2014.21. Epub 2014 Jan 29. PMID: 24569319; PMCID: PMC4023147.