Open-label Feasibility Trial of HD-tDCS During Cognitive Behavioral Therapy for Cocaine Use Disorder

Cocaine Use Disorder (CocUD) is a significant public health issue with increasing cocaine-related overdose mortality. Effective treatments for CocUD are highly needed. One understudied target for CocUD therapeutics is improving cognitive function (CF) in that key theories attribute development of CocUD and other substance use disorders (SUD) to impaired CF, such as decreased ability to inhibit behavior. Heavy cocaine users show impairments in attention, working memory, planning, and response inhibition, affecting as many as 30-80% of individuals with SUD. These cognitive deficits affect patient engagement and participation in SUD treatment, thus necessitating SUD programs assess and accommodate cognitive problems throughout treatment.

Inclusion Criteria * Between 18 and 65 years-of-age. * Meet current DSM-5 criteria for Cocaine Use Disorder (CocUD), moderate or severe * Professed interest in CocUD treatment or reducing cocaine use. * Understand and comply with study procedures * Positive urine result for cocaine metabolite in at least one screening visit. Exclusion Criteria * Current DSM-5 diagnosis of any non-cocaine substance use disorder (SUD) other than alcohol use disorder-mild or cannabis use disorder-mild * Epilepsy or a history of multiple seizures * Taking any medications known to reduce seizure threshold * History of migraines, ringing in the ears, and/or a head injury that resulted in a diagnosis of concussion and/or loss of consciousness * Current scalp condition (e.g. psoriasis) or head wound that has not completely healed * Currently pregnant or hoping to become pregnant at any point during the study * Significant current suicidal or homicidal ideation * Metal plate in skull or other embedded metal fragments in body or other bodily metal * Claustrophobia or other MRI contraindications * Fitted with electrical implants such as pacemaker * Present with clinically significant symptoms of acute cocaine or opioid withdrawal (these individuals would be rescheduled after resolution of acute withdrawal, if possible).