In memoriam: Warren Bickel, professor and global pioneer in addiction recovery research

Warren Bickel, whose innovative approach to addiction research saved lives, inspired generations of scientists, and put him among the top 1 percent of the world most highly cited researchers, died Saturday, Sept. 28. He was 68.

In 2011, Bickel was among the first scientists to join Virginia Tech’s Fralin Biomedical Research Institute at VTC. There, he became the inaugural director of the institute’s Addiction Recovery Research Center and in 2016 was named director of its Center for Health Behaviors Research.

His research helped pioneer buprenorphine treatment, one of only three Food and Drug Administration (FDA)-approved medications to treat opioid use disorder, which affects more than 40 million people worldwide.

Appointed as the Virginia Tech Carilion Behavioral Health Research Professor by the university Board of Visitors in 2016, Bickel applied principles of behavioral economics to the study of addiction and recovery. He established the world’s first registry of people in recovery, sorting through factors that make some people more successful than others in overcoming addictions.

Bickel’s research analyzes how people think about the future and how that affects their decision-making. It grew from his observation that a hallmark of addiction is the tendency to choose immediate gratification over longer-term outcomes, usually at great cost to a person’s health and well-being.

Michael Friedlander, executive director of the research institute and Virginia Tech’s vice president of health sciences and technology, recruited Bickel to join Virginia Tech in 2010.

“Warren’s innovative work has already made a difference by helping save many lives of people who are battling the power of substances that often hijack the brain’s decision-making functions,” Friedlander said. “We are all deeply saddened by this tragic loss. His work will continue to make meaningful impact in the world and his personal connections and good heart leave us all much richer for having known him as a friend and a colleague.”

On Sept. 16 at a Festschrift Symposium, an academic event in which his colleagues and protégés share how the honoree shaped the field and their lives, current and former colleagues and associates celebrated Bickel’s achievements.

The event, which typically recognizes a scholar upon retirement, was organized following Bickel’s diagnosis in May of pancreatic cancer.

Stephen Higgins, a professor of psychiatry at the University of Vermont and Bickel’s roommate in graduate school, reflected on four decades of collaboration and friendship.

“He stands among the giants in addiction research,” Higgins said. “Here’s something that flies under the radar screen in Warren’s career, and it’s critically important. He was the first author on two pivotal studies that helped get FDA approval for buprenorphine as a treatment for opioid use disorder. Where would we be, during the opioid crisis that’s been raging, if there weren’t buprenorphine?”

Nora D. Volkow, director of the National Institutes of Health’s National Institute of Drug Abuse, described Bickel’s work as ahead of its time.

“His insight into how deficits in delayed gratification contribute to harmful brain patterns and substance abuse disorder has been groundbreaking,” Volkow said. “I have always admired the humility with which he approaches challenges, consistently finding solutions — this quality has been a source of inspiration for me over the years.”  

Soon after his arrival at Virginia Tech, Bickel launched the International Quit & Recovery Registry, a research tool that has helped advance scientific understanding of long-term recovery.

“When I came to Roanoke, I realized that we don't study recovery very systematically in addiction science,” Bickel said in 2022. “With the institute’s support, I developed a registry of people in recovery. We asked anybody who has quit anything to give us a valid email address, give us information about their drug and substance use history, and their treatment history.”

Today, the registry includes more than 10,000 people representing all 50 states, about 60 countries, and six continents. It provides both a community for people in recovery from alcohol, tobacco, and drugs and a rich resource for scientists studying success in recovery.

“His pioneering initiative to establish a patient registry to explore and comprehend the intricacies of successful addiction recovery was ahead of its time, recognizing the importance of this work long before others did,” Volkow said.

The Experimental Tobacco Marketplace was another tool Bickel developed to study the effects of tax and regulatory policies on health behaviors such as cigarette smoking, the leading cause of preventable death in the U.S. Study participants use an online account in an Amazon-like interface to purchase tobacco and nicotine products, including replacement therapies.

“In the process, we’re understanding how new policies may change consumers’ behavior,” Bickel said of the tool. “If we can actually start addressing and forecasting the impact of policy on health disparity, that’s a game-changer.”

Another legacy of his work is BEAM Diagnostics, one of his spinoff companies to launch from the Fralin Biomedical Research Institute. The Roanoke-based company is led by co-founder and CEO Sarah Snider, formerly a postdoctoral fellow who worked with Bickel in the Addiction Recovery Research Center.

BEAM Diagnostics provides health systems with a digital screening tool that quickly and accurately determines a patient’s risk for a range of behavioral health conditions, including alcohol and opioid use disorder.

Bickel received an undergraduate degree in psychology from the State University of New York at New Paltz and master’s and doctoral degrees in developmental and child psychology from the University of Kansas. He conducted postdoctoral research at the University of North Carolina at Chapel Hill and the Johns Hopkins University School of Medicine in Baltimore, Maryland.

He taught and led research at the University of Vermont College of Medicine and the University of Arkansas for Medical Sciences before joining the faculty of Virginia Tech, where he also held appointments in the Department of Psychology of the College of Science and the Department of Psychiatry and Behavioral Medicine of the Virginia Tech Carilion School of Medicine.

A hallmark of his career was his collaborative approach to science, which was highlighted during the Festschrift. He mentored 14 doctoral students and 30 postdoctoral researchers. His national service included serving on the editorial board of 16 scientific and medical journals.

Throughout his career he was awarded more than a dozen national prizes and awards, including in 2016 the Nathan B. Eddy Award, the highest honor bestowed by the College on Problems of Drug Dependence, which since 1929 is the longest standing U.S. group addressing problems of drug use, misuse, and dependence.

During his career Bickel had more than 500 publications, and his work has been cited more than 50,000 times. Six of his papers have been cited more than 1,000 times, a testament to his scientific and scholarly impact globally.

Shortly after learning of his diagnosis, Bickel hosted a gathering for family, friends, and colleagues at the Taubman Museum of Art in downtown Roanoke, a short walk from his home. In the invitation to what he called a “Fare Thee Well” party, he wrote that it was a way to have agency following his cancer diagnosis.

In his final months he continued to pursue his research with unwavering passion and curiosity.

He attended conferences, worked with students and trainees, and collaborated with colleagues in approaching the challenge of addiction from many angles. In September alone, he co-authored research investigating the neural effects of episodic future thinking in alcohol use disorder, the effects of cigarette and e-cigarette flavors on demand and substitution, and physical activity as a tool in treatment and recovery.

While his academic reputation had global reach, he was also engaged with the community, where he contributed his expertise to local recovery initiatives.

New York Times bestselling author Beth Macy described boarding a plane at LaGuardia Airport after a publisher’s meeting where she had been contracted to write “Dopesick,” her first of two books on the opioid epidemic. Bickel, on his way back from a conference, was the last passenger to board and had a seat next to her.

They struck up a conversation, and she learned not only that they lived on the same street in Roanoke, but that he was one of the world’s foremost experts on addiction.

“Over the next two years, he met with me regularly, fine-tuning my arguments, sending me his data, letting me tell him what I was seeing on the ground, and sometimes just lending a shoulder for me to cry and spew anger on,” Macy said. “Since the 1980s, he has known the best ways to treat this terrible disease. The nation still isn’t offering treatment anywhere near approaching the scale of the crisis. But in Warren’s name, we should all aspire and work toward it.”

Virginia Tech will place a wreath in his honor at the Fralin Biomedical Research Institute on Oct. 7. In lieu of flowers, donations honoring Bickel can be made to the Jefferson Center in Roanoke, the College on Problems of Drug Dependence, or the Dr. Warren K. Bickel Tribute Fund at Virginia Tech. Lotz Funeral Home in Roanoke is handling arrangements; there will be no visitation.