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Deep Brain Stimulation for Addiction

Medically Reviewed by Sabrina Felson, MD on May 03, 2022

Addiction is a complex and treatable disease. It’s usually treated with counseling or other therapies. Sometimes you might need medicine along with behavioral therapies. Unfortunately many people with a substance use disorder or addiction find it hard to stop. They may stop for a time and then go back to misusing substances. Because of this, doctors would like to find new ways to treat addictions of all kinds. One promising but still unproven approach involves targeting key parts of the brain using a technique called deep brain stimulation (DBS).

DBS involves surgery to place electrodes in your brain. It’s approved for some other conditions and has shown early promise for treating substance use disorders in case reports and small studies. But it’s not yet clear whether or how well it works for addiction. Because the FDA hasn’t approved its use for any type of substance use disorder or addiction, the only way to try it for this today is in a clinical trial.

How Does Deep Brain Stimulation (DBS) Work?

Deep brain stimulation is just what it sounds like. A surgeon puts electrodes deep in your brain in specific places. Those specific brain areas depend on what you’re getting DBS for. The electrodes send electrical impulses into your brain. Doctors compare DBS to a pacemaker used to correct abnormal heart rhythms. Instead the goal of DBS is to correct abnormal or troubling brain rhythms that play a role in various conditions.

Your surgeon also puts a device under the skin in your chest. Its job is to control the amount of electrical stimulation that’s going to your brain. A wire under your skin connects the electrodes in your brain to the pacemaker-like device in your chest.

If you get DBS for a movement disorder, then doctors place the electrodes in brain areas that control movement. Although DBS isn’t yet proven for addiction, the idea is that you’d place electrodes in parts of the brain that are involved in your inability to control your substance use. One of the most common areas that’s been targeted in studies of DBS for addiction is called the nucleus accumbens. It’s important in addiction and the way your brain processes and responds to rewards.

Doctors now use DBS for conditions including:

Besides studying DBS for treatment of substance use disorders, researchers are also checking to see if it can help conditions such as:

Does Deep Brain Stimulation (DBS) Work for Addiction?

It’s too soon to say if DBS might help treat addiction or substance use disorders in the future. Doctors know that DBS can work for some other conditions and is safe enough to use when there’s a serious brain condition that isn’t getting better with other kinds of treatment.

One of the reasons doctors got the idea that DBS might work for addiction came from observations that people who got DBS to treat their Parkinson’s disease showed less compulsive behavior, such as gambling. Some other case reports of people who got DBS for another reason found that it got rid of a drug addiction they also had. But there’s not enough evidence from studies of people who got DBS for an addiction or substance use disorder to show whether or how well it works.

Studies in animals support the idea that DBS could help with addiction to many different substances. With DBS, animals were less likely to seek out substances. It’s mainly been tested in animals that were actively using drugs. It’s not as well known if DBS can help with withdrawal symptoms or to prevent a relapse later.

While DBS has been tried in people for addiction, the data on this are still very limited. There are some reports that stimulation of the brain’s nucleus accumbens helped people use less alcohol, nicotine, and heroin. One person who had DBS stopped using heroin for 2.5 years with the device in place and didn’t go back to heroin after it was removed. Another report followed two people with hard-to-treat heroin use disorder. They reportedly used heroin only once after DBS surgery. Another study of 5 people with hard-to-treat alcohol use disorder showed that DBS stopped their alcohol cravings for many years.

In another report, a 47-year-old woman who got DBS targeting the nucleus accumbens to treat her OCD lost weight and stopped smoking without even trying. So it’s possible that DBS could help with addictions by targeting some of the same brain circuits that are involved in OCD and compulsive behavior. A recent review of studies found 14 that looked at DBS to treat substance use disorders. Overall the studies found some evidence DBS of the nucleus accumbens can make people with substance use disorders less likely to relapse and have better quality of life.

Some of the studies published so far don’t give detailed information about how they were done. The studies are also small. It’s not clear from the isolated case reports and small studies if DBS works well enough for addiction that it might one day become an approved treatment option for any substance use disorder. Doctors are running clinical trials now to learn more.

Deep Brain Stimulation (DBS) Risks and Side Effects

DBS is not a high-risk procedure, but it’s possible with any surgery for things to go wrong. Possible complications of DBS include:

DBS devices aren’t turned on right away. Once they are on, the brain stimulation could have side effects including:

  • Tingling or numbness
  • Muscle tightness in face or arms
  • Trouble with speaking or balance
  • Feeling lightheaded
  • Trouble with vision
  • Changes in your mood

If you think you might get DBS for addiction or any other condition, you’ll want to make sure you understand all the possible risks and benefits that come with it.

How Can I Join a Clinical Trial?

Since DBS isn’t approved for addiction, the only way to get it today is in a clinical trial. Talk to your doctor to see if you might be a candidate to take part in a clinical trial of DBS for an addiction. You can also search for clinical trials near you at clinicaltrials.gov.

The clinical studies that are happening now are mostly small pilot studies. For example, researchers running one pilot study testing DBS for opioid use disorder only plan to enroll three people. They’ll look to see if it helps people stop using opioids for 6 months and then 1 year, but the main goal is to see if it looks safe to use DBS for opioid use disorder. If the results are good and it seems safe, then researchers would move on to larger studies testing DBS in more people.

To be eligible for a trial testing DBS for addiction, you’d have to meet many different requirements such as:

  • A long history of substance use disorder
  • Not getting better with multiple other approved treatments for substance use disorders
  • Survived an overdose or other serious complications related to substance use
  • Relapsed after treatment with therapy and medicines

You won’t be able to be in a trial if you have a history of brain surgery, attempted suicide, or certain other conditions.

The best way to get help with a substance use disorder right away is with approved treatments that often include therapy and medicines. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a free helpline you can call anytime for information and treatment referrals. You can also search for providers using their online treatment services locator.

Show Sources

SOURCES:

National Institute on Drug Abuse: “Treatment Approaches for Drug Addiction.”

Journal of the Neurological Sciences: “Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment.”

Mayo Clinic: “Deep Brain Stimulation.”

Pain Med: “Neurostimulation for Treatment of Migraine and Cluster Headache.”

Neurosurgical Review: “Outcomes of deep brain stimulation surgery for substance use disorder: a systematic review.”

Neurosurgery: “Smoking cessation and weight loss after chronic deep brain stimulation of the nucleus accumbens: therapeutic and research implications: case report.”

UCLA Health: “FDA approves deep brain stimulation for treatment of severe epilepsy.”

National Institute of Neurological Disorders and Stroke: “Deep brain stimulation (DBS) for the treatment of Parkinson’s disease and other movement disorders.”

Neurosurg Focus: “Deep brain stimulation for the treatment of drug addiction.”

Clinicaltrials.gov: “Deep Brain Stimulation Effects In Patients With Opioid Use Disorder.”

Substance Abuse and Mental Health Services Administration: “SAMHSA’S National Helpline,” “Behavioral Health Treatment Services Locator.”

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