Deep Brain Stimulation for Addiction
Written by
Kendall K. Morgan
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:
Parkinson’s disease
Obsessive-compulsive disorder (
OCD)
Besides studying DBS for treatment of substance use disorders, researchers are also checking to see if it can help conditions such as:
Huntington’s disease
Chronic pain
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 that things can go wrong. Possible complications of DBS include:
Misplaced leads
Brain bleeds
Infection
Heart trouble
DBS devices aren’t turned on right away. Once they are on, the brain stimulation could have side effects, including:
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.
Deep brain stimulation (DBS) is used to treat movement disorders, epilepsy, and OCD. But does it work for addiction to opioids or other substances?
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