A new potential “cure” for addiction is on the horizon. But it isn’t a magic pill or a new counseling approach. Instead, it’s a wire that’s surgically inserted into the brain.
This radical approach sounds extreme, and it is. Drug overdoses have reached epidemic proportions, taking more than 100,000 lives in a year, the most ever recorded in American history. Last year, Florida ranked second for overdose deaths, behind only California. For comparison, in 2020, 7,579 people died from a drug overdose. That’s an increase of 37 percent from 2019.
Enter brain surgery. The procedure, known as Deep Brain Stimulation or DBS, is still in the clinical testing phases. The research is being performed by the Rockefeller Neuroscience Institute, based at the University of West Virginia.
It begins with a neurosurgeon drilling a hole into the skull, through which a small metal probe is inserted. The electrical probe is a fine piece of wire barely a millimeter wide that is pushed into the brain tissue into a region known as the nucleus accumbens. Doctors run an electrical current through the wire to cause “stimulation.” They use real-time imaging to get feedback on the patient’s response to images shown on a screen, such as drugs and drug use. The doctors can then adjust the probe’s position and intensity, hoping to create a positive effect.
Deep brain stimulation is approved by the US Food and Drug Administration to treat a range of ailments, like severe epilepsy and Parkinson’s disease. But Substance Use Disorder presents a more complex set of emotional and behavioral challenges, and it’s not yet clear whether the procedure is safe or effective when used this way.
But some people struggling with opioid addiction don’t mind the risk. Or, more accurately, accept it knowing the inevitable outcome of continued drug abuse. So, clinical testing has been performed on volunteers with mixed outcomes.
One test subject, a West Virginia man previously unable to abstain from opioid abuse, attributes his current success to the wire implant. The young man reports that it has helped him maintain sobriety for nearly two and a half years. But what isn’t apparent without closer inspection is that the patient has been on Suboxone, a narcotic opioid medication, the whole time. So, regardless of the vocabulary used, it’s difficult to deny that taking any opioid drug doesn’t qualify as abstinence. And then, there’s the matter of the other test subjects. Only one other person had similar success.
In the Tampa Bay area, 23 out of every 100,000 residents died from an overdose last year. That rate was 9 percent higher than the rest of Florida and 50 percent higher than the national average. In the Tampa Bay area alone, 30 people die from a drug overdose each week.
And in Pinellas County alone, there were 546 overdose deaths reported by the Medical Examiner’s office in 2020. But in the first six months of 2021, there were already 298 overdose deaths. That put the area on track to surpass last year’s record-breaking numbers by 35 percent.
According to Addicted.org, the pandemic was largely responsible for the increased drug overdose rates in Florida and the rest of the country. The coronavirus dominated media coverage and limited resources by hampering access to treatment and prevention services. In short, the drug epidemic that’s been raging for the last two decades exploded to a level never witnessed, thanks to the Covid-19 pandemic.
There are just as many reasons to be leery of using deep brain stimulation to treat addiction as there are reasons to be hopeful. While it may not be a magic bullet “cure” for addiction or even a safe therapy long-term, the testing presents an opportunity we’ve never had before. We get to see what’s happening in the brain during active addiction and where it’s happening. And we get to test how it responds to stimulus.
The value of the current DBS study is immeasurable. Who knows what discoveries may be made that help shape our understanding of substance use and how to treat it best. In the meantime, studies like this one may just be worth the risk. After all, the patients who volunteered for the study certainly believe so. They’re dying for a cure.
Ramsey Darwish has been working in the field of Substance Use Disorder for over 15 years. He uses his experience to provide insight into current issues surrounding addiction and recovery.