Doctors in West Virginia are trialling an experimental brain surgery on chronic opioid addicts that they hope will rewire patients’ neural reward systems.
The surgery is part of a clinical trial run by West Virginia University’s Rockefeller Neuroscience Institute, and involves implanting tiny electrodes that send electrical pulses to the part of the brain that rewards pleasure-seeking behaviours.
Doctors hope the study will help to drown out cravings, offering a way out of long-term addiction for patients who have exhausted other rehabilitation methods and suffered multiple overdoses.
The method is known as deep brain stimulation (DBS) and has previously been used to successfully treat the symptoms of Parkinson’s Disease, by changing the way the brain’s reward centre works.
James Fisher told NBC News he was desperate to take part in the study after suffering four near-fatal drug overdoses.
Mr Fisher said he had been using drugs since his teenage years, and became addicted to benzodiazepine or “benzos”.
He found it easy to get prescriptions for a time, and when that dried up he was forced to buy from friends, and began stealing to pay for his habit.
“I don’t want to die,” Mr Fisher told NBC News prior to his surgery in July.
“I don’t want to live that miserable life of being sober and still wanting something and not being able to get it.”
Since his surgery, Mr Fisher said he no longer felt depressed or anxious, and no longer craved drugs. He told NBC News he had been clean for two months.
“It’s like night and day,” he said.
According to the National Institute on Drug Abuse, the brain reward system is a brain circuit that causes feelings of pleasurewhen it’s “turned on” by something an enjoyable activity, such as eating good food or sex.
Whenever this reward circuit is activated, our brains note that something important is happening that’s worth remembering and repeating.
Drugs such as opioids and benzodiazepine hijack the reward system, causing addicts to crave larger quantities to satisfy them.
The Rockefeller Neuroscience Institute’s executive chair Dr Ali Rezai told NBC News deep brain stimulation had been used successfully to treat the symptoms of Parkinson’s disease for decades.
Doctors at the institute began developing a similar technique to treat addicts who were beyond the help of other treatments.
“Our hypothesis was that by using the DBS in this part of the brain, we would essentially be normalizing the dopamine levels,” Dr Rezai said.
“In addiction, the rewards part of the brain releases dopamine when the drug is taken and people feel good. And then they want more next time to get to the same feeling.”
The trial began in 2019, and Mr Fisher was only the third patient to undergo the surgery.
Doctors are planning a second phase involving 10 patients who have tried everything else to get off opioids.
The need for innovative treatments is acute, with more than 93,000 Americans dying of drug overdoses in 2020, according to the Centers for Disease Control and Prevention. Synthetic opioids accounted for 60 per cent of deaths.
The coronavirus pandemic has been blamed on the soaring drug overdose figures, with a nearly 50 per cent spike in fatalities since 2018.