Publication date: Nov 07, 2019
His patient, 33-year-old hotel worker Gerod Buckhalter, said he had been unable to remain sober for more than four months since the age of 15, despite trying a variety of medications and other inpatient and outpatient treatments.
It is aimed at a small percentage of opioid abusers with the most treatment-resistant cravings for opioids, who may face a lifetime of overdoses, relapses, inability to hold a job and other consequences of addiction.
-I’m not advocating for deep brain stimulation as a first line or a second line [treatment],” Rezai said.
Rezai’s surgical team opened a hole in Buckhalter’s skull about the size of a nickel, then inserted four wires into his nucleus accumbens, a part of the brain’s reward system that responds strongly to opioids.
About 180,000 people around the world have deep brain stimulators, Rezai said.
The same surgery for people with opioid use disorder has been performed in China and Holland, said Helen S. Mayberg, director of the Center of Advanced Circuit Therapeutics at Mt. Sinai Medical Center’s Icahn School of Medicine, and also has been tried as a cure for alcoholism.
Other countries have employed different approaches for people with the most severe addictions as the opioid crisis continues.
Rezai’s effort is believed to be the first attempt to use deep brain stimulation on opioid use disorder in the United States.
Mayberg, who was not involved in the trial, said the that logic of the effort is sound and that the circuitry of this part of the brain is well-mapped compared with other regions.
Linda J. Porrino, a professor of physiology and pharmacology at Wake Forest School of Medicine, said animal studies and anecdotal evidence among humans who have had deep brain stimulation for other diseases indicates the procedure could be helpful in curbing cravings for opioids, alcohol, nicotine and cocaine.
Buckhalter said he tries not to consider what he will do if deep brain stimulation doesn’t work for him.
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