For the first time in the US, brain surgeons have surgically implanted electrodes into the brain of an opioid addiction.
West Virginia University (WVU) scientists believe that so-called deep brain stimulation can help alleviate the craving for addictive and dangerous drugs.
Admittedly, they don't know exactly how deep brain stimulation works to treat addiction.
But based on promising research that it uses to treat the symptoms of Parkinson's epilepsy and depression, the WVU team believes it might be related to the neurotransmitter, dopamine, and interferes with the brain's reward circuit.
The method has been tried in the Netherlands and China, but according to the researchers this is the first test in the US – and so far Gerod Buckhalter (33) is recovering well, although the device is not yet turned on.
Led by Dr. Ali Rezai (center), brain surgeons implanted electrode wires into the brain of 33-year-old Gerod Buckhalter (pictured right, on screen and awake for surgery) in an initial opioid addiction treatment in the US.
Over the last decade, the patient, Gerod Buckhalter, has received multiple overdoses due to his addiction to opioids and benzodiazepines.
The hotel staff member told the Washington Post that he has not spent more than four months sober since he was 15 years old.
He has tried an inpatient and outpatient addiction treatment, with and without medication.
Nothing worked. Buckhalter's addiction is & # 39; treatment resistant & # 39; in the medical language.
About 2.1 million Americans were addicted to opioids in 2016, according to the latest data from the Drug Abuse and Mental Health Services Administration. That number is no doubt swollen because the epidemic persisted.
For most of these people, attempts to break the addiction will fail at least once, but ultimately once.
A small subset exhausts all options.
"Despite our efforts using current, evidence-based treatment methods, there are a number of patients who simply do not respond," said Dr. James Berry, director of the school's addiction services.
And there are many addiction patients in West Virginia who have the highest rate of opioid addictions and overdoses of any state in the US.
Gerod Buckhalter was operated on November 1, 2019 at WVU
Before he puts it in Buckhalter's brain, Dr. Rezai one of the electrodes for deep brain stimulation
Scans show the electrode wires that neurosurgeons insert into the core of Buckhalter to act as a & # 39; brain pacemaker & # 39; (left). The electrodes provide & # 39; deep brain stimulation & # 39 ;, allegedly due to the location of the nucleus accumbens in the center of the brain (right)
& # 39; Some of these patients continue to run a very high risk of ongoing catastrophic health problems and even death. & # 39;
But Dr. Ali Rezai and his team at WVU want to add brain surgery to the end of the treatment options list.
They call the operation a & # 39; brain stimulator & # 39; operation.
Dr. Rezai and his neurosurgical team made a hole the size of a nickel in the Buckhalter skull while under anesthesia, according to the Washington Post.
After the piece of bone was removed, they eased the anesthesia and woke it up to check that none of the procedures disturbed Buckhalter's cognitive functions, speech, or other normal brain activity.
Buckhalter lay awake during the operation so that doctors could follow his speech and cognition, as well as the electrical activity in his brain
Buckhalter has been struggling with addiction to opioids and benzodiazepines since he was 15 years old. He, his parents and the WVU team hope that deep brain stimulation can finally help him to break free
They then led electrode wires through the hole in the & # 39; deep brain & # 39; – in particular the nucleus accumbens, a hub for information about past experiences and therefore addiction in the brain.
Just like with a pacemaker, the wires can regularly deliver small shocks to the brain. In response, the brain fires shots of dopamine, a & # 39; feel good & # 39; neurotransmitter.
Opioids make their way through the blood-brain barrier to the nucleus accumbens and begin a cascade of processes that trigger the release of more dopamine and flood it with pleasure.
And when the drug is gone – with withdrawals – the brain feels starved for dopamine until an addict gets his next solution.
The hope is that the electrodes cause Buckhalter's brain to pump steady, healthy doses of dopamine away from the wild addiction from feast to famine and back.
& # 39; Addiction is a brain disease that involves brain reward centers, and we need to explore new technologies, such as the use of DBS, to help those who are severely affected by opioid usage disorders, & # 39; said Dr. Rezei.
Brain surgery is certainly not a minor intervention, and would be far from first-line treatment, but for the most difficult to treat addiction patients, such as Buckhalter, it can offer hope where there was none.
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