A man who had been swallowing more than 100 pain pills a day has reportedly overcome his dependence after undergoing a pioneering 20-minute procedure.
The patient, an unnamed man in his 40s referred to only as “H,” developed the problem after a neck injury years earlier led physicians to prescribe opioid painkillers.
Although his pain eventually eased, his reliance on the medication intensified, reaching the point where he was taking 130 tablets a day simply to function.
Opioids work by attaching to receptors in the brain, blocking pain messages while also prompting a surge of dopamine — the “feel-good” chemical that can train the brain to link the drug with reward.
That powerful effect helps explain why medications such as hydrocodone, oxycodone and morphine can be so addictive, with opioid dependence affecting an estimated 6 million people in the US.
For H, who lives in Israel, the original injury was no longer causing significant physical pain, but his body had adapted to the drugs so strongly that stopping them risked severe withdrawal symptoms, including sweating, muscle aches, nausea, vomiting and intense restlessness.
Specialists at Rambam Health Care Campus in Israel treated him with an experimental sound-wave technique that assessed activity in the nucleus accumbens (NAc), a brain region central to reward and motivation where opioids act and dopamine is released.
Because the sound waves are noninvasive and require no surgery, doctors were able to target and quiet opioid receptors, helping curb H’s craving for the drugs.
The anonymous patient, who is in his 40s and identified only as ‘H,’ (pictured above) suffered a neck injury several years ago, which led doctors to prescribe him opioid pain medication
During the 20-minute treatment, H immediately reported a reduction in cravings, and one week later, urine drug tests showed he had no opioids or other substances in his system. H told doctors he had a craving score of zero out of ten.
Additionally, he had begun smoking less, going from three packs a day to just a handful of cigarettes. He also had no desire to drink alcohol.
Doctors treating H believe the in-development therapy could be used to help treat opioid dependence around the world without detox programs and invasive procedures.
‘This is a new therapeutic platform that allows us to offer a range of noninvasive treatments for many problems affecting people around the world,’ Dr Lior Lev-Tov, lead investigator and head of the Functional Neurosurgery Unit at Rambam Health Care Campus, said.
‘This is a major scientific breakthrough that could have far-reaching implications and reshape the way we approach treatment.’
H was part of a 22-person study from Lev-Tov’s team testing the treatment at a small number of medical centers in the US and Israel. H was the first participant to undergo the treatment while in active withdrawal.
The researchers used sound waves delivered in an MRI-like machine to perform neuromodulation, which alters or regulates nerve activity deep within the brain. It has been compared to a pacemaker in the heart, which sends mild electrical signals to the heart to maintain a normal beat.
Doctors at Rambam Health Care Campus in Israel (pictured above) gave H an experimental treatment using sound waves that measured activity in a region of the brain called the nucleus accumbens (NAc), part of the reward and motivation system where opioids bind and dopamine is released
More invasive forms of neuromodulation, such as deep brain stimulation – which involves surgically implanting electrodes in certain areas of the brain – have been used for conditions like Parkinson’s disease, disrupting faulty nerve signals to reduce tremors and stiffness.
For H, researchers targeted his nucleus accumbens (NAc), a brain structure that releases dopamine in response to opioids in addiction, without heating or damaging surrounding tissue.
H had no negative side effects or complications from the treatment.
‘In a treatment that took about 20 minutes, our patient was able to detox from an extreme dependence that had been part of his daily life for years,’ Lev-Tov said.
‘This is nothing less than a medical and therapeutic revolution.’
Two weeks after the treatment, H has remained cleaned from opioids, telling his doctors that he now had his life back.
The experts at Rambam also noted that study patients in the US have reported a decrease in cravings for heroin, a process that can take years.
‘We hope this new development will be able to help many thousands of people dependent on opioids, in a safe and less traumatic way,’ Dr Amir Minerbi, director of Rambam’s Institute for Pain Medicine, said.
