Switching off drug addiction
Shanghai doctors use electronic implants to curb drug abuse
SHANGHAI: Patient No.1 is a thin man with a scabby face and bouncy knees. His head, shaved for surgery, is wrapped in a clean, white cloth.
Years of drug use cost him his wife, money and self-respect, before landing him in this Shanghai hospital, facing the surgeon who will soon drill two holes in his skull and feed electrodes deep into his brain.
The hope is that technology will extinguish his addiction, quite literally, with the flip of a switch.
The treatment – deep brain stimulation (DBS) – has long been used for movement disorders like Parkinson’s. Now, the first clinical trial of DBS for methamphetamine addiction is being done at Ruijin Hospital, along with parallel trials for opioid addicts. This man is the first patient.
The surgery involves implanting a device that acts as a kind of pacemaker for the brain, electrically stimulating targeted areas.
While Western attempts to conduct human trials of DBS for addiction have foundered, China is emerging as a hub for this research.
Scientists in Europe struggle to recruit patients for such studies, and ethical, social and scientific questions make it hard to push forward such work in the United States.
But the suffering wrought by the
opioid epidemic may be changing the risk-reward calculus for doctors and regulators in the United States.
Now, the experimental surgery Patient No.1 is about to undergo is coming to America. In February, the US Food and Drug Administration greenlighted a clinical trial in West Virginia of DBS for opioid addicts.
Patient No.1 wanted only his surname, Yan, be published; he feared losing his job if he was identified.
At 9am on a October Friday in Shanghai, Dr Li Dianyou drilled
through Yan’s skull and threaded two electrodes down to his nucleus accumbens, a small structure near the base of the forebrain that has been implicated in addiction.
At 4pm, Yan went under general anesthesia for a second surgery to implant a battery pack in his chest to power the electrodes in his skull.
Three hours later, Yan still hadn’t woken up. His doctors wondered if drug abuse had altered his sensitivity to anesthesia.
After 10 hours, he opened his eyes. Two days after the surgery, doctors switched on his DBS device. The current running through Yan’s body kept him awake; he spent the whole night thinking about drugs.
The next day, he sat across from Dr Li, who used a tablet computer to remotely adjust the machine thrumming inside Yan’s head.
He was in high spirits, saying: “This machine is magical. It controls your happiness, anger and grief.”
More than six months later, Yan said he’s still off drugs. With sobriety, his skin cleared and he put on weight. When his friends got back in touch, he refused their drugs.
Sometimes, he touches the hard cable in his neck that leads from the battery pack to the electrodes in his brain and wonders: What is the machine doing in his head?