Treating addiction with TMS: A new hope for recovery

Addiction is a complex issue that affects millions of individuals worldwide, with substances like cocaine, alcohol, and nicotine wreaking havoc on the lives of those caught in their grip. The impact of addiction on the brain's reward circuitry is well-documented, but effective treatments have remained elusive for many. In this article, leading consultant psychologist Dr Justin Stephenson explores Transcranial Magnetic Stimulation (TMS) as a promising avenue for treating addiction. Dr Stephenson delves into how addiction affects the brain, traditional treatment options, and the scientific evidence supporting the use of TMS in addiction recovery.

Understanding addiction and its effect on the brain:

Addictive substances, whether it's cocaine, alcohol, or nicotine, share a common mechanism of action in the brain. They elevate the levels of dopamine, a natural chemical messenger, in brain circuits that regulate pleasure and movement. Typically, the brain releases dopamine in response to potential rewards, like the anticipation of a delicious meal. Afterwards, it reabsorbs dopamine, effectively shutting off the signalling between nerve cells. However, addictive substances disrupt this process, leading to a buildup of excessive dopamine levels between nerve cells. This dopamine flood disrupts normal brain communication and results in the intense pleasurable effects associated with addiction.

Over time, repeated use of addictive substances can lead to long-term changes in the brain's reward circuit and other systems, which may culminate in addiction. The reward circuit adapts to the excess dopamine, causing individuals to seek stronger and more frequent doses to achieve the same high and alleviate withdrawal symptoms.

Traditional treatment options for addiction:

Addiction treatment varies depending on the substance involved. Here are some traditional approaches for addressing different addictions:

• Cocaine addiction: No FDA or NICE-approved treatment for cocaine addiction exists to date. Various medications have been explored but have not shown clear efficacy. Psychological approaches such as cognitive behavioural therapy (CBT) and Contingency Management are effective but time-consuming.
• Alcohol addiction: Counselling, including CBT, self-help groups, and family therapy, is recommended by the NHS.  Detoxification can be done at home or in a hospital, with medication to alleviate withdrawal symptoms. Drugs like Acamprosate, Naltrexone, Nalmefene, and Disulfiram may be used to prevent relapse. The high risk of relapse, especially in the first year, underscores the importance of scientifically proven methods for maintaining sobriety.
• Nicotine/Smoking addiction: NHS recommendations include individual counselling, group counselling, self-help materials, and telephone counselling. Nicotine replacement therapy (NRT) and prescription medications like Bupropion (Zyban) are options. Exercise can also help distract from nicotine cravings.

The Role of Transcranial Magnetic Stimulation (TMS) in Addiction Treatment:

TMS offers a novel approach to addiction treatment by stimulating specific brain regions through magnetic fields. It increases cortical excitability, enhances neuroplasticity (connections between nerves), and releases dopamine neurotransmitters, targeting areas associated with cravings and addictive behaviour. Recent studies have highlighted the potential of TMS in addiction treatment:

• Cocaine addiction: Studies report significant reductions in craving and doses consumed with TMS, with no serious adverse effects. TMS can be considered as a treatment as a treatment option, along with psychological therapy and maintenance TMS sessions.
• Alcohol addiction: TMS holds promise as a potential treatment, with evidence supporting its efficacy in rewiring the brain in alcohol dependence. Potential patients should follow NHS guidance initially; if cravings persist, consider TMS along with psychological therapy and maintenance TMS.
• Nicotine/Smoking addiction: TMS has shown high smoking cessation rates and reduced cigarette cravings in multiple studies. It is recommended to first follow NHS recommendations; if unsuccessful, TMS can be considered.
• Smart TMS Case Series: Smart TMS has observed promising results in 27 patients with various addictions treated over two weeks with TMS. Most patients experienced a significant reduction in cravings, and a substantial number were entirely free of addiction cravings after TMS treatment.

In conclusion, incorporating TMS into addiction treatment strategies may provide new hope for those battling addiction, helping them regain control of their lives and achieve lasting recovery. Consult with medical professionals for personalised treatment plans based on your specific addiction and needs.

If you would like to book an appointment with Dr Justin Stephenson, you can do so today via his Top Doctors profile.