By Fiona Rowlands
Alcohol abuse and addiction is very prevalent in America with 10% of people over the age of 12 having alcohol use disorders. This means an inability to stop drinking alcohol even in the face of consequences.
As most are aware, Covid-19 lockdowns took a toll on mental health. Many people use alcohol to cope with stress and other mental health issues, so it is no surprise that 60% of Americans increased their alcohol use during lockdown.
Addiction is a very serious and debilitating condition that, contrary to popular belief, is not an issue of willpower. Current treatments include therapy, social support groups, and medications. These can provide aid but are not entirely effective for many people.
Scientists are now looking into new types of treatment such as deep brain stimulation (DBS) of the nucleus accumbens portion of the brain.
The nucleus accumbens is part of the mesolimbic dopamine pathway, also known as the reward circuit, that helps regulate reward and motivation. Dopamine, which is associated with pleasure, is the main neurotransmitter used in the nucleus accumbens.
Another area of the brain, called the ventral tegmental area, is activated when a person does something enjoyable. This sends a signal to activate the nucleus accumbens and the activation leads to a repeat of the same behavior.
Drugs of abuse use this reward system to create dependency and addiction. Since the nucleus accumbens is vital to the process of addiction, stimulating it may be a way to decrease drug cravings.
A 2016 study used DBS of the nucleus accumbens to treat severe alcohol addiction. The study longitudinally looked at five patients, meaning scientists followed up with the patients over eight years.
After having surgery to implant the stimulation device, all had a significant decrease in cravings, though only one of the patients was able to stay sober for the entire eight years of the study. Relapses tended to be short and would often follow periods of high stress.
This study showed that stress and coping mechanisms are an important factor in addiction and that craving a drug is only a portion of it. If cravings were the only component, all patients would have remained sober.
Treatment may have been more effective if DBS had been paired with therapy to teach coping skills and stress management. Despite some relapses DBS has very few side effects.
Though there are minimal side effects, DBS does require surgery. The device is implanted in the chest and the wires of the device must be placed in the specific brain area it is targeting.
There are always risks with any surgery and exposing the brain brings risks of infection and possible brain damage. The surgery is still relatively safe despite its risks.
While the results of this study are promising, it is important to remember the limitations of the study design. The study only followed five male patients and there would ideally be a larger, more diverse sample population to increase the validity of the data.
Given the risks and cost of surgery, DBS will likely not be the first line of defense in treating addiction but will be helpful to those who have not had success with more traditional treatments.
Alcohol addiction affects many people and is very serious. Deep brain stimulation of the nucleus accumbens offers hope to those who have not been able to stay sober. Hopefully in the next few years this can become a standard treatment in conjunction with therapy to help people with addiction.
