We hear from Rio, our TMS Practitioner at our Golders Green clinic in London who looks at TMS treatment for addiction. We also hear directly from a patient treated for drug and alcohol addiction and her experience of TMS treatment in the video below.
Alcohol is an integral part of our society today. We drink to celebrate, commiserate and even as a way to unwind. Although most of us can drink in moderation, for others it can become a crippling addiction. This can destroy the life of the person addicted and the lives of their loved ones too. So how can something that society considers safe, fun and enjoyable, also be so destructive and dangerous? To understand this, we must consider the impact of regular alcohol abuse on the brain.
When we first consume alcohol, the brain releases the feel-good chemical, dopamine. In normal circumstances, dopamine is released naturally in response to rewarding activities, such as eating our favourite food. This makes us feel good, reinforcing this reward-seeking behaviour. Likewise, alcohol consumption is reinforced by the brain’s reward system via dopamine release.
On the surface it may not be obvious that someone has crossed the line from social drinking to dependency. However, many changes are taking place in the brain. For some people, alcohol consumption overstimulates the reward system. This causes excess dopamine to build up, creating extremely intense pleasurable effects. This encourages repeated and continual consumption. Over time, the brain becomes physically altered and damaged as it tries to adapt to the excess dopamine and more and more alcohol is needed to feel the same effects. Damage occurs within the brain’s frontal lobe, the area responsible for decision-making and judgement. These neurophysiological changes drive further compulsive alcohol usage, in order to satisfy the powerful cravings and withdrawal symptoms, and just to feel normal.
Fortunately, much of the neural damage caused by alcohol addiction can be reversed. TMS is a promising solution for this because it directly targets and rewires the affected brain areas. Specifically, high frequency TMS stimulates neuroplasticity (connections between nerves) and causes dopamine neurotransmitters to be released. Over time this effect penetrates more deeply into the brain, rewiring the areas associated with the alcohol craving and addictive behaviour. Recent scientific research supports the efficacy of TMS in treating alcohol addiction. For instance, Hanlon et al(2018) and Diana et al(2019) reviewed the scientific evidence and found beneficial effects of TMS in rewiring the brain in alcohol addiction. Furthermore, a randomized controlled study by Mishra et al(2015) compared two different TMS treatment protocols for cravings in 20 patients with alcohol dependence. Each patient received 10 sessions and the average reduction in craving scores over the 2 weeks was 50%.
Treatment options for addiction recommended by the NHS include counselling, such as CBT or 12 Steps facilitation therapy. After detoxification, a variety of drugs are also recommended to reduce the likelihood of a relapse, such as Acamprosate or Naltrexone. However, it is reported that more than 80% of patients who receive such treatments can relapse in the first year (Rubio et al, 2001). Further caveats to these approaches include unpleasant pharmacological side effects and time commitment needed for psychotherapies. Thus, there is an urgent need for more reliable options that can help to maintain sobriety long-term. TMS is a strong contender as it circumvents any harsh side-effects, and a full treatment course can be completed in 3 weeks. Long-term follow up research for TMS in addictions is so far limited, due to small sample sizes and differing TMS parameters across studies. Growing the current research base will allow for definitive conclusions about its long-term sustainability. Furthermore, Smart TMS are working towards releasing 6 month and 12-month follow-up outcomes for the patients treated for addictions.
Alcohol addiction is a serious illness and not a lifestyle choice. The acute neurobiological changes hinder rational decision-making and drive compulsive usage, making medical intervention an absolute necessity. Scientific research has bettered our understanding of the biological basis of addiction development. This has encouraged a move away from the stigma of “choice” in an addiction, and has allowed for new innovative treatments, such as TMS, to become available to those struggling with this debilitating disease.
Words kindly written by Rio from our Golders Green clinic.
References available on request.
Hear from a recent patient treated at our Dublin clinic for drug and alcohol addiction.
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- Tel: 0345 222 5678
- Email: info@smarttms.co.uk