Addiction is costly in many ways. It can cost relationships, families, jobs, and lives. The stigma of addiction can cause people not to seek help, and it seems that the stigma is international, just like the disease of addiction itself.
China has been experimenting with different solutions for addiction for years. People often go to the research doctors out of desperation. A recent article by the Associated Press detailed the desperation a man named Yan, in China, felt when over the years he became addicted to crystal meth and, eventually, heroin. His father wanted to help but was tired of watching him bounce in and out of drug rehabilitation. He gave him a choice between another trip to drug rehabilitation, or to try Deep Brain Stimulation surgery. “Of course, I chose surgery,” Yan said. “With surgery, I definitely have the chance to get my life back.”
China’s Research into DBS for Addiction
China doesn’t have the same medical laws as America, and for many years they tried an archaic and painful surgery to “cure” addiction doctors call “brain lesioning”. Desperate families paid doctors thousands of doctors to “lesion” the brain. Similar to a lobotomy, the method destroyed small clumps of brain tissue, causing a variety of neurological ailments for patients, including mental health disorders, memory problems and sexual dysfunction. Even worse, it rarely worked.
Deep brain surgery involves an implant in the brain, which electrically stimulates specific areas. In the United States, DBS has only been approved for Parkinson’s disease. Few patients, however, can afford the $100,000 DBS surgery costs.
In China, where medical regulations are lax, clinical trials are already underway. Dr. Sun Bomin, director of Ruijin Hospital’s functional neurosurgery department, says the need outweighs concerns about side effects or efficacy. “They are human beings. You cannot say, ‘Oh, we do not have any help, any treatment for you guys.’”
Sun said he has served as a consultant for two Chinese companies that make deep brain stimulators — SceneRay Corp. and Beijing PINS Medical Co. He has tried to turn Ruijin into a center of DBS research, not just for addiction, but also Tourette syndrome, depression and anorexia.
China’s studies don’t come to any definitive conclusions. One trial had a patient that died from a heroin overdose just a few months after surgery. Another study in January by doctors at a military hospital in Xi’an found five out of eight heroin users stayed off drugs for two years after DBS surgery.
Yan, it turns out, is more of a Guinea pig than a patient. There are risks of a brain hemorrhage, changes to his personality, seizures, or an infection. There is also scant evidence that DBS will cure or treat his addiction.
DBS in the USA
The scientific community has concerns about any clinical trials done in China, outside of labs with ethical guidelines and rigor in place.
“It would be fantastic if there were something where we could flip a switch, but it’s probably fanciful at this stage,” Adrian Carter, who heads the neuroscience and society group at Monash University in Melbourne, told the Associated Press “There’s a lot of risks that go with promoting that idea.”
Few clinical trials have explored DBS outside of Parkinson’s research. U.S. clinical trials on DBS for depression were nixed due to a lack of evidence for benefits. (It is incredibly hard for scientists to ethically justify cutting into somebody’s skull without any scientific evidence it will help.) SceneRay, another Chinese company exploring DBS for addiction, was turned down for clinical research trials by the U.S. Food and Drug Administration.
However, the FDA has allowed a small, separate trial of DBS for opioid use disorder. Led by Dr. Ali Rezai, at the West Virginia University Rockefeller Neuroscience Institute, it will launch in June.