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Burning Brain Tissue: a Cure for Drug Addiction?

Burning away pieces of the brain as a cure for drug addiction might sound barbaric, but this questionable practice has been in use for some time. The concept is similar to a lobotomy: by altering or removing sections of the brain thought to be responsible for compulsive behavior, drug addiction or alcoholism can be permanently arrested for some people. However, the risks are frightening and include radical changes in personality and a lifelong inability to feel any emotions. For some, this is a fate that is worse than addiction.

The process is called Nucleus Accumbens Ablation

The nucleus accumbens is responsible for sending and receiving signals related to the mesocorticolimbic dopaminergic system: the system responsible for the production and use of dopamine in the brain. Dopamine is the neurotransmitter associated with addiction to opiates. In fact, heroin and other drugs are not directly responsible for the “high” associated with such drug use. Instead the euphoric feelings are a result of the effects the drugs have on neurotransmitters like dopamine. (1)

Because the nucleus accumbens is largely responsible for these processes, some researchers have sought to control addiction by altering it through ablation: the surgical removal of brain tissue. This is accomplished by drilling holes in the skull and using electrodes to heat sections of the brain and cause tissue death, essentially forming small lesions in the nucleus accumbens.

The surgery is primarily done in China as a method of treating addiction and a number of other mental illnesses. However, the practice was originally banned by the Chinese government in 2004, which obviously recognized the dangers and barbarism involved in this type of procedure. But a number of hospitals and doctors were conditionally allowed to continue offering the surgery for research purposes, and a related study of these operations was eventually released.

The study in question indicates that the surgery was successful because 47% of patients who were formerly addicted to opiates were drug-free a full 5 years later. But in an article for the Wall Street Journal, Nicholas Zamiska presents some evidence that the study may not be credible, including reports from one mother who says her son received the surgery within hours of his first hospital visit for a depressive episode lasting only a few months. The hospital took cash and performed the surgery nearly immediately. (2)

Burning Brain Tissue also in Practice in the U.S.

It’s not just China that is using this procedure on its addicts and mentally ill. Even highly developed nations like the United States and Great Britain perform the procedure from time to time, although the requirements in order to do so are far more rigid than in China. (3) Additionally, the number of nucleus accumbens ablations performed in these countries pales in comparison to the (potentially) thousands that have been performed in China. For instance, one Chinese doctor alone has publicly admitted to performing more than 1,000 such surgeries.

However, very little credible research exists other than the study conducted in China, and considering the methods used in the study might not have been 100% ethical, this data cannot be relied upon. This is especially true considering that in the conclusion of the abstract for the Chinese study, the authors wrote the following;

“Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction.”

The problem here is that these “neuropsychological adverse events” can include permanent symptoms that may prevent the very emotions, joys, love, inner triumphs and sadness that are what make us human. Curing an opiate addiction but leaving nothing but a shell of a person behind is not an acceptable risk. Fortunately, these surgeries are rarely performed today, but a large number of researchers and medical professionals are interested in the data collected by those who have performed it, indicating that research into the practice may continue.

References:

A RANDOMIZED BLINDED TRIAL OF NUCLEUS ACCUMBENSABLATION TO TREAT OPIATE DEPENDENCE IN HUMANS – LOCATION CORRELATES WITH OUTCOME
Xuelien Wang, M.D., Prof.; Chongwang Chang, M.D.; John R Adler, M.D.; ShunnanGe, M.D.; Nan Li, M.D.; Ning Geng, M.D.; Jing Wang, M.D.; Xin Wang, M.D.;Guodong Gao, M.D., Prof.
Department of Neurosurgery, Tangdu Hospital Fourth Military Medical University Xi’an, China

(1) Davis, James F., CAS Understanding Neurotransmitters and Substance Abuse Recovery First, Inc http://recoveryfirst.org/understanding-neurotransmitters-and-substance-abuse.html/

(2) Zamiska, Nicholas In China, Brain Surgery is Pushed on the Mentally Ill The Wall Street Journal 11/02/2007 http://online.wsj.com/article/SB119393867164279313.html

(3) Szalavitz, Maia Controversial Surgery for Addiction Burns Away Brain’s Pleasure Center Time Health and Family 12/13/2012 http://healthland.time.com/2012/12/13/controversial-surgery-for-addiction-burns-away-brains-pleasure-center/

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