China looking at brain implant to treat addicts

Credit to Author: ASSOCIATED PRESS| Date: Wed, 08 May 2019 16:17:06 +0000

SHANGHAI: Patient Number One is a thin man, with a scabby face and bouncy knees. His head, shaved in preparation for surgery, is wrapped in a clean, white cloth.

Years of drug use cost him his wife, his money and his self-respect, before landing him in this drab yellow room at a Shanghai hospital, facing the surgeon, who, in 72 hours, will drill two small holes in his skull and feed electrodes deep into his brain.

The hope is that technology will extinguish his addiction, quite literally, with the flip of a switch.

The treatment — deep brain stimulation (DBS) — has long been used for movement disorders like Parkinson’s. Now, the first clinical trial of DBS for methamphetamine addiction is being conducted at Shanghai’s Ruijin Hospital, along with parallel trials for opioid addicts. And this troubled man is the very first patient.

Bloodied white mesh covers the head of a methamphetamine user named Yan on Monday, Oct. 29, 2018, three days after he had a deep brain stimulation device implanted as part of a clinical trial at Ruijin Hospital in Shanghai, China. The hope is that DBS will extinguish his addiction, quite literally, with the flip of a switch. Critics say such human experiments are premature and risky, but U.S. regulators in February greenlighted a human trial of DBS for opioid addiction at West Virginia University. AP PHOTO

The surgery involves implanting a device that acts as a kind of pacemaker for the brain, electrically stimulating targeted areas. While Western attempts to push forward with human trials of DBS for addiction have foundered, China is emerging as a hub for this research.

Scientists in Europe have struggled to recruit patients for their DBS addiction studies, and complex ethical, social and scientific questions have made it hard to push forward with this kind of work in the United States, where the devices can cost $100,000 to implant.

China has a long, if troubled, history of brain surgery on drug addicts. Even today, China’s punitive anti-drug laws can force addicts into years of compulsory treatment, including “rehabilitation” through labor. It has a large patient population, government funding and ambitious medical device companies ready to pay for DBS research.

There are eight registered DBS clinical trials for drug addiction being conducted in the world, according to a US National Institutes of Health database. Six are in China.

But the suffering wrought by the opioid epidemic may be changing the risk-reward calculus for doctors and regulators in the US. Now, the experimental surgery Patient Number One is about to undergo is coming to America. In February, the US Food and Drug Administration greenlighted a clinical trial in West Virginia of DBS for opioid addicts.

Patient Number One insisted that only his surname, Yan, be published; he fears losing his job if he is identified.

He said doctors told him the surgery wasn’t risky. “But I still get nervous,” he said. “It’s my first time to go on the operating table.”

Three of Yan’s friends introduced him to meth in a hotel room shortly after the birth of his son in 2011. They told him: “Just do it once, you’ve had your kid, you won’t have problems.” Smoking made Yan feel faint and slightly unhinged. Later, he found meth brought crystalline focus to his mind, which he directed at one thing: Cards. Every time Yan smoked, he gambled. And every time he gambled, he lost — all told, around $150,000 since he started using drugs.

AP

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