Addiction therapy: a compelling first indication
The cost to the USA of tobacco, drugs and alcohol abuse is estimated at more than $700 billion annually. Deaths from drug overdose passed those from motor vehicle collisions in 2009. Approaches to reducing the mortality from the current opioid epidemic have included increasing patient access to naloxone and the passage of Good Samaritan laws (to encourage calls to the emergency medical system). Animal studies have pinpointed limbic circuitry involving the nucleus accumbens (NAc) as a key element of addiction to all drugs of abuse. The NAc is a deep-seated structure, which is difficult to target with transcranial magnetic stimulation (TMS) devices. Deep-brain stimulation of the NAc with electrodes has been successful in attenuating drug-seeking behavior in animal studies, with clinical studies underway in Europe that have shown early success in treating addiction. Electrode placement and follow-up care for clinical DBS is expensive (between $30,000 and $100,000) and invasive. Neuroparticle™ therapy shows promise as a potential non-invasive replacement for DBS.