Already known as a treatment for depression, transcranial magnetic stimulation (TMS) is showing promise as an effective addiction therapy option.
Addiction is a mental health disorder that can include substance use (alcohol, nicotine, opioids, stimulants) and behaviors (gambling, compulsive sexual behavior, gaming, shopping.) It is typically treated with a combination of therapy, medication, and community-based programs, such as Alcoholics Anonymous.
However, many patients still struggle with cravings and relapse, which is why innovative treatments like TMS are being studied as part of comprehensive addiction therapy.
One study, for example, found that participants experienced a 40% to 55% reduction in alcohol cravings after a series of TMS sessions, with benefits lasting for weeks after treatment ended.
TMS is emerging as a promising tool for addiction therapy, offering new hope for patients who haven’t found success with traditional addiction therapy approaches.
What is TMS?
TMS is a non-invasive therapy that delivers focused magnetic pulses to stimulate parts of the brain linked to mood regulation, executive control, and reward processing. These pulses “wake up” underactive nerve cells to promote neuroplasticity, the brain’s ability to change, adapt, and form new connections.
TMS was originally cleared by the US Food and Drug Administration (FDA) to treat treatment-resistant depression (TRD) and major depressive disorder (MDD). Since then, it has been cleared to treat obsessive-compulsive disorder (OCD), certain migraine headaches, and smoking cessation.
Given its effectiveness against smoking addiction, TMS is often used off-label in addiction therapy to treat other addictions, such as cocaine and alcohol dependence. One of the benefits of TMS is that it can also be used to treat other underlying mental health problems like depression that often go hand in hand with addiction therapy.
How does addiction affect the brain?
Addiction occurs when people use substances or engage in behaviors that have become compulsive and harmful. Addiction involves a number of interconnected brain systems and is influenced by genetics, the environment, and individual life experiences.
Addiction starts in the mesolimbic dopamine system, often called the brain’s reward pathway. Eating a delicious meal after being hungry is an example of how this reward system works:
- Satisfying the urge to eat releases dopamine, which produces feelings of pleasure and satisfaction.
- The hippocampus (the brain’s memory center) and the amygdala (the brain’s alarm system) store the memory as a positive experience.
- The sight of food motivates a person to eat again.
Addictive substances such as alcohol, cocaine, stimulants, opioids, and methamphetamine have a similar effect. These flood the brain with unusually high levels of dopamine, which can create intense reward signals to do it again.
Similar to food, cues such as the smell of alcohol or seeing drug paraphernalia can trigger powerful cravings. At the same time, repeated substance use can weaken the prefrontal cortex, which helps us make decisions and resist impulses.
Over time, the brain adapts to the substance by reducing its own natural dopamine production and decreasing the sensitivity of these receptors. This, in turn, can drive increased dependence on a substance, causing an individual to use more to achieve that same feeling.
Breaking an addiction is not simply about willpower. It is a chronic brain disorder that involves changes in reward, motivation, memory, and control circuits. All of these can be primed for craving and compulsion, even after a detox, which is why specialized addiction therapy is often required.
How is TMS used to treat addiction?
Addiction alters several of the brain’s reward and self-control systems, including:
- Prefrontal cortex: Sits behind the forehead and helps with decision-making, impulse control and cravings. Addiction can weaken this part of the brain, making it harder to resist cravings or think about long-term consequences.
- Insula: This part of the brain helps you notice sensations in the body, such as hunger, thirst, or stress. In addiction, the insula can trigger strong cravings and connect them with the need to use a substance.
- Anterior cingulate cortex: This brain region is involved in emotions, attention, and impulse control. Addiction suppresses its ability to manage stress, control urges, or avoid risky behavior.
TMS treatment for addiction tends to focus on the dorsolateral prefrontal cortex, a spot located just above the left temple, the same area used to treat depression. Treating this area indirectly affects other parts of the brain associated with addiction.
Effects can include:
- Reducing cravings by calming overactive reward circuits.
- Strengthening self-control by improving prefrontal regulation.
- Rebalancing dopamine signaling, which is disrupted in addiction.
A typical treatment protocol involves 36 20-minute treatments spread out over nine weeks. Some patients opt for regular maintenance sessions or as-needed boosters as part of their ongoing addiction therapy.
Who is more at risk for addiction?
There is no single cause for addiction. Rather, it is a complex interplay of biological, psychological, and environmental vulnerabilities and exposures. These can include:
- Genetics
- Brain chemistry, structure, and function
- Pre-existing mental health conditions
- Trauma and stress
- Poor emotional regulation, low self-esteem, or difficulty handling distress
- Family environment
- Peer influence
- Access and exposure
- Cultural and socioeconomic influences
Having one or more of these indicators does not guarantee a person will develop an addiction. Rather, the cause of addiction is unique to each person and can be spurred by any number of combinations.
Additional risk factors can include:
- Youth and young adults: Exposure at a young age can alter the prefrontal cortex, which is still developing.
- Epigenetics: Environmental factors and life experiences can influence how genes are expressed and turned on or off.
- Personality traits: People who engage in risky behavior or are sensation-seekers or novelty-seekers may be at higher risk for addiction.
- Chronic pain, medical conditions: Prescriptions for addictive medications, such as opioids, may increase the risk of dependency.
- Lack of connection or purpose: A lack of meaning or community may drive people to seek out substances as a form of escape or numbing relief.
When to seek help for addiction
One of the hardest steps for anyone struggling with addiction is acknowledging the problem. Admitting to addiction and grappling with its effects can lead to feelings of denial, shame, or fear.
In fact, loved ones are often the first to notice something is wrong.
Signs it’s time to seek help
- Difficulty cutting back or stopping despite wanting to
- Intense cravings or urges that feel uncontrollable
- Withdrawal symptoms when not using
- Interfering with work, school, or relationships
- Loss of interest in hobbies or daily responsibilities
- Secretive behavior, lying, or covering up use
- Escalating risky behavior to obtain or use the substance
Addiction is treatable, and recovery is possible. Addiction therapy involves a personalized and comprehensive approach that considers both the addiction and any underlying mental health issues.
Traditionally, addiction therapy has included therapy, medication, lifestyle and wellness strategies, and support groups and community programs.
The use of TMS as part of addiction therapy has the potential to “retrain” the brain by building new and stronger connections and pathways. Over time, this can give people the strength and courage to resist urges and make healthier choices.
Key takeaways
- Addiction is a complex brain disorder influenced by genetics, environment, and mental health.
- Traditional addiction therapy treatments include talk therapy, medication, and community support programs, but many people continue to struggle with cravings and relapse.
- Transcranial magnetic stimulation (TMS) is a non-invasive therapy that stimulates brain regions linked to self-control, decision-making, and reward processing.
- Research shows that TMS can reduce cravings, improve impulse control, and rebalance dopamine signaling, making it a promising tool in modern addiction therapy.
Looking for TMS treatment near you?
Pacific Mind Health offers transcranial magnetic stimulation (TMS) for depression, OCD, and other mental health conditions. Our experienced clinicians provide compassionate, evidence-based care to help you feel better.
Ready to take the next step? Schedule a free consultation today to see if TMS is right for you.
