The Scientist Who Got a Brain Implant to Cure His Alcoholism

Deep brain stimulation could help curb drug and alcohol addiction

Emily Mullin
Jan 30 · 8 min read
Left: Frank Plummer. Photo: Kevin Van Paassen, Sunnybrook Health Sciences Centre. Right: An X-ray of Gerod Buckhalter’s brain, where scientists have placed a deep brain stimulation device. Credit: West Virginia University Rockefeller Neuroscience Institute

Update: According to a news report on February 4, Plummer passed away suddenly. The cause of death has not been identified.

or years, Frank Plummer was dependent on alcohol, drinking 20 ounces of scotch a day. An infectious disease scientist who worked in Kenya at the height of the HIV epidemic, Plummer turned to alcohol in the 1980s to deal with the stress of his job, and also the grief that came with witnessing the devastation of AIDS firsthand.

Plummer drank to celebrate and relax, too. Alcohol controlled his life, but he didn’t realize that until 2012, when his liver began to fail. Even when he got a liver transplant in 2014, he soon started drinking heavily again. He tried Alcoholics Anonymous, rehab, medication, and counseling, but nothing worked. He wasn’t able to stop drinking.

“I was basically on a path to death,” he tells OneZero.

Then he learned about an experimental treatment for alcohol use disorder that would require drilling two nickel-sized holes into his skull. There was no guarantee it would work, but Plummer decided to sign up for a small study in Canada to test the treatment. In December 2018, surgeons opened up his skull and placed two tiny electrodes deep in his brain. The electrodes deliver steady pulses of electricity, like a pacemaker.

A few weeks after Plummer’s surgery, researchers turned on the electrical current. Plummer can’t feel the stimulation, but he thinks it is helping. Since getting the implant more than a year ago, he says he doesn’t crave alcohol as much as he used to. Though he isn’t completely sober, he thinks the implant is allowing him to moderate his drinking. He doesn’t drink every day, and when he does, he has no more than three or four drinks. “I still drink a little bit, but I think it’s under control now,” he says. “It’s not ruining my life.”

“I was basically on a path to death.”

Plummer and a handful of others are the first people in North America to get brain implants to treat their drug and alcohol addictions. Having tried all other options, they’re putting their hope in a drastic treatment that could be revolutionary.


eep brain stimulation (DBS) first emerged in the 1960s and 1970s as a possible treatment for pain management, but clinical trials showed only modest results. Then, in the 1980s, DBS was used to successfully treat symptoms of Parkinson’s disease, which opened the door to using it for other movement disorders.

The U.S. Food and Drug Administration approved DBS for Parkinson’s and essential tremor in 1997, for dystonia in 2003, and for epilepsy in 2018. These successes spurred interest in using DBS to also treat psychiatric conditions, like depression and obsessive-compulsive disorder. DBS was approved to treat the latter in 2018, but its potential for treating severe cases of depression is still being debated. A few ongoing pilot studies are also testing DBS in people with anorexia and obesity. Despite decades of research and application, exactly why DBS works remains a bit of a mystery.

Now, as scientists unravel the brain mechanisms that drive addiction, some think DBS could help reduce cravings for alcohol and drugs as well. In addition to the trial for alcohol addiction in Canada, researchers at West Virginia University are investigating DBS for opioid addiction.

“People are increasingly dying of addictions,” says Ali Rezai, a neurosurgeon and principal investigator of the West Virginia trial. “Despite our best efforts with the evidence-based treatments that we have, there are a lot of patients who simply don’t respond, and they remain at a very high risk of ongoing health problems and death from overdose.”

Amid a deadly opioid epidemic, deaths related to alcohol use are also on the rise in the United States, according to the National Institutes of Health. That’s why some scientists think it’s time to try DBS for severe cases of addiction.

“The field is changing. We now understand that addiction is a brain disease,” says Lorenzo Leggio, a physician and scientist at the National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse. “There’s no reason why a more inventive treatment like DBS shouldn’t be tried.”

Today, scientists recognize that addiction is a complex brain disorder driven by many factors, including brain circuits, genetics, the environment, and a person’s life experiences. And in recent years, they have gained a better understanding of the brain circuits — or populations of neurons — that are involved in addiction and other mood and anxiety disorders, giving DBS researchers something to target.

“We believe that with deep brain stimulation, we can access key parts of the circuits that are malfunctioning in those disorders to see if we can reset those circuits to influence behaviors,” says Nir Lipsman, the neurosurgeon at Sunnybrook Health Science Center in Toronto who operated on Plummer. “The idea with deep brain stimulation is that you are sort of overriding an abnormal circuit and trying to restore an equilibrium or balance to that circuit in the brain,” Lipsman says.

Similar to how a pacemaker controls abnormal heart rhythm by delivering electrical pulses to the heart, deep brain stimulation helps to regulate abnormal brain activity. DBS consists of three parts: the electrodes that go in the brain, a battery-powered pulse generator that’s implanted in the chest below the collarbone, and a thin wire that connects the two, delivering electric pulses from the generator to the brain electrodes.

To implant these components, neurosurgeons drill a nickel-sized hole in the skull, and using neuroimaging to guide them, thread a wire attached to an electrode to the location in the brain that they want to stimulate. For Plummer and the other North American addiction patients, the electrodes are placed in a part of the brain called the nucleus accumbens. There are two of these in the brain, one in each hemisphere. Patients are fully awake when the electrodes are inserted so that surgeons can assess their brain function.


he idea behind using DBS for addiction is that electrical pulses could act like a circuit breaker or a computer reboot to reset the faulty brain circuits in the nucleus accumbens. This area is known to play a role in pleasure, motivation, and mood, and has been shown to be dysfunctional in patients who have alcohol use disorder and other addictive behaviors.

In people with substance use disorder, drugs and alcohol change the normal circuitry of the brain over time. “At its most basic level, drug use causes a reorganization of the circuitry in the brain,” says Susan Ferguson, associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, who is not involved in the deep brain stimulation trials for addiction.

Addictive substances like drugs and alcohol flood the nucleus accumbens with dopamine, a neurotransmitter that produces the euphoric effects of a high or a buzz. Years of drug or alcohol abuse weaken the circuits in the brain, including those that regulate dopamine. When these circuits are dysfunctional, people need to use more drugs and alcohol to achieve the dopamine effect they used to get. “That’s why people keep seeking drugs. Your brain is seeking this reward, it craves it,” Rezai says.

Interestingly, clinical trials of deep brain stimulation for other conditions, like Parkinson’s, depression, and OCD, found that the procedure also seemed to curb certain pleasure-seeking behavior in some patients, like gambling, hypersexuality, and alcohol and drug use. A small trial in Germany of five patients with alcohol addiction found that DBS reduced cravings in all the participants, and two patients remained abstinent for several years.

But even after decades of implanting patients with electrodes, scientists admit they don’t fully understand the exact mechanisms behind deep brain stimulation. “It’s causing a reboot of the circuits, but we don’t know exactly why it reboots them,” says Ferguson. The result of that reboot, scientists think, is that it strengthens those neural circuits and restores some of their normal functions.


November, a 33-year-old man named Gerod Buckhalter received a brain implant in the West Virginia University trial. The state has the highest rate of drug overdose deaths involving opioids in the country. Buckhalter began using prescription opioids at 15 for pain following shoulder surgery, but he soon became dependent on them, and eventually developed an opioid addiction. Over the years, he overdosed multiple times. Like Plummer, he tried every available treatment, with only temporary success.

Rezai says that thanks to DBS, Buckhalter’s self-control seems better and his cravings aren’t as intense, though it hasn’t been long enough to know whether the brain implant will be a long-term fix. “We are optimistic,” he says. “But we’ve got a long way to go before this is a proven method of treatment.”

“I think it has a lot of promise for people like me who have exhausted all other possibilities”

Buckhalter is the first of four patients to receive the implant in the West Virginia University trial, which is partly funded by the National Institute on Drug Abuse. If the study goes well, Rezai says his team plans to conduct a larger trial with a control group to better assess whether the stimulation is working.

At Toronto’s Sunnybrook Health and Science Centre, three patients have received stimulators, including Plummer, and investigators plan to implant three more. The trials are small because brain surgery is risky, and researchers need to first determine whether the approach is safe and doesn’t come with significant side effects. DBS for other disorders is considered safe, but in some cases can cause seizures, vision and speech problems, loss of balance, and confusion.

In these early addiction trials, researchers will also need to find the precise location for the electrodes to avoid unintended side effects. “We need to keep that in mind that we’re messing with brain circuits,” Ferguson says. “We don’t want a treatment that produces a terrible cognitive side effect or changes in other behaviors.”

Lipsman says his team wants to make sure the procedure is no riskier than DBS surgery for Parkinson’s or another approved use.

Eventually, he sees the technology becoming smaller and longer-lasting, which could open up DBS to more people. As it stands, batteries have to be replaced every several years, which means taking the stimulator out of a patient’s chest. Electrodes in the brain can also degrade over time and stop working. Sometimes scar tissue or an infection can form around implanted electrodes, which means the implant needs to be taken out. Advances in neuroimaging could also help surgeons be more precise in their placement of electrodes, potentially improving outcomes for patients.

For now, though, even if DBS proves safe and effective for addiction, it will likely remain a last-resort treatment for patients like Plummer. “I don’t think it will ever be the first thing that people do,” he says. “But I think it has a lot of promise for people like me who have exhausted all other possibilities.”

OneZero

The undercurrents of the future. A Medium publication about tech and science.

Emily Mullin

Written by

Staff writer at OneZero, covering the intersection of biology and technology. emullin@medium.com

OneZero

OneZero

The undercurrents of the future. A Medium publication about tech and science.

Welcome to a place where words matter. On Medium, smart voices and original ideas take center stage - with no ads in sight. Watch
Follow all the topics you care about, and we’ll deliver the best stories for you to your homepage and inbox. Explore
Get unlimited access to the best stories on Medium — and support writers while you’re at it. Just $5/month. Upgrade