Nerve Stimulation for Symptoms of Opioid Withdrawal

Nerve stimulators offer a way to minimize acute symptoms of opioid withdrawal, such as tremors, agitation, and joint pain. Here's what you should know.

Kicking an opioid habit without help is extremely difficult. The withdrawal period might not be as dangerous as withdrawal from benzodiazepines or alcohol. Yet, in rare cases, addicted people die when they stop taking opioids. Although the acute phase is typically five days, the process can take as many as two weeks.

But you can get through the ordeal with medication or nerve stimulation, sometimes used together.  

If you have medical supervision, you’re likely to receive buprenorphine, which may have the best results in reducing symptoms. Other possible medications include methadone and the blood-pressure drugs clonidine and lofexidine.

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Note that you can’t take buprenorphine immediately: You need to wait from six to 72 hours after your last dose of opioids, depending on which kind you used.

You don’t have to wait to start one non-medication option, nerve stimulation through your ear. The U.S. Food and Drug Administration has approved several devices that calm your body, targeting brain areas involved in withdrawal and reduce symptoms.

The concept isn’t new. Nerve stimulation through an ear — with roots in acupuncture — can treat migraines, severe osteoarthritis, and other painful conditions.

Without any help, in the acute phase of withdrawal, you might feel like you have a severe flu — with nausea, fever, sweating, vomiting, and diarrhea. Those last two symptoms can become dangerous if they lead to dehydration and high levels of sodium in your blood. The result may be heart failure.

More often, people just can’t get through withdrawal and miss their chance to break free of addiction.

The latest device, called Sparrow Ascent, builds on a product already used on people in-patient units, and you can use it at home. The battery-powered device delivers mild electrical signals through your skin in and around your ear, a process called transcutaneous auricular neurostimulation, or tAN. The signals are designed to trigger the release of endorphins — your natural happy brain chemicals that, as the company puts it, “fill the empty opioid receptors.”

In a small company-sponsored clinical trial, volunteers treated with the device had a 42 percent reduction in withdrawal symptoms within a half hour. People wearing a sham device also felt a reduction of 24 percent. None of the volunteers received any opioid medication, including buprenorphine.

After the initial experiment, the volunteers received treatment for five days, with an average reduction in symptoms of 75 percent.

Earlier devices are similar. First approved in 2017, the NSS-2 Bridge looks like a hearing aid behind your ear, but it’s linked to electrodes placed on your ear that send pulses into your body. Its main function is to activate your parasympathetic nervous system — which slows your heart and breathing rates, lowers blood pressure, and promotes digestion.

Within about 20 minutes, wearers can feel their symptoms drop dramatically, according to one study. In that research, 64 out of 73 patients returned to the clinic on day five and moved on to treatment with naltrexone to maintain abstinence.

The agency approved a similar device, Drug Relief, in 2018.

You might think that wearing an electrical device might make you feel like a robot — but it’s simply unfamiliar. Your brain and entire nervous system runs on electrical signals; intervening in electrical pathways may be therapeutic.

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