Neuromodulation and the Future of Addiction Treatment with Dr. James Mahoney

Despite significant advances in the treatment of substance use disorders, effective treatment options remain limited for certain substances, including methamphetamine and cocaine. As researchers continue to explore new approaches, neuromodulation has emerged as a promising strategy that may complement existing behavioral and medication-based treatments by targeting the brain circuits involved in addiction.

In this Ask the Expert video, Dr. James Mahoney, Associate Professor, Clinical Neuropsychologist, and Director of the Center for Neuromodulation Research at the University of Virginia, discusses focused ultrasound, a noninvasive form of neuromodulation being investigated as a potential adjunctive treatment for substance use disorders. He explains how the technology uses MRI-guided ultrasound to precisely target the nucleus accumbens, a key region of the brain's reward system associated with craving and addiction. Dr. Mahoney also reviews findings from early clinical studies demonstrating that focused ultrasound was safe and associated with sustained reductions in cue-induced cravings for opioids and other substances. Participants also experienced promising improvements in substance use outcomes, mood, anxiety, motivation, and daily functioning.

The conversation highlights the potential of neuromodulation as an additional tool to support long-term recovery rather than a standalone treatment. Dr. Mahoney explains focused ultrasound is “not... something that's just going to flip the addiction switch off,” but rather “an added component, an added tool in that toolbox” to be used alongside behavioral therapies and medication treatment, helping individuals better manage cravings while strengthening engagement in recovery. As research continues, these early findings offer encouraging evidence that neuromodulation may expand the range of effective treatment options for substance use disorders.

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References/Research Articles:

Mahoney, J. J., Haut, M. W., Carpenter, J., Ranjan, M., Thompson-Lake, D. G. Y., Marton, J. L., Zheng, W., Berry, J. H., Tirumalai, P., Mears, A., D'Haese, P., Finomore, V. S., Hodder, S. L., & Rezai, A. R. (2023). Low-intensity focused ultrasound targeting the nucleus accumbens as a potential treatment for substance use disorder: safety and feasibility clinical trial. Frontiers in psychiatry, 14, 1211566. https://doi.org/10.3389/fpsyt.2023.1211566

Mahoney, J. J., 3rd, Thompson-Lake, D. G. Y., Ranjan, M., Marton, J. L., Carpenter, J. S., Zheng, W., Berry, J. H., Farmer, D. L., D'Haese, P., Finomore, V. S., Tirumalai, P., Mears, A. S., Suffridge, J., Ames, A., Hodder, S. L., & Rezai, A. R. (2023). Low-Intensity Focused Ultrasound Targeting the Bilateral Nucleus Accumbens as a Potential Treatment for Substance Use Disorder: A First-in-Human Report. Biological psychiatry, 94(11), e41–e43. https://doi.org/10.1016/j.biopsych.2023.06.031