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Bremner JD, Gazi AH, Lambert TP, Nawar A, Harrison AB, Welsh JW, Vaccarino V, Walton KM, Jaquemet N, Mermin-Bunnell K, Mesfin H, Gray TA, Ross K, Saks G, Tomic N, Affadzi D, Bikson M, Shah AJ, Dunn KE, Giordano NA, Inan OT. Noninvasive Vagal Nerve Stimulation for Opioid Use Disorder. ANNALS OF DEPRESSION AND ANXIETY 2023; 10:1117. [PMID: 38074313 PMCID: PMC10699253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Background Opioid Use Disorder (OUD) is an escalating public health problem with over 100,000 drug overdose-related deaths last year most of them related to opioid overdose, yet treatment options remain limited. Non-invasive Vagal Nerve Stimulation (nVNS) can be delivered via the ear or the neck and is a non-medication alternative to treatment of opioid withdrawal and OUD with potentially widespread applications. Methods This paper reviews the neurobiology of opioid withdrawal and OUD and the emerging literature of nVNS for the application of OUD. Literature databases for Pubmed, Psychinfo, and Medline were queried for these topics for 1982-present. Results Opioid withdrawal in the context of OUD is associated with activation of peripheral sympathetic and inflammatory systems as well as alterations in central brain regions including anterior cingulate, basal ganglia, and amygdala. NVNS has the potential to reduce sympathetic and inflammatory activation and counter the effects of opioid withdrawal in initial pilot studies. Preliminary studies show that it is potentially effective at acting through sympathetic pathways to reduce the effects of opioid withdrawal, in addition to reducing pain and distress. Conclusions NVNS shows promise as a non-medication approach to OUD, both in terms of its known effect on neurobiology as well as pilot data showing a reduction in withdrawal symptoms as well as physiological manifestations of opioid withdrawal.
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Affiliation(s)
- J Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta GA
- Atlanta Veterans Affairs Healthcare System, Decatur GA
| | - Asim H Gazi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Tamara P Lambert
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Afra Nawar
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Anna B Harrison
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Justine W Welsh
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta GA
| | - Kevin M Walton
- Clinical Research Grants Branch, Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, MD
| | - Nora Jaquemet
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Kellen Mermin-Bunnell
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Hewitt Mesfin
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Trinity A Gray
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Keyatta Ross
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Georgia Saks
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Nikolina Tomic
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Danner Affadzi
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY
| | - Amit J Shah
- Atlanta Veterans Affairs Healthcare System, Decatur GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta GA
| | - Kelly E Dunn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD
| | | | - Omer T Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA
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