• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia
    • Books
    • eBooks
    • ABPN SA Courses
    • Social Work Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
    • Psychiatry News Videos
    • Medication Guide Videos
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • FAQs
  • Med Fact Book App
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Neurostimulation for Opioid Withdrawal Symptoms

Neurostimulation for Opioid Withdrawal Symptoms

January 1, 2018
Rehan Aziz, MD
From The Carlat Addiction Treatment Report
Issue Links: Learning Objectives | Editorial Information
Rehan Aziz, MD Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

REVIEW OF: Miranda A and Taca A, Am J Drug Alcohol Abuse 2017:1–8

A challenging barrier for patients with opi­oid use disorders is the discomfort that can occur during the “induction phase” of their treatment, which is the period between discontinuation of opioids and initiation of medication-assisted therapy (MAT). Difficulties with induction arise due to several factors, including fear of withdrawal itself and poorly managed withdrawal symptoms.

In 2017, the FDA cleared a device for the use of electrical stimulation to reduce opioid withdrawal symptoms. The prescription-only product, called NSS-2 BRIDGE®, is attached behind the ear using adhesives and does not require surgery. It generates low-voltage electrical current that stimulates percutaneous nerves around the ear. This results in diminished withdrawal-associated pain and negative emotional states. It is worn continuously for 5 days during the withdrawal period, which covers the full life of the device’s battery. BRIDGE® is thought to produce rapid and sustained improvements in withdrawal symptoms, leading to higher MAT transition rates.

The FDA’s approval of the device was based on an open-label, uncontrolled, retrospective study in adult patients. Seventy-three medical records were reviewed from outpatient clinics in several Midwestern states. Concerning patient characteristics, the mean length of opioid dependence was 70 months, and most used heroin. Outcomes assessed included withdrawal scores during the induction phase measured by the Clinical Opioid Withdrawal Scale (COWS), and the percentage of patients who transitioned to MAT after 5 days.

Overall, most patients had moderate withdrawal symptoms, and their average initial COWS score was 20.1. But using the device for 20 minutes produced a 63% drop in average COWS scores, to 7.5. Scores then dropped to 3.1 after 60 minutes and 0.6 after 5 days. On the fifth day, 64 of 73 participants (88%) returned to the clinic and successfully transitioned to MAT. No rescue medications were administered, and no adverse events were noted.

CATR’s Take
This pilot study provides us with exciting data, but falls short of indicating whether use of this device leads to improved short- and long-term outcomes for patients with opioid use disorders. It is also unclear how the device compares to standard detox protocols. BRIDGE® costs approximately $500 and is not covered under insurance plans, limiting its utility in many patient populations. It is for one-time use and requires special training to place. Ultimately, BRIDGE® is an encouraging step in addiction treatment, but is unlikely to make a profound impact.
Addiction Treatment
KEYWORDS addiction research-update
    Rehan Aziz, MD

    Breaking the Silence: Addressing the Hidden Crisis of Elder Abuse

    More from this author
    www.thecarlatreport.com
    Issue Date: January 1, 2018
    SUBSCRIBE NOW
    Table Of Contents
    Prescribing Gabapentin for Substance Use Disorders
    Interventions for Treatment or Prevention of Alcohol Hangover: Systematic Review
    Neurostimulation for Opioid Withdrawal Symptoms
    CME Post-Test - Stigma and Addiction, CATR, January/February 2018
    New Study Shows That Vivitrol Is Just as Effective as Suboxone…But Not Really
    Helping Patients With Stigma and Addiction
    Featured Book
    • OUDFB1e_Cover_Binding.png

      Treating Opioid Use Disorder—A Fact Book (2024)

      All the tools you need to assess and treat patients struggling with opioid use disorder. 
      READ MORE
    Featured Video
    • KarXT (Cobenfy)_ The Breakthrough Antipsychotic That Could Change Everything.jpg
      General Psychiatry

      KarXT (Cobenfy): The Breakthrough Antipsychotic That Could Change Everything

      Read More
    Featured Podcast
    • shutterstock_2622607431.jpg
      General Psychiatry

      Should You Test MTHFR?

      MTHFR is a...
      Listen now
    Recommended
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    carlat@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2025 Carlat Publishing, LLC and Affiliates, All Rights Reserved.