Physicians in China treat addictions by destroying the brain's pleasure center

Drug addiction in China is highly stigmatized. And now, some doctors are trying to cure it with a radical procedure known as as a "stereotactic ablation." More simply, it's the practice of destroying parts of the brain's "pleasure centers" (the nucleus accumbens) in heroin addicts and alcoholics as a way to stop drug cravings. At the same time, however, damage to this region could also impair a person's ability to experience natural longings and other emotions, including joy.

Ablations are not entirely exclusive to China. They're sometimes performed in the U.S. and U.K. on a select number of patients who have untreatable depression or obsessive compulsive disorder. But experts tend to agree that the technique should never be used to treat addictions.

Indeed, given the way the procedure is being researched and conducted in China, there is genuine cause for concern. Writing in TIME, neuroscience journalist Maia Szalavitz explains:

The authors [of a new study], led by Guodong Gao, claim that the surgery is "a feasible method for alleviating psychological dependence on opiate drugs." At the same time, they report that more than half of the 60 patients had lasting side effects, including memory problems and loss of motivation. Within five years, 53% had relapsed and were addicted again to opiates, leaving 47% drug free.

Conventional treatment only results in significant recovery in about 30-40% of cases, so the procedure apparently improves on that, but experts do not believe that such a small increase in benefit is worth the tremendous risk the surgery poses. Even the most successful brain surgeries carry risk of infection, disability and death since opening the skull and cutting brain tissue for any reason is both dangerous and unpredictable. And the Chinese researchers report that 21% of the patients they studied experienced memory deficits after the surgery and 18% had "weakened motivation," including at least one report of lack of sexual desire. The authors claim, however, that "all of these patients reported that their [adverse results] were tolerable." In addition, 53% of patients had a change in personality, but the authors describe the majority of these changes as "mildness oriented," presumably meaning that they became more compliant. Around 7%, however, became more impulsive.

The surgery is actually performed while patients are awake in order to minimize the chances of destroying regions necessary for sensation, consciousness or movement. Surgeons use heat to kill cells in small sections of both sides of the brain's nucleus accumbens. That region is saturated with neurons containing dopamine and endogenous opioids, which are involved in pleasure and desire related both to drugs and to ordinary experiences like eating, love and sex.

And as Szalavitz's article also points out, there is a disturbing amount of scientific fraud associated with the procedure. Many Chinese scientists conduct shoddy and unethical research where "rewards for publication in international journals are high."

Moreover, it's particularly disturbing to see mind-altering ablations being performed in a country where citizens are essentially property of the state. And given that thousands of Chinese have undergone the procedure — and that their behavior is being modified — it's a practice that should definitely cause serious concern.

There's lots more to Szalavitz's article, including a good discussion on why some scientists support the research.

Top image Shutterstock/Oliver Sved.