China Uses Controversial Brain Surgery To Cure Drug Addiction

47 32 Loading

A small handful of doctors in China are going to extremes to rid people of addiction. As a last resort against intractable addiction to heroine and alcohol, these doctors are attempting to erase motivation by erasing a part of the addict’s brain. And they are doing it in the face of worldwide condemnation, and in the name of scientific research.

The procedure involves drilling small holes into the skulls of patients and inserting long electrodes which extend down to the part of the brain called the nucleus accumbens. This area, often referred to as the “pleasure center” of the brain, is the major nucleus of the brain’s reward circuit. The neurotransmitter dopamine stimulates cells here to elicit the pleasurable sensations we get from eating fatty foods, getting a job promotion, or taking heroin. Electrical current is passed through the electrodes which kill the cells of the nucleus accumbens. By ridding the addicts of their pleasure centers, doctors hope to rid them of their addictions as well. The surgery is performed while the patients are awake to minimize the chance of damaging regions involved in sensation, movement or consciousness.

The stigma associated with drug addiction is particularly strong in China where thousands are executed every year for drug trafficking. Thus, the drastic cure might be considered commensurate with the sickness. In 2004, however, the Chinese Ministry of Health banned the procedure after they determined that there wasn’t enough scientific evidence to show that it was safe in the longterm.

But, according to Time, the ablation surgery has been performed at least 1,000 times since the 2004 ban. The reason: some doctors were allowed to continue the procedure for research purposes. And making good on their scientific pursuit, doctors at the military Tangdu Hospital in Xi’an last month published a study documenting the “long-term outcome and changes of the personality and psychopathological profile of opiate addicts after bilateral stereotactic nucleus accumbens ablative surgery.”

The MRI remnants of a burned out nucleus accumbens.

The surgery proved more effective than conventional methods at ending addiction. Five years after the surgery 47 percent of the 60 patients remained free from their opiate addiction; 53 percent had relapsed. That’s an improvement over the 30 to 40 percent of people who end their addiction by conventional treatments.

Lasting side effects, however, were seen in 60 percent of patients following surgery. Memory deficits were observed in 21 percent and motivation loss in 18 percent (one individual suddenly lacked sexual desire). Perhaps most disturbingly, 53 percent of the patients demonstrated some change in personality, which the authors described as “mildness oriented.”

Not surprisingly the procedure is roundly condemned by experts around the world. David Linden, professor of neuroscience at Johns Hopkins and author of “The Compass of Pleasure” that explores the brain chemistry behind feeling good, called the procedure “horribly misguided” in a Time article. He added, “This treatment will almost certainly render the subjects unable to feel pleasure from a wide range of experiences, not just drugs alone.”

And the publications in Western journals have sparked a heated debate in the scientific and medical communities on the wisdom of publishing such studies in legitimate and reputable scientific journals. Many fear that, by publishing the results, the scientific community is condoning the methods by which the data was produced. Shi-Min Fang, a Chinese biochemist/writer with a history of criticizing science fraud in China, told the New York Times that “the results of clinical research in China are very often fabricated. I suspect that the approvals by Ethics Committee mentioned in these papers were made up to meet the publication requirement. I also doubt if the patients were really informed in detail about the nature of the study.”

Similar “corrective” surgeries in China have been condemned in the past. In 2007 the Wall Street Journal reported the case of Mi Zhantao, an impoverished 25-year-old who had a part of his brain ablated in an effort to treat his depression. The surgery didn’t work. It did, unfortunately, have other effects. Mr. Mi’s right arm is now partially limp and his speech is slurred. Mr. Mi’s mother, Kong Lingxia, says she’ll regret going through with the surgery that cost her family about $4,800 – about four years of family income – for the rest of her life.

The brain's incredible complexity makes it impossible to predict the consequences of ablation surgeries.

Dr. Wang Yifang, Mr. Mi’s surgeon and head of neurosurgery at No. 454 Hospital of the People’s Liberation Army in Nanjing, said he’d performed the ablative surgery about 1,000 times to treat schizophrenia mostly, but also to treat depression and epilepsy. Michael Shulder, president of the American Society for Stereotactic and Functional Neurosurgery was astounded at the number, telling the Journal the amount was “completely off the charts” and that even 10 would be considered “highly controversial.”

Dr. Wang stands by the procedure. “In many of the mental disease hospitals 30 to 50 percent of patients cannot be treated by medicine. And these patients have caused a great burden to their families and society,” he told the Journal. And according to over 300 surveys filled out by family members of people who had undergone the procedure, Dr. Wang says, 93 percent of the respondents said the patients had shown improvement.

Some targeted brian ablation does occur elsewhere as measures of last resort. About two dozen ablations are performed each year in the US and the UK. These rare cases are reserved for people suffering from debilitating depression or obsessive-compulsive disorder for which conventional treatments have been ineffective. And the procedures are only performed in these countries after an “extensive review by institutional review boards and intensive discussions with the patient, who must acknowledge the risks.”

By 1951 nearly 20,000 lobotomies – surgeries removing part of the frontal cortex – had been performed in the United States. António Egas Moniz won the Nobel Prize for Physiology or Medicine in 1949 for his work demonstrating the therapeutic value of lobotomies for certain psychiatric conditions. But about the same time the number of lobotomies being performed was dropping off and, by the late 70s, were blacklisted in the US.

The brain ablation surgeries being performed in China are vastly more precise than blunt dissection lobotomies, but any brain surgery carries with it serious risk to the patient. In addition to infection and other complications that all surgeries entail, the incredible complexity of the brain makes the consequence of even a perfect procedure highly unpredictable. Moreover, the “pleasure center” isn’t just the part of the brain that makes people drug addicts, it’s also essential to seeking the more worthy rewards in life such as a completed novel, a beautiful sunset, a lifelong love. It also gives us that non-negotiable impulse that leads us to make bad choices. Perhaps more than any other brain region, the “pleasure center” could be renamed to the “human nature” center, for what’s more human than rejoice and regret?

Ignoring for the moment the risk of devastating brain damage, is it worth being cured of addiction if, losing the addiction, we also lose part of who we are? That’s a choice that each society has to make for itself. Correction: that’s a choice each society has already made for itself.

Peter Murray

Peter Murray was born in Boston in 1973. He earned a PhD in neuroscience at the University of Maryland, Baltimore studying gene expression in the neocortex. Following his dissertation work he spent three years as a post-doctoral fellow at the same university studying brain mechanisms of pain and motor control. He completed a collection of short stories in 2010 and has been writing for Singularity Hub since March 2011.

Discussion — 32 Responses

  • Fons Jena December 30, 2012 on 2:29 pm

    It is sad that we have to go so far to cure addiction. Addiction is all about raising you kids in a healthy environment with the right moral values. But it seems that lots of people can’t handle life so maybe this development can help them. Addiction is by definition unethical so everything may be used to counter it. And if the surgery fails all you lose is an addicted person… I don’t see the problem.

    • Ormond Otvos Fons Jena December 30, 2012 on 3:34 pm

      “Addiction is all about raising you kids in a healthy environment with the right moral values.”

      Words are easy to type…Apparently, you know very little about addiction.

      • why06 Ormond Otvos December 31, 2012 on 11:56 am

        I agree with Ormond completely.

        And just because of the choices someone has made doesn’t mean their life should have any less value.

        • Fons Jena why06 January 1, 2013 on 3:07 am

          ‘And just because of the choices someone has made doesn’t mean their life should have any less value.’

          I admit I was a bit harsh there but I don’t believe in the well-known statement saying that we are all of equal value. It does sound offensive but I believe that what you do in your life determines your value and the more ‘good’ you do the higher value you have. That being said an addicted person can still do many good things so in that sense my statement was totally misplaced, sorry.

          • Jenny Nielsen Fons Jena January 8, 2013 on 9:24 am

            That’s utter trash. People are valuable because they are people. Inherently. Who decides who is more “valuable” ? You? We all have to treat everyone alive with respect. The only kinds of people who lack value are people who don’t care about other people.

      • Fons Jena Ormond Otvos January 1, 2013 on 2:58 am

        Yes I know nothing about addiction because I’m not addicted to something. But how do you define it? If you define it as a consequence of wrong wiring in your brain so it isn’t the individual’s fault I have to agree with you. But from when is it nature’s fault and from when is it the individual’s fault? I would compare it with ADHD but I’m not a biochemist so it is just my opinion. Its always easy to say its because of some unlucky genes…

      • Jenny Nielsen Ormond Otvos January 8, 2013 on 9:28 am

        “raising your kids with the right moral values” …
        Who determines what are the right moral values??? A drug addict can come from any level of life, from any kind of home, with any moral values. The problem with drug addiciton is that it’s an almost irresistible urge to take in the substance a second time after trying it the first time. Many teenagers and adults make one mistake with alcohol or cocaine and are stuck with these irresistible urges to repeat that mistake the rest of their lives. Granted it’s very stupid that they tried it the first time, but many of the people who try these drugs are already experiencing some other problem (like abuse or bipolar depression) and struggling to actually regain some control of when they feel pleasure.

        Freud was a cocaine hound, Richard Feynman tried LSD, Carl Sagan was a pot smoker, Edgar Allan Poe was an alcoholic…the list of major contributors to mankind who have tried or become addicted to drugs goes on and on and on. The worst thing I’ve ever been addicted to is energy drinks (caffeine and sugar) but it’s only obvious that this is not the sort of thing you treat by turning someone’s mind off.

        • Jenny Nielsen Jenny Nielsen January 8, 2013 on 9:30 am

          Also, your idea that addicts are “lying to themselves” is a classic misconception — many if not most addicts know they are addicts. They just are overwhelmed by the urges and don’t have the coping skills or the biochemical assistance necessary to overcome the addiction which was probably tripped off by an underlying depressive disorder anyway.

    • rgraham42690 Fons Jena December 31, 2012 on 8:33 pm

      You were that pompous naive child who grew up believing your parents to be perfect and righteous, weren’t you? Well, here’s a little hint about the real world in case you haven’t encountered it yet, and judging from your comment, it doesn’t seem to be the case. Drug addiction happens not only to people of morally indefensible attitudes, but otherwise good people too. Surgery patients, doctors, those born with them, people dealing with stress and depression. You arrogant fuck, you know nothing about what addiction really is.

      It is worth treating, and properly so. It is not to be ignored. It does not make that person inherently evil or immoral. Wake the fuck up, naive child.

      • Fons Jena rgraham42690 January 4, 2013 on 3:08 pm

        It was not my intention to be offensive. It seems that my first reaction was a bit shortsighted of me and I may have judged too fast but you seem to be good at it too (should have added a smiley after my last sentence). Yes good people can get addicted to things like drugs but by doing so they lie to themselves which is morally not the right thing to do (but that still doesn’t make that person evil). But hey everyone makes a mistake now and then! And yes I grew up in a pretty protective environment that isn’t used to many extreme situations, I feel sorry for you that you haven’t. You seem to be addicted to the word ‘fuck’? What does it mean? I never got into contact with such vocabulary in my protective environment…

        • Jenny Nielsen Fons Jena January 8, 2013 on 9:16 am

          A “Smiley” ????? Losing an addicted person’s personality isn’t funny or cute or something to “smile” about.

        • Jenny Nielsen Fons Jena January 8, 2013 on 9:20 am

          It seems to me Fons Jenna that you have a congenital absence of empathy. Maybe you were born with an area of your brain turned off already and thus can’t see the significance of what you’re talking about or saying. Good luck.

    • HereItComes Fons Jena January 7, 2013 on 3:05 pm

      You are talking about killing healthy brain tissue. The brain tissue isn’t unhealthy it’s the way the person is using the brain tissue, the way the person is moving their thoughts/electrons through the synapses is unhealthy. By destroying the tissue instead of helping the addict to reconfigure their thoughts you are destroying it even for good purposes.

      I agree we’re NOT all necessarily equal BUT one thing that is for sure is that NOONE is infallible so how do you know the value you put on a person’s life is the right answer or not? I believe that talking about the “value” of a person and whether we are equal or not is nonsensical. You are talking about a property that can’t be measured in scientific terms and so it is subjective and nobody should be allowed to force their subjectivity upon another. For the sake of all nobody should have the authority to decide someone else’s life is worthless.

      If addiction is by definition unethical and so everything may be used to counter it then we’re all in trouble. Everyone has some sort of addiction and everything can be addictive. Gambling, going online, food, getting job promotions,…

      When you only examine objective factors and not value factors something is an addiction whether or not it is good or bad. But then just because something is generally good or bad doesn’t mean it is always good or bad. A person could pursue getting endless promotions and neglect their family. But then maybe their family consists of a spouse you should’ve never married in the first place and getting a divorce and continuing your hard work in your career may be the best decision. There are shades of gray and so one can not always be 100% when labeling something an “addiction” when you do incorporate the values part of the definition. Nor is it true that “everything may be used to counter it”. There are degrees of badness.

      I find it odd you compare it with ADHD. I suppose you think we should resort to radical, dangerous surgeries to try to cure that too?

    • Jenny Nielsen Fons Jena January 8, 2013 on 9:14 am

      Actually some of the greatest artists and novelists and scientists of all time were addicts. “…If the surgery fails, all you lose is an addicted person.” Are you a diagnosed sociopath?

    • Fons Jena Fons Jena January 14, 2013 on 1:26 pm

      I wrote this comment after I got frustrated by being ‘smoked’ by fumes of people smoking cigarettes!! So when I read this article after inhaling all that garbage I directly sounded off by writing this comment! Nothing more nothing less!! I confess that I’m someone who gets easily frustrated by seeing bad habbits but I realise that humans aren’t perfect so I try to get over it. And please I don’t think the lives of addictive people are worthless! I have good friends that smoke too much but I love them!

      Anyway it was an interesting experience reading these comments. It teached me that you have to be more careful when placing something on the world wide web and that lots of different people can read it and thus react on their own way. I will not judge anybody that responded on my comment so I hope the responders will do the same…

      I would appreciate if Singularity hub would delete all my comments (at least the first one!) but anyway I have learned and will still enjoy the cool news I find on this website.

      on topic: don’t mess with people’s brains! 😉

  • jw-singularity December 30, 2012 on 2:53 pm

    The underlying issues driving this research are of a greater concern. I can see research in blocking compulsive behavior using nano-level treatments as possibly application in the not too distant future. The moral and ethical implications are a huge and will require a larger conversation. I can see this coming (very soon) and can only imagine how quickly and easily it will be to alter our brain’s chemistry and the way our minds work in the future. With all the fascinating work pouring in around the brain (China’s experiments not withstanding), we are fast approaching an inflection point with the introduction of nano technology which may jeopardize our concept of individuality (behavior, thinking, and beliefs). As we approach the singularity in technology and medicine, these issues will likely spill have x-over impacts in other domains (defense, law enforcement, and beyond). Wondering if there’s a need to discuss the right governance structures (that we need to establish now) to proactively guide singularity to the continued benefit of mankind (versus the very real possibility of manipulation and/or destruction) ?

    • Ormond Otvos jw-singularity December 30, 2012 on 3:38 pm

      You need to postulate your own opinions. Merely reviewing the problem does nothing.

      Society’s needs must be balanced with the needs of the individual, and perhaps a simple economic formula would do it. Resources are limited, damage isn’t.

      I say continue the research, and closely monitor the results. China has developed a different society than ours. They had the moral certitude to limit child raising, for the good of ALL of us in the world. The West just backs away in horror from making decisions.

  • Roaidz December 31, 2012 on 6:07 am

    Stopping addiction could mean eradicating the sources. If there are no pushers, then there be no addicts also. And not that boring the skull of the suspected addict.

    • phoenixxl Roaidz January 5, 2013 on 7:21 pm

      Every doctor is a pusher.
      Every bit of serious pain medication has a euphoric sensation as a side effect due to it’s nature.
      If a substance exists it will be made , sold and consumed.

      Addiction has little to do with “pushers” , most people who sell narcotics do so to pay for their own addiction. They would rather not be doing what they do. The “pusher” concept is really archaic , the money makers are at the top. It’s on par with people thinking MDMA will mysteriously end up in their drinks when going to techno parties. Believe me , at 30 dollars a pill , nobody is going to treat you to one for free. However date rape drugs , ie strong benzodiazepines , are a real thing but those things happen in very different circumstances.

      A review on how society handles drugs is definitely something that needs to be addressed. “Eradicating the sources” is something someone who lives a secluded life comes up with. It is impossible.

      Removing the pleasure centers from someone’s brain is probably the most inhumane thing that can be done to someone.

    • HereItComes Roaidz January 7, 2013 on 3:13 pm

      We’ve been trying to eradicate the sources.
      Topple one king pin and 10 more are fighting each other for his place.
      The only solution is to stop the war on drugs.
      It’s better for an addict to be able to know what they are getting doesn’t contain contaminants. Less people would die that way.
      And then there are people who die who never were addicted, who were experimenting and died anyways. This would be less likely within a legal, regulated system where dosage and purity is controlled.
      People are going to take drugs. If we limit it to special, licensed salons where professionals can watch the people on drugs and intervene if there is a problem such as overdose or a bad trip or violence then the problem would be in a place where we can keep an eye on it.
      And drugs really aren’t evil. MDMA can sometimes help people to overcome serious psychological problems in a very fast period of time. The salons could also limit the amount of substances and how often you can come in to take them. This would help prevent addiction or at least keep addiction at manageable levels where a person can still be productive yet addicted and working with a counselor towards getting off their addiction.

  • Leif Burrow December 31, 2012 on 6:40 am

    “That’s a choice that each society has to make for itself.”

    No. That’s a choice that each individual should get to make for themselves. Societies are not even people. They are an idea. It is a real person who gets operated on. It is the individuals much more than society who have to live with both the consequences and benefits of these choices.

    • Roaidz Leif Burrow December 31, 2012 on 8:01 am

      So, it is the choice of any individual to become an addict. but we all know that it is against the Law. You mean, you’re choice is against the law. So, if there is absolutely No supply of Illegal Drugs, then there will be No addicts.

    • Jenny Nielsen Leif Burrow January 8, 2013 on 9:17 am

      That’s my thought exactly, thank you. If we let societies make these decisions we’ve basically kissed our personhood goodbye.

  • Howard Samson December 31, 2012 on 10:27 am

    As long as all those involved consented- knowing the risk involved- I can’t see the problem behind trying, even if it is drastic.

    • Jenny Nielsen Howard Samson January 8, 2013 on 9:32 am

      The problem is that China has major ethics problems and the scientists who published the paper and performed the surgeries probably did not obtain informed consent.

  • Andrew Atkin January 2, 2013 on 1:30 pm

    This is a good article – with good commentary.

    It illuminates in its most drastic form the cost of getting rid of problematic feelings – you end up getting rid of far more than that. The truth is we all “carpet bomb” our emotions all the time, via repression. Trauma must be repressed, and the more repressed we are the more shut-off we become to our feelings in general (reduced access to the brain stem and mid brain). In cognitive therapy, for example, the individual is basically just encouraged to to over-activate the neocortex to suppress feelings (think – don’t feel).

    Trauma changes the set-points of the brain, leading to “addictive personality”. Understand that every junkie, in whatever form, is ultimately only trying to feel ok. For the traumatised feeling ok is hard work – drugs in their own way help them, at least temporarily.

    But the trauma is not a chemical problem, it is an informational problem. It’s code in the brain, and the code is what you need to get to. Medical professionals generally don’t yet understand or respect this, because they can’t see it – we can’t yet see the brain actually processing information, and we can’t see the relationship between imprinted code and the neuro-physiological reactions to it.

    Try here for another outlook:

  • LuminatedSlave January 3, 2013 on 4:46 pm

    George Orwell’s 1984 coming to life! No pleasure, no sex, no rewards – just work! Looks like their searching for the perfect mindless slave/drone with population control in mind… Something tells me this has little to do with addiction.

    For those interested in combating addiction for real, look into Ibogaine.

  • phoenixxl January 5, 2013 on 7:03 pm

    Let’s imagine a future where this is mandatory for people who are the 99 percent!
    Take away people’s pleasure centers in their brains ! how forward thinking !

    No pleasure , no disillusions , so sadness . A huge collection of programs and experiences that can be put to good use. Use the carrot and stick to teach them their tricks their whole lives , then remove carrot and stick from the equation.

    What can you take away from people who don’t experience pleasure anymore. What motivation do they have to keep in check.

    This is probably the most horrific thing being done today. I bet most people who read this don’t even realize it.

  • phoenixxl January 5, 2013 on 7:26 pm

    Murder , while leaving a living corpse behind.
    He did it to 1000 people already…Charles Manson , eat your heart out.

  • Roberta Harty Romey January 9, 2013 on 4:37 am

    All Addiction Help | Addiction Treatment & Recovery Services Center

    Looking for an addiction treatment center? We appreciate the unique features of each individual suffering from all addiction. We offer a unique addiction recovery program for our patients.

    • phoenixxl Roberta Harty Romey January 9, 2013 on 11:31 pm

      Advertising in a comment thread is inappropriate. Everyone considers this on par with spam.

      Confidence in your treatment is what you sell. These kinds of business ethic really don’t inspire much confidence.

      • Roberta Harty Romey phoenixxl January 13, 2013 on 6:11 am

        Learn more about addiction programs to know how to identify and cope with drug addiction, and find out how you can help a loved one or yourself start down the path to treatment & recovery.