Neuromodulation with percutaneous electrical nerve field stimulation is associated with reduction in signs and symptoms of opioid withdrawal: a multisite, retrospective assessment

Miranda, Adrian; Taca, Arturo

doi:10.1080/00952990.2017.1295459

Cited by 61Opioid Use Disorder TreatmentPain Management and TreatmentPain Management and Opioid Use

Neuromodulation with percutaneous electrical nerve field stimulation is associated with reduction in signs and symptoms of opioid withdrawal: a multisite, retrospective assessment

Open access

Miranda, Adrian, Taca, Arturo·2018·The American Journal of Drug and Alcohol Abuse

DOI 10.1080/00952990.2017.1295459

Open this paper in CoChat — free account Open PDF

Abstract

BACKGROUND: Finding an effective, non-pharmacological approach to treat opioid withdrawal could remove some of the barriers associated with pharmacotherapy. The BRIDGE® is a noninvasive, percutaneous electrical nerve field stimulator developed to target pain. OBJECTIVES: This pilot study aimed to determine (1) the effects of the BRIDGE on withdrawal scores during the induction phase of opioid withdrawal therapy, (2) the percentage of subjects who successfully transitioned to medication assisted therapy (MAT). METHODS: Adult patients treated with the BRIDGE during medically supervised withdrawal were included in this open label, uncontrolled, and retrospective study. The clinical opioid withdrawal scale (COWS) scores were prospectively recorded at different intervals (20, 30, and 60 min) and analyzed retrospectively. A subset of patients had scores recorded 5-days post-BRIDGE. Those who returned to the clinic and received their first dose of maintenance medication were considered to be successfully transitioned. RESULTS: In this cohort (n=73), 65% were male. The mean COWS score prior to BRIDGE placement was 20.1 (±6.1). Twenty minutes after BRIDGE placement, the mean score was reduced to 7.5 (±5.9) (62.7% reduction, p<0.001). The scores further decreased after 30 minutes 4.0 (±4.4) and 60 minutes 3.1 (±3.4) (84.6% reduction, p<0.001). No rescue medications were administered during this period. The mean withdrawal score on day 5 was 0.6 (97.1% reduction, p<0.001) (n=33). Overall, 64/73 patients (88.8%) successfully transitioned to MAT. CONCLUSIONS: Neurostimulation with the BRIDGE is associated with a reduction in opioid withdrawal scores. This effect persisted during the induction period and allowed for effective transition to MAT.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1080/00952990.2017.1295459

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

The FDA clearance for PNFS was based on a single-arm, open label, multi-center retrospective study of 73 patients measuring reduction in Clinical Opioid Withdrawal Score (COWS) where the mean COWS score was reduced by 62.7% twenty minutes after initiation of therapy.
“The FDA clearance was based on a single-arm, open label, multi-center retrospective study of 73 patients measuring reduction in Clinical Opioid Withdrawal Score (COWS) where the mean COWS score was reduced by 62.7% twenty minutes after initiation of therapy.”
From Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment (2020) · cites this paper as [125]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Neurocircuitry of Addiction
Koob, G. F., & Volkow, N. D. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.110 · Cited by 5,340 · see citing works
The Clinical Opiate Withdrawal Scale (COWS)
Wesson, D. R., & Ling, W. W. (2003) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2003.10400007 · Cited by 1,120 · see citing works
A Role for Brain Stress Systems in Addiction
Koob, G. F. (2008) · Neuron · doi:10.1016/j.neuron.2008.06.012 · Cited by 1,056 · see citing works
Stress dysregulation of drug reward pathways, and the transition to drug dependence
Koob, & Kreek, M. J. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.05030503 · Cited by 868 · see citing works
Non-invasive Access to the Vagus Nerve Central Projections via Electrical Stimulation of the External Ear: fMRI Evidence in Humans
Frangos, E., Ellrich, J., & Komisaruk, B. R. (2014) · Brain stimulation · doi:10.1016/j.brs.2014.11.018 · Cited by 764 · see citing works
The organization of projections from the cortes, amygdala, and hypothalamus to the nucleus of the solitary tract in rat
van der Kooy, D., Koda, L. Y., McGinty, J. F., Gerfen, C. R., & Bloom, F. E. (1984) · The Journal of Comparative Neurology · doi:10.1002/cne.902240102 · Cited by 733 · see citing works
The amygdala and persistent pain
Neugebauer, V., Li, W., Bird, G. C., & Han, J. S. (2004) · The Neuroscientist · doi:10.1177/1073858403261077 · Cited by 719 · see citing works
Marked inhibition of mesolimbic dopamine release: a common feature of ethanol, morphine, cocaine and amphetamine abstinence in rats
Rossetti, Z. L., Hmaidan, Y., & GESSA, G. L. (1992) · European Journal of Pharmacology · doi:10.1016/0014-2999(92)90706-a · Cited by 526 · see citing works
Projections from the nucleus tractus solitarii to the rostral ventrolateral medulla
Ross, C. A., Ruggiero, D. A., & Reis, D. J. (1985) · The Journal of Comparative Neurology · doi:10.1002/cne.902420405 · Cited by 518 · see citing works
Amygdala intercalated neurons are required for expression of fear extinction
Likhtik, E., Popa, D., Apergis-Schoute, J., Fidacaro, G. A., & Paré, D. (2008) · Nature · doi:10.1038/nature07167 · Cited by 474 · see citing works
The central projections of the trigeminal, facial, glossopharyngeal and vagus nerves: an autoradiographic study in the rat
Contreras, R. J., Beckstead, R. M., & Norgren, R. (1982) · Journal of the Autonomic Nervous System · doi:10.1016/0165-1838(82)90003-0 · Cited by 419 · see citing works
Buprenorphine maintenance treatment of opiate dependence: a multicenter, randomized clinical trial
Ling, W., Charuvastra, C., Collins, J. F., Batki, S., Brown, L. S., Kintaudi, P., Wesson, D. R., Mcnicholas, L., Tusel, D. J., Malkerneker, U., et al. (1998) · Addiction · doi:10.1046/j.1360-0443.1998.9344753.x · Cited by 402 · see citing works
Geographic and Specialty Distribution of US Physicians Trained to Treat Opioid Use Disorder
Rosenblatt, R. A., Andrilla, C. H. A., Catlin, M., & Larson, E. H. (2015) · The Annals of Family Medicine · doi:10.1370/afm.1735 · Cited by 380 · see citing works
Basal extracellular dopamine levels in the nucleus accumbens are decreased during cocaine withdrawal after unlimited-access self-administration
Weiss, F., Markou, A., Lorang, M. T., & Koob, G. F. (1992) · Brain Research · doi:10.1016/0006-8993(92)91327-b · Cited by 318 · see citing works
Common brain mechanisms of chronic pain and addiction
Elman, I., & Borsook, D. (2016) · Neuron · doi:10.1016/j.neuron.2015.11.027 · Cited by 303 · see citing works
CNS BOLD fMRI Effects of Sham-Controlled Transcutaneous Electrical Nerve Stimulation in the Left Outer Auditory Canal – A Pilot Study
Kraus, T., Kiess, O., Hösl, K. M., Terekhin, P., Kornhuber, J., & Forster, C. (2013) · Brain stimulation · doi:10.1016/j.brs.2013.01.011 · Cited by 299 · see citing works
Barriers to Primary Care Physicians Prescribing Buprenorphine
Hutchinson, E., Catlin, M., Andrilla, C. H. A., Baldwin, L., & Rosenblatt, R. A. (2014) · The Annals of Family Medicine · doi:10.1370/afm.1595 · Cited by 289 · see citing works
Alpha2-adrenergic agonists for the management of opioid withdrawal
Gowing, L., Farrell, M., Ali, R. L., & White, J. M. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002024.pub5 · Cited by 272 · see citing works
Changes in substance abuse treatment use among individuals with opioid use disorders in the United States, 2004–2013
Saloner, B., & Karthikeyan, S. (2015) · JAMA · doi:10.1001/jama.2015.10345 · Cited by 226 · see citing works
Depression of Mesolimbic Dopamine Transmission and Sensitization to Morphine During Opiate Abstinence
Acquas, E., & Chiara, G. D. (1992) · Journal of Neurochemistry · doi:10.1111/j.1471-4159.1992.tb10033.x · Cited by 223 · see citing works
Office-Based Management of Opioid Dependence with Buprenorphine: Clinical Practices and Barriers
Walley, A. Y., Alperen, J. K., Cheng, D. M., Botticelli, M. P., Castro-Donlan, C., Samet, J. H., & Alford, D. P. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0686-x · Cited by 220 · see citing works
Basolateral amygdala inactivation abolishes conditioned stimulus- and heroin-induced reinstatement of extinguished heroin-seeking behavior in rats
Fuchs, R. A., & See, R. E. (2002) · Psychopharmacology · doi:10.1007/s00213-001-0997-7 · Cited by 193 · see citing works
Retention rate and substance use in methadone and buprenorphine maintenance therapy and predictors of outcome: results from a randomized study
Soyka, M., Zingg, C., Koller, G., & Küfner, H. (2008) · The International Journal of Neuropsychopharmacology · doi:10.1017/s146114570700836x · Cited by 184 · see citing works
Concurrent validation of the Clinical Opiate Withdrawal Scale (COWS) and single-item indices against the Clinical Institute Narcotic Assessment (CINA) opioid withdrawal instrument
Tompkins, D. A., Bigelow, G. E., Harrison, J. A., Johnson, R. E., Fudala, P. J., & Strain, E. C. (2009) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2009.07.001 · Cited by 181 · see citing works
Office-Based Treatment of Opioid-Dependent Patients
Fiellin, D. A., & O'Connor, P. G. (2002) · New England Journal of Medicine · doi:10.1056/nejmcp013579 · Cited by 148 · see citing works
The central nucleus of the amygdala contributes to the production of morphine antinociception in the formalin test
Manning, B. H., & Mayer, D. J. (1995) · Pain · doi:10.1016/0304-3959(95)00027-p · Cited by 122 · see citing works
Expanding treatment capacity for opioid dependence with office-based treatment with buprenorphine: National surveys of physicians
Arfken, C. L., Johanson, C., di Menza, S., & Schuster, C. R. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2010.05.004 · Cited by 120 · see citing works
Supply of buprenorphine waivered physicians: The influence of state policies
Stein, B. D., Gordon, A. J., Dick, A. W., Burns, R. M., Pacula, R. L., Farmer, C. M., LESLIE, D. L., & Sorbero, M. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.07.010 · Cited by 109 · see citing works
State policy influence on the early diffusion of buprenorphine in community treatment programs
Ducharme, L. J., & Abraham, A. J. (2008) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/1747-597x-3-17 · Cited by 88 · see citing works
Biphasic Modulation of Spinal Visceral Nociceptive Transmission From the Rostroventral Medial Medulla in the Rat
Zhuo, M., Sengupta, J. N., & Gebhart, G. F. (2002) · Journal of Neurophysiology · doi:10.1152/jn.2002.87.5.2225 · Cited by 87 · see citing works
Predictors of early dropout in outpatient buprenorphine/naloxone treatment
Marcovitz, D. E., McHugh, R. K., Volpe, J., Votaw, V. R., & Connery, H. S. (2016) · American Journal on Addictions · doi:10.1111/ajad.12414 · Cited by 86 · see citing works
Effectiveness of interventions on opiate withdrawal treatment: an overview of systematic reviews
Amato, L., Davoli, M., Ferri, M., Gowing, L., & Perucci, C. A. (2004) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2003.11.002 · Cited by 80 · see citing works
Activation in extended amygdala corresponds to altered hedonic processing during protracted morphine withdrawal
Harris, G. C. M., & Aston‐Jones, G. (2006) · Behavioural Brain Research · doi:10.1016/j.bbr.2006.10.012 · Cited by 79 · see citing works
Inhibition of the tail flick reflex following microinjection of morphine into the amygdala
Helmstetter, F. J., Bellgowan, P. S. F., & Tershner, S. A. (1993) · Neuroreport · doi:10.1097/00001756-199305000-00002 · Cited by 79 · see citing works
The amygdala, a relay station for switching on and off pain
Rouwette, T., Vanelderen, P., Roubos, E. W., Kozicz, T., & Vissers, K. C. P. (2011) · European Journal of Pain · doi:10.1002/j.1532-2149.2011.00071.x · Cited by 70 · see citing works
Involvement of the bed nucleus of the stria terminalis activated by the central nucleus of the amygdala in the negative affective component of morphine withdrawal in rats
Nakagawa, T., Yamamoto, R., Fujio, M., Suzuki, Y., Minami, M., Satoh, M., & Kaneko, S. (2005) · Neuroscience · doi:10.1016/j.neuroscience.2005.03.029 · Cited by 66 · see citing works
The development of cranial nerve and visceral afferents to the nucleus of the solitary tract in the rat
Zhang, L.-L., & Ashwell, K. W. S. (2001) · Anatomy and Embryology · doi:10.1007/s004290100185 · Cited by 64 · see citing works
Circadian Alteration in Neurobiology During 30 Days of Abstinence in Heroin Users
Li, S., Shi, J., Epstein, D. H., Wang, X., Zhang, X.-L., Bao, Y., Zhang, D., Zhang, X., Kosten, T. R., & Lü, L. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.11.025 · Cited by 63 · see citing works
Opioid detoxification with buprenorphine, clonidine, or methadone in hospitalized heroin-dependent patients with HIV infection
Umbricht, A., Hoover, D. R., TUCKER, M., Leslie, J. M., Chaisson, R. E., & Preston, K. L. (2003) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(02)00325-3 · Cited by 59 · see citing works
Assessing Differences in the Availability of Opioid Addiction Therapy Options: Rural Versus Urban and American Indian Reservation Versus Nonreservation
Hirchak, K. A., & Murphy, S. M. (2016) · The Journal of Rural Health · doi:10.1111/jrh.12178 · Cited by 53 · see citing works
A double-blind, double-dummy, randomized, prospective pilot study of the partial Mu opiate agonist, buprenorphine, for acute detoxification from heroin
Oreskovich, M. R., Saxon, A. J., Ellis, M. L., Malte, C. A., Reoux, J. P., & Knox, P. C. (2004) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2004.07.008 · Cited by 52 · see citing works
Precipitated withdrawal during maintenance opioid blockade with extended release naltrexone
Fishman, M. J. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02252.x · Cited by 45 · see citing works
Treatment outcomes in opioid dependent patients with different buprenorphine/naloxone induction dosing patterns and trajectories
Jacobs, P., Ang, A., Hillhouse, M. P., Saxon, A. J., Nielsen, S., Wakim, P., Mai, B. E., Mooney, L. J., Potter, J. S., & BLAINE, J. D. (2015) · American Journal on Addictions · doi:10.1111/ajad.12288 · Cited by 41 · see citing works
States’ implementation of the Affordable Care Act and the supply of physicians waivered to prescribe buprenorphine for opioid dependence
Knudsen, H. K., Lofwall, M. R., Havens, J. R., & WALSH, S. L. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.09.032 · Cited by 31 · see citing works
Buprenorphine in the treatment of opioid addiction: opportunities, challenges and strategies
Li, X., Shorter, D. I., & Kosten, T. R. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2014.955469 · Cited by 30 · see citing works
Transcutaneous Electrical Acupoint Stimulation for the Treatment of Withdrawal Syndrome in Heroin Addicts
Ma, D., Han, J., Diao, Q.-H., Deng, G.-F., Ping, X., Jin, W.-J., Wu, L., Cui, C., & Li, X. (2015) · Pain Medicine · doi:10.1111/pme.12738 · Cited by 25 · see citing works
Minimal adverse effects profile following implantation of periauricular percutaneous electrical nerve field stimulators: a retrospective cohort study
Roberts, A., Sithole, A., Sedghi, M., Walker, C., & Quinn, T. (2016) · Medical Devices Evidence and Research · doi:10.2147/mder.s107426 · Cited by 24 · see citing works
Acute opioid withdrawal is associated with increased neural activity in reward-processing centers in healthy men: A functional magnetic resonance imaging study
Chu, L. F., Lin, J. C., Clemenson, A., Encisco, E. M., Sun, J. S., Hoang, D., Alva, H. L., Erlendson, M. J., Clark, J. D., & Younger, J. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.04.019 · Cited by 20 · see citing works
Buprenorphine 101
Torrington, M., Domier, C. P., Hillhouse, M. P., & Ling, W. W. (2007) · Journal of Addictive Diseases · doi:10.1300/j069v26n03_10 · Cited by 19 · see citing works
Catecholaminergic neurons in the nucleus tractus solitarii which send their axons to the naidbrain periaqueductal gray express Fos protein after noxious stimulation of the stomach: a triple labeling study in the rat
Chen, L.-W., Rao, Z., & Shi, J.-W. (1995) · Neuroscience Letters · doi:10.1016/0304-3940(95)11475-c · Cited by 17 · see citing works
Efficacy of Buprenorphine/Naloxone Rapidly Dissolving Sublingual Tablets (BNX-RDT) After Switching From BNX Sublingual Film
Gunderson, E. W., & Sumner, M. (2016) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000201 · Cited by 15 · see citing works
Efficacy and safety of a sublingual buprenorphine/naloxone rapidly dissolving tablet for the treatment of adults with opioid dependence: A randomized trial
Webster, L. R., Hjelmström, P., Sumner, M., & Gunderson, E. W. (2016) · Journal of Addictive Diseases · doi:10.1080/10550887.2016.1195608 · Cited by 14 · see citing works
Neurotransmitter Mechanisms of Morphine Withdrawal Syndrome
Лелевич, С. В., Лелевич, В. В., & Novokshonov, A. A. (2009) · Bulletin of Experimental Biology and Medicine · doi:10.1007/s10517-009-0672-2 · Cited by 13 · see citing works
Challenges and Opportunities for the Use of Medications to Treat Opioid Addiction in the United States and Other Nations of the World
Parrino, M. W., Maremmani, A. G. I., Samuels, P. N., & Maremmani, I. (2015) · Journal of Addictive Diseases · doi:10.1080/10550887.2015.1059113 · Cited by 9 · see citing works
The Prevalence of Musculoskeletal Pain and Forward Head Posture among Heroin Users during their Withdrawal with Methadone.
Fahimeh, K. S., Motiallah, T., & Ghaffarinejad, F. (2014) · Europe PMC (PubMed Central) · Cited by 8 · see citing works
Managing Acute and Chronic Pain in a Substance Abuse Treatment Program for the Addicted Individual Early in Recovery: A Current Controversy
Markowitz, J. D., Francis, E. M., & Gonzales-Nolas, C. (2010) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2010.10400691 · Cited by 7 · see citing works

Flagged first, then by citations

Research works printed but not linked: 3

Koob GF, Volkow ND. Neurocircuitry of addiction. Neuropsychopharmacology 2010;35:217-238.
Ross CA, Ruggiero DA, Reis DJ. Projections from the nucleus tractus solitarii to the rostral ventrolateral medulla. J Comp Neurol 1985;242:511-534.
Rossetti ZL, Hmaidan Y, Gessa GL. Marked inhibition of mesolimbic dopamine release: a common feature of ethanol, morphine, cocaine and amphetamine absti- nence in rats. Eur J Pharmacol 1992;221:227-234.

Sorted by citations

Neuroscience of Addiction: Relevance to Prevention and Treatment
Volkow, N. D., & Boyle, M. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.17101174 · Cited by 355 · see citing works
Current Directions in the Auricular Vagus Nerve Stimulation I – A Physiological Perspective
Kaniušas, E., Kampusch, S., Tittgemeyer, M., Panetsos, F., Gines, R. F., Papa, M., Kiss, A., Podesser, B. K., Cassara, A. M., Tanghe, E., et al. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00854 · Cited by 331 · see citing works
Neurostimulation for abdominal pain-related functional gastrointestinal disorders in adolescents: a randomised, double-blind, sham-controlled trial
Kovacic, K. K., Hainsworth, K. R., Sood, M. R., Chelimsky, G. G., Unteutsch, R., Nugent, M., Simpson, P. M., & Miranda, A. (2017) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(17)30253-4 · Cited by 175 · see citing works
Kratom use and mental health: A systematic review
Swogger, M. T., & Walsh, Z. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.10.012 · Cited by 152 · see citing works
Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment
Mahoney, J. J., Hanlon, C. A., Marshalek, P. J., Rezai, A. R., & Krinke, L. (2020) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2020.117149 · Cited by 121 · see citing works
Percutaneous electrical nerve field stimulation modulates central pain pathways and attenuates post-inflammatory visceral and somatic hyperalgesia in rats
Babygirija, R., Sood, M. R., Kannampalli, P., Sengupta, J. N., & Miranda, A. (2017) · Neuroscience · doi:10.1016/j.neuroscience.2017.05.012 · Cited by 57 · see citing works
Wearable and Wireless mHealth Technologies for Substance Use Disorder
Goldfine, C. E., Lai, J. T., Lucey, E., Newcomb, M., & Carreiro, S. (2020) · Current Addiction Reports · doi:10.1007/s40429-020-00318-8 · Cited by 59 · see citing works
Exploration of the Impact of Brief Noninvasive Vagal Nerve Stimulation on EEG and Event-Related Potentials
Lewine, J. D., Paulson, K. M., Bangera, N. B., & Simon, B. J. (2018) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.12864 · Cited by 56 · see citing works
Technologies for Opioid Use Disorder Management: Mobile App Search and Scoping Review
Nuamah, J. K., Mehta, R. K., & Sasangohar, F. (2020) · JMIR mhealth and uhealth · doi:10.2196/15752 · Cited by 53 · see citing works
Auricular neural stimulation as a new non-invasive treatment for opioid detoxification
Qureshi, I. S., Datta, T., Tracey, K. J., Pavlov, V. A., & Chen, A. C. H. (2020) · Bioelectronic Medicine · doi:10.1186/s42234-020-00044-6 · Cited by 39 · see citing works
Transcutaneous cervical vagus nerve stimulation reduces behavioral and physiological manifestations of withdrawal in patients with opioid use disorder: A double-blind, randomized, sham-controlled pilot study
Gazi, A. H., Harrison, A. B., Lambert, T. P., Obideen, M., Alavi, P., Murrah, N. V., Shallenberger, L. H., Driggers, E. G., Ortega, R. A., Washington, B. P., et al. (2022) · Brain stimulation · doi:10.1016/j.brs.2022.08.017 · Cited by 30 · see citing works
Clinical Efficacy of Auricular Vagus Nerve Stimulation in the Treatment of Chronic and Acute Pain: A Systematic Review and Meta-analysis
Duff, I. T., Likar, R., Perruchoud, C., Kampusch, S., Köstenberger, M., Sator, S., Stremnitzer, C., Wolf, A., Neuwersch-Sommeregger, S., & Abd-Elsayed, A. A. (2024) · Pain and Therapy · doi:10.1007/s40122-024-00657-8 · Cited by 29 · see citing works
Non-invasive brain stimulation modalities for the treatment and prevention of opioid use disorder: a systematic review of the literature
Young, J. R., Smani, S., Mischel, N., Kritzer, M. D., Appelbaum, L. G., & Patkar, A. A. (2020) · Journal of Addictive Diseases · doi:10.1080/10550887.2020.1736756 · Cited by 26 · see citing works
Prevention of Opioid Abuse and Treatment of Opioid Addiction: Current Status and Future Possibilities
Park, K., & Otte, A. (2019) · Annual Review of Biomedical Engineering · doi:10.1146/annurev-bioeng-060418-052155 · Cited by 26 · see citing works
Transcutaneous Auricular Neurostimulation (tAN): A Novel Adjuvant Treatment in Neonatal Opioid Withdrawal Syndrome
Jenkins, D., Khodaparast, N., O’Leary, G. H., Washburn, S. N., Covalin, A., & Badran, B. W. (2021) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2021.648556 · Cited by 20 · see citing works
Managing Opioid Withdrawal Symptoms During the Fentanyl Crisis: A Review
Weber, A. N., Trebach, J. D., Brenner, M., Thomas, M. A., & Bormann, N. L. (2024) · Substance Abuse and Rehabilitation · doi:10.2147/sar.s433358 · Cited by 19 · see citing works
Looking beyond the opioid receptor: A desperate need for new treatments for opioid use disorder
Lee, Y. K., Gold, M. S., & Fuehrlein, B. (2021) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2021.120094 · Cited by 19 · see citing works
Delivering transcutaneous auricular neurostimulation (tAN) to improve symptoms associated with opioid withdrawal: results from a prospective clinical trial
Tirado, C. F., Washburn, S. N., Covalin, A., Hedenberg, C., Vanderpool, H., Benner, C., Powell, D. P., McWade, M. A., & Khodaparast, N. (2022) · Bioelectronic Medicine · doi:10.1186/s42234-022-00095-x · Cited by 18 · see citing works
Percutaneous auricular neuromodulation (nerve stimulation) for the treatment of pain following total knee arthroplasty: a randomized, double-masked, sham-controlled pilot study
Ilfeld, B. M., Finneran, J. J., Alexander, B. S., Abramson, W. B., Sztain, J. F., Ball, S. T., Gonzales, F. B., Abdullah, B., Cha, B. J., & Said, E. T. (2024) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2023-105028 · Cited by 17 · see citing works
A Systematic Review of Noninvasive Brain Stimulation for Opioid Use Disorder
Ward, H. B., Mosquera, M. J., Suzuki, J., & Mariano, T. Y. (2020) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.13108 · Cited by 16 · see citing works
Pain is reduced by transcutaneous cervical vagus nerve stimulation and correlated with cardiorespiratory variability measures in the context of opioid withdrawal
Gazi, A. H., Harrison, A. B., Lambert, T. P., Nawar, A., Obideen, M., Driggers, E. G., Vaccarino, V., Shah, A. J., Rozell, C. J., Bikson, M., et al. (2022) · Frontiers in Pain Research · doi:10.3389/fpain.2022.1031368 · Cited by 12 · see citing works
Percutaneous auricular nerve stimulation (neuromodulation) for the treatment of pain following outpatient surgery: a proof-of-concept case series
Ilfeld, B. M., Finneran, J. J., Dalstrom, D. J., Wallace, A. M., Abdullah, B., & Said, E. T. (2022) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2022-103777 · Cited by 11 · see citing works
Transcutaneous Auricular Vagus Nerve Stimulation Restores Cognitive Impairment in Morphine‐Withdrawn Rats: Role of BDNF and Glial Cells in the Hippocampus
Nazari, S., Niknamfar, S., Ghazvini, H., Rafaiee, R., Allahverdy, A., Khazaie, H., & Tamijani, S. M. S. (2025) · Addiction Biology · doi:10.1111/adb.70016 · Cited by 10 · see citing works
Medication for the Treatment of Opioid Use Disorder
Renner, J. A., & Crawford, M. B. (2019) · Current clinical psychiatry · doi:10.1007/978-3-030-16257-3_5 · Cited by 11 · see citing works
Percutaneous auricular neuromodulation (nerve stimulation) for the treatment of pain following cholecystectomy and hernia repair: a randomized, double-masked, sham-controlled pilot study
Ilfeld, B. M., Abramson, W. B., Alexander, B. S., Sztain, J. F., Said, E. T., Broderick, R. C., Sandler, B. J., Doucet, J. J., Adams, L. M., Abdullah, B., et al. (2024) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2024-105283 · Cited by 9 · see citing works
Auricular transcutaneous vagus nerve stimulation for alcohol use disorder: A chance to improve treatment?
Konjusha, A., Colzato, L. S., Ghin, F., Stock, A., & Beste, C. (2022) · Addiction Biology · doi:10.1111/adb.13202 · Cited by 9 · see citing works
Auricular field nerve stimulation using the NSS-2 BRIDGE ® device as an alternative to opioids following kidney donor surgery
Chelly, J. E., Monroe, A., Planinsic, R. M., Tevar, A. D., & Norton, B. E. (2021) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2021-0208 · Cited by 9 · see citing works
Percutaneous auricular nerve stimulation (neuromodulation) for the treatment of pain: A proof-of-concept case report using total joint arthroplasty as a surrogate for battlefield trauma
Ilfeld, B. M., Finneran, J. J., Said, E. T., Cidambi, K. R., & Ball, S. T. (2022) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000003706 · Cited by 8 · see citing works
Auricular percutaneous nerve field stimulator device as alternative therapy for Cesarean delivery analgesia: proof of concept
Lim, G., LaSorda, K. R., Monroe, A., & Chelly, J. E. (2019) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-019-01465-x · Cited by 8 · see citing works
Pupillary response to percutaneous auricular vagus nerve stimulation in alcohol withdrawal syndrome: A pilot trial
Treiber, M., Grünberger, J., Vyssoki, B., Széles, J. C., Kaniušas, E., Kampusch, S., Stöhr, H., Walter, H., Lesch, O., König, D., et al. (2023) · Alcohol · doi:10.1016/j.alcohol.2023.08.009 · Cited by 7 · see citing works
Noninvasive Vagal Nerve Stimulation for Opioid Use Disorder
Bremner, J. D. (2023) · Annals of Depression and Anxiety · doi:10.26420/anndepressanxiety.2023.1117 · Cited by 7 · see citing works
Bioelectronic Therapeutics: A Revolutionary Medical Practice in Health Care
Garg, I., Verma, M., Kumar, H., Maurya, R., Negi, T., & Jain, P. (2025) · Bioelectricity · doi:10.1089/bioe.2024.0039 · Cited by 8 · see citing works
No time to lose: the current state of research in rapid-acting psychotherapeutics
Gordon, J. A., Volkow, N. D., & Koob, G. F. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-023-01627-y · Cited by 6 · see citing works
A Concept Analysis of Dependence Using Rodgers’ Evolutionary Method
Lingerfelt, C. N., & Hutson, S. P. (2020) · Issues in Mental Health Nursing · doi:10.1080/01612840.2020.1820118 · Cited by 6 · see citing works
NEUROSCIENTIFIC BASIS OF TREATMENT FOR SUBSTANCE USE DISORDERS
Bozkurt, M. (2022) · Nöro Psikiyatri Arşivi · doi:10.29399/npa.28172 · Cited by 5 · see citing works
Percutaneous Auricular Nerve Stimulation (Neuromodulation) for Analgesia and Opioid-Sparing Following Knee and Hip Arthroplasty: A Proof-of-Concept Case Series
Finneran, J. J., Said, E. T., Ball, S. T., Cidambi, K. R., Abdullah, B., & Ilfeld, B. M. (2022) · A&A Practice · doi:10.1213/xaa.0000000000001621 · Cited by 5 · see citing works
Regaining control over opioid use? The potential application of auricular transcutaneous vagus nerve stimulation to improve opioid treatment in China
Colzato, L. S., Elmers, J., Xu, X., Zhou, Q., Hommel, B., & Beste, C. (2023) · Addiction Biology · doi:10.1111/adb.13343 · Cited by 5 · see citing works
NSS-Bridge Device for Post-Cesarean Delivery Analgesia: A Randomized Controlled Trial
Lim, G., Nowakowski, E., LaSorda, K. R., Altamirano, V., Morgan, M., Makeen, M., Beck, S., Krans, E. E., & Chelly, J. E. (2022) · Obstetrics and Gynecology Research · doi:10.26502/ogr094 · Cited by 5 · see citing works
Percutaneous electrical nerve field stimulation to reduce clinical opiate withdrawal: a case series
Buono, F. D., Pickering, R., Berlepsch, R., & Halligan, S. (2021) · Journal of Substance Use · doi:10.1080/14659891.2021.1961894 · Cited by 5 · see citing works
Transcutaneous Cervical Vagus Nerve Stimulation Modulates Prefrontal Cortex Activity During Opioid Withdrawal in Individuals With Opioid Use Disorder
Rahman, F. N., Nawar, A., Nye, J. A., Choi, J., Lambert, T. P., Robinson, M., Gazi, A. H., Abbaraju, V., Tomic, N., Harrison, A. B., et al. (2025) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2025.04.012 · Cited by 3 · see citing works
Neuromodulation and Opioid Use Disorder: Ethical Opportunities for Canada
Boyle, Q., & Illes, J. (2023) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2022.328 · Cited by 4 · see citing works
Tackling an Epidemic: New and Emerging Opioid Addiction Treatments Offer Hope for Solutions to This Crisis
Bates, M. (2018) · IEEE Pulse · doi:10.1109/mpul.2018.2790904 · Cited by 3 · see citing works
A randomized, sham-controlled, quintuple-blinded trial to evaluate the NET device as an alternative to medication for promoting opioid abstinence
Greenwald, M. K., Ghosh, S., & Winston, J. R. (2022) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2022.101018 · Cited by 2 · see citing works
Feasibility and acceptability of wearing a neuromodulation device at night in individuals in recovery from opioid use disorder
Meads, K., Huettner, S. S., Amata, D., Johnson, H., Devine, J. K., Warnakulasuriya, S., Murphy, K. R., & Good, C. H. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1481795 · Cited by 2 · see citing works
Lessons from the National institutes of health innovation corps program: defining barriers to developing and commercializing novel solutions for persons with opioid use disorder
Heshmatipour, M., Duvernay, T. M., Hite, D. Z., Versi, E., Hite, M. P., Reeser, D., Prikhodko, V., Nelson, A. M., Julian, B., & Greenberg, M. L. (2025) · Addiction Science & Clinical Practice · doi:10.1186/s13722-025-00554-1 · Cited by 2 · see citing works
Pain Management Following Total Hip Arthroplasty With Percutaneous Auricular Stimulation (Neuromodulation): A Randomized, Double-Masked, Sham-Controlled Pilot Study
Ilfeld, B. M., Said, E. T., Alexander, B. S., Ball, S. T., Abdullah, B., Jensen, E. J., Schaar, A. N., & Finneran, J. J. (2025) · Cureus · doi:10.7759/cureus.78920 · Cited by 1 · see citing works
Percutaneous auricular neuromodulation for postoperative analgesia
Finneran, J. J., & Ilfeld, B. M. (2025) · Expert Review of Medical Devices · doi:10.1080/17434440.2025.2474731 · Cited by 1 · see citing works
Percutaneous auricular neuromodulation to treat pain after ambulatory breast surgery: A randomized, double-masked, sham-controlled pilot study
Ilfeld, B. M., Abramson, W. B., Said, E. T., Sztain, J. F., Finneran, J. J., Griggs, J. L., Abdullah, B., Jensen, E. J., Schaar, A. N., & Wallace, A. M. (2025) · Canadian Journal of Pain · doi:10.1080/24740527.2025.2521117 · Cited by 1 · see citing works
Post-discharge use of opioids, psychostimulants, and treatment medications following residential opioid discontinuation with NET Device™ monotherapy
Greenwald, M. K., Arfken, C. L., & Winston, J. R. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1627267 · Cited by 1 · see citing works
Supervised Withdrawal Opioid Use Disorder Treatments
Dunn, K. E., & Huhn, A. S. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197618431.013.24 · Cited by 1 · see citing works
Reduction in Postoperative Opioid Requirement Associated With Use of the NSS-2® Bridge Device, a Disposable Auriculo-Nerve Field Stimulator, and Factors Affecting the Response in Cancer Patients Undergoing Abdominal Surgical Procedures
Chelly, J. E., Holtzman, M. P., Bartlett, D. L., Choudry, H. A., Pingpank, J. F., Zureikat, A. H., Norton, B. E., Sadhasivam, S., & Vogt, K. M. (2024) · doi:10.36266/jpmtc/119 · Cited by 1 · see citing works
Vagus nerve stimulation for the management of addiction disorders
Washburn, S. N., Khodaparast, N., & Covalin, A. (2024) · Elsevier eBooks · doi:10.1016/b978-0-12-816996-4.00005-8 · Cited by 1 · see citing works
Single-cell systems neuroscience: A growing frontier in mental illness
O’Sullivan, S. J. (2021) · Biocell · doi:10.32604/biocell.2022.017680 · Cited by 1 · see citing works
Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
O’Sullivan, S. J., Srivastava, A., Vadigepalli, R., & Schwaber, J. S. (2022) · Journal of Visualized Experiments · doi:10.3791/64014 · Cited by 1 · see citing works
NIDA Boosts Research and Development of Medical Devices for Substance use Disorder via the NIH Blueprint MedTech Initiative
Kostov, Y. V., Angelone, L. M., Gutowski, S., & Koustova, E. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2184209 · Cited by 1 · see citing works
Nonpharmacological Modality of Treating Opioid Withdrawal.
Nair, A. S. (2019) · Europe PMC (PubMed Central) · doi:10.4103/ijpc.ijpc_116_18
Der Vagusnerv und die Stimulation seines aurikulären Astes in der Schmerztherapie
Likar, R., Köstenberger, M., Sator, S., & Crevenna, R. (2025) · Schmerz Nachrichten · doi:10.1007/s44180-025-00221-6
Novel Modalities in Regional Anesthesia for Knee Arthroplasty
Gabriel, R. A., & Ilfeld, B. M. (2025) · Anesthesiology Clinics · doi:10.1016/j.anclin.2025.07.007
Needle-based acupuncture monotherapy for illicit drug use disorders: a comparator-stratified systematic review and meta-analysis
Huang, L., (3548), F. G., Jia, D., & Xue, S. (2026) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2026.102693
Non-invasive vagus nerve stimulation for substance use disorder: A narrative review
Thompson-Lake, D. G. Y., Snetkov, G., Johnson, L., Ait‐Daoud, N., & Mahoney, J. J. (2026) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2026.113244
Exploratory Pilot Randomized Crossover Study of Transcutaneous Vagus Nerve Stimulation on Sleep Quality and Mood in Healthy Adults
Hong, S. W., Im, J., Koh, C. S., Roh, S., Jung, H. H., & Chang, J. W. (2026) · Journal of Korean Medical Science · doi:10.3346/jkms.2026.41.e279

Prospective Study of Masimo NSS-2 BRIDGE; as a Non-Pharmacological Treatment for Acute Opioid Withdrawal Symptoms
Matta, C., & Wieseler, A. (2023) · Pain Management Nursing · doi:10.1016/j.pmn.2023.02.022
Percutaneous electrical nerve field stimulation to reduce clinical opiate withdrawal: a case series
Buono, F. D., Pickering, R., Berlepsch, R., & Halligan, S. (2021) · Journal of Substance Use · doi:10.1080/14659891.2021.1961894 · Cited by 5 · see citing works
Delivering transcutaneous auricular neurostimulation (tAN) to improve symptoms associated with opioid withdrawal: results from a prospective clinical trial
Tirado, C. F., Washburn, S. N., Covalin, A., Hedenberg, C., Vanderpool, H., Benner, C., Powell, D. P., McWade, M. A., & Khodaparast, N. (2022) · Bioelectronic Medicine · doi:10.1186/s42234-022-00095-x · Cited by 18 · see citing works
A randomized, sham-controlled clinical trial to evaluate the NET Device™ for reducing withdrawal symptom severity during opioid discontinuation
Greenwald, M. K., Arfken, C. L., & Winston, J. R. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1510428 · Cited by 5 · see citing works
FDA Clears Way for Stimulation Device to Treat Opioid Withdrawal Symptoms
Zagorski, N. (2017) · Psychiatric News · doi:10.1176/appi.pn.2018.1a16 · Cited by 2 · see citing works

Authors: Miranda, A., & Taca, A.
Affiliations: Medical College of Wisconsin (US)
Saint Louis University (US)
Corresponding author: Miranda, Adrian
ORCID: Miranda, Adrian
Venue: The American Journal of Drug and Alcohol Abuse
Publisher: Informa UK Limited
Published: 2017-03-16
Volume: 44
Issue: 1
Pages: 56-63
ISSN: 0095-2990 (ISSN-L)
1097-9891
DOI: 10.1080/00952990.2017.1295459
OpenAlex: W2595186199
Cited by: 61
References: 56
Citations by year: 2026: 3 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 11 · 2021: 5 · 2020: 7 · 2019: 5 · 2018: 3 · 2017: 3
FWCI: 4.61
Type: journal article
Language: en
Update notices: correction (2018-04-11)
Open access: bronze
doi.org
Locations: The American Journal of Drug and Alcohol Abuse (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: opioid withdrawal, non-pharmacological treatment, opioid use disorder
MeSH terms: Adult, Combined Modality Therapy, Transcutaneous Electric Nerve Stimulation, Female, Humans, Male, Opioid-Related Disorders, Pilot Projects, Retrospective Studies, Substance Withdrawal Syndrome, Young Adult, Opiate Substitution Treatment

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Neuromodulation with percutaneous electrical nerve field stimulation is associated with reduction in signs and symptoms of opioid withdrawal: a multisite, retrospective assessment

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks