Neurofeedback Training for Opiate Addiction: Improvement of Mental Health and Craving

Psychological improvements in patients with substance use disorders have been reported after neurofeedback treatment. However, neurofeedback has not been commonly accepted as a treatment for substance dependence. This study was carried out to examine the effectiveness of this therapeutic method for opiate dependence disorder. The specific aim was to investigate whether treatment leads to any changes in mental health and substance craving. In this experimental study with a pre-post test design, 20 opiate dependent patients undergoing Methadone or Buprenorphine maintenance treatment were examined and matched and randomized into two groups. While both experimental and control groups received their usual maintenance treatment, the experimental group received 30 sessions of neurofeedback treatment in addition. The neurofeedback treatment consisted of sensory motor rhythm training on Cz, followed by an alpha-theta protocol on Pz. Data from the general health questionnaire and a heroin craving questionnaire were collected before and after treatment. Multivariate analysis of covariance showed that the experimental group achieved improvement in somatic symptoms, depression, and total score in general mental health; and in anticipation of positive outcome, desire to use opioid, and relief from withdrawal of craving in comparison with the control group. The study supports the effectiveness of neurofeedback training as a therapeutic method in opiate dependence disorder, in supplement to pharmacotherapy.

[1]  Arif Demirdaş,et al.  Kaplan Sadock Comprehensive Textbook of Psychiatry , 2007 .

[2]  A. Schmetzer Substance Abuse in the Mentally and Physically Disabled , 2002 .

[3]  Siegfried Othmer,et al.  Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population , 2005, The American journal of drug and alcohol abuse.

[4]  Thomas R. Rossiter The Effectiveness of Neurofeedback and Stimulant Drugs in Treating AD/HD: Part I. Review of Methodological Issues , 2004, Applied psychophysiology and biofeedback.

[5]  D. Trudeau The Treatment of Addictive Disorders by Brain Wave Biofeedback: A Review and Suggestions for Future Research , 2000, Clinical EEG.

[6]  Thomas J. H. Chen,et al.  The Reward Deficiency Syndrome: A Biogenetic Model for the Diagnosis and Treatment of Impulsive, Addictive and Compulsive Behaviors , 2000, Journal of psychoactive drugs.

[7]  J. O'mahony,et al.  Intellectual impairment among recently abstinent alcohol abusers. , 1996, The British journal of clinical psychology.

[8]  J. Kruse,et al.  Psychometric properties of the General Health Questionnaire (GHQ‐12) in a German primary care sample , 1999, Acta psychiatrica Scandinavica.

[9]  J. Démos Getting Started with Neurofeedback , 2005 .

[10]  R. K. Simpson Nature Neuroscience , 2022 .

[11]  N. Birbaumer,et al.  Self-regulation of Slow Cortical Potentials: A New Treatment for Children With Attention-Deficit/Hyperactivity Disorder , 2006, Pediatrics.

[12]  J. Gruzelier,et al.  The effects of alpha/theta neurofeedback on personality and mood. , 2005, Brain research. Cognitive brain research.

[13]  B. Kennedy,et al.  Altered states of consciousness therapy. A missing component in alcohol and drug rehabilitation treatment. , 1991, Journal of substance abuse treatment.

[14]  S. Shiffman,et al.  The measurement of drug craving. , 2000, Addiction.

[15]  D. Hammond,et al.  Neurofeedback with anxiety and affective disorders. , 2005, Child and adolescent psychiatric clinics of North America.

[16]  G. Di Chiara Drug addiction as dopamine-dependent associative learning disorder. , 1999, European journal of pharmacology.

[17]  N. Jainchill,et al.  Editors' Introduction: Issues in Adolescent Substance Abuse Treatment , 2000 .

[18]  D. Hammond QEEG-Guided Neurofeedback in the Treatment of Obsessive Compulsive Disorder , 2003 .

[19]  THE EFFICACY OF ALPHA AND THETA NEUROFEEDBACK TRAINING IN TREATMENT OF GENERALIZED ANXIETY DISORDER , 1998 .

[20]  D. Kaiser,et al.  Effect of Neurofeedback on Variables of Attention in a Large Multi-Center Trial , 2000 .

[21]  N. Volkow,et al.  Cerebral Blood Flow in Chronic Cocaine Users: A Study with Positron Emission Tomography , 1988, British Journal of Psychiatry.

[22]  C. Marchesi,et al.  TRH test in alcoholics: relationship of the endocrine results with neuroradiological and neuropsychological findings. , 1992, Alcohol and alcoholism.

[23]  E. Saxby,et al.  Alpha-theta brainwave neurofeedback training: an effective treatment for male and female alcoholics with depressive symptoms. , 1995, Journal of clinical psychology.

[24]  Heroin and Cocaine , 1964, British medical journal.

[25]  M. J. Kelley “Native Americans, Neurofeedback, and Substance Abuse Theory”. Three Year Outcome of Alpha/theta Neurofeedback Training in the Treatment of Problem Drinking among Dine' (Navajo) People , 1997 .

[26]  Effectiveness of Broad Spectrum Approaches to Relapse Prevention in Severe Alcoholism , 1994 .

[27]  J. Putman EEG Biofeedback on a Female Stroke Patient with Depression: A Case Study , 2002 .

[28]  S. Rabe-Hesketh,et al.  Stratum-specific likelihood ratios of two versions of the General Health Questionnaire , 2001, Psychological Medicine.

[29]  S. Shiffman,et al.  The measurement of drug craving. , 2000, Addiction.

[30]  R. Rostami,et al.  Effectiveness of Neurofeedback Training as a Treatment for Opioid-Dependent Patients , 2010, Clinical EEG and neuroscience.

[31]  D. Haran,et al.  Community Screening for Mental Illness: A Validity Study of the General Health Questionnaire , 1982, British Journal of Psychiatry.

[32]  J. Fagan Women and Drugs Revisited: Female Participation in the Cocaine Economy , 1994 .

[33]  D. Goldberg,et al.  A scaled version of the General Health Questionnaire , 1979, Psychological Medicine.

[34]  Nora D. Volkow,et al.  The addicted human brain viewed in the light of imaging studies: brain circuits and treatment strategies , 2004, Neuropharmacology.

[35]  U. Strehl,et al.  Modification of Slow Cortical Potentials in Patients with Refractory Epilepsy: A Controlled Outcome Study , 2001, Epilepsia.

[36]  John G. Cull,et al.  REWARD DEFICIENCY SYNDROME , 1996 .

[37]  D. V. Nelson,et al.  Treatment of fibromyalgia incorporating EEG-Driven stimulation: a clinical outcomes study. , 2001, Journal of clinical psychology.

[38]  E. John,et al.  Persistent QEEG Abnormality in Crack Cocaine Users at 6 Months of Drug Abstinence , 1998, Neuropsychopharmacology.

[39]  J. Kropotov,et al.  Changes in EEG Spectrograms, Event-Related Potentials and Event-Related Desynchronization Induced by Relative Beta Training in ADHD Children , 2007 .

[40]  E. Peniston,et al.  Alpha-theta brainwave training and beta-endorphin levels in alcoholics. , 1989, Alcoholism, clinical and experimental research.

[41]  D. Epstein,et al.  Heroin and cocaine craving and use during treatment: measurement validation and potential relationships. , 2006, Journal of substance abuse treatment.

[42]  Frank Masterpasqua,et al.  Neurofeedback in Psychological Practice. , 2003 .

[43]  O. Gureje,et al.  The GHQ-12 as a screening tool in a primary care setting , 1990, Social Psychiatry and Psychiatric Epidemiology.

[44]  E. Dale Walters,et al.  Alterations in EEG amplitude, personality factors, and brain electrical mapping after alpha-theta brainwave training: a controlled case study of an alcoholic in recovery. , 1992, Alcoholism, clinical and experimental research.

[45]  A. Lobo,et al.  Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population , 1986, Psychological Medicine.

[46]  E. Butelman,et al.  Genetic influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction , 2005, Nature Neuroscience.

[47]  N. Volkow,et al.  The addicted human brain: insights from imaging studies. , 2003, The Journal of clinical investigation.

[48]  E. Peniston,et al.  Alpha-Theta Brainwave Neuro-Feedback for Vietnam Veterans with Combat­ Related Post-Traumatic Stress Disorder , 1991 .

[49]  Manuel Schabus,et al.  Increasing Individual Upper Alpha Power by Neurofeedback Improves Cognitive Performance in Human Subjects , 2005, Applied psychophysiology and biofeedback.

[50]  G. Badger,et al.  Outpatient behavioral treatment for cocaine dependence: One-year outcome. , 1995 .

[51]  A. Leuchter,et al.  Quantitative EEG abnormalities in recently abstinent methamphetamine dependent individuals , 2003, Clinical Neurophysiology.

[52]  G. Chiara Drug addiction as dopamine-dependent associative learning disorder , 1999 .

[53]  J. Marsden,et al.  Factors associated with abstinence, lapse or relapse to heroin use after residential treatment: protective effect of coping responses. , 2002, Addiction.

[54]  T. Egner,et al.  The effect of training distinct neurofeedback protocols on aspects of cognitive performance. , 2003, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[55]  C. O'brien,et al.  Cocaine dependence: a disease of the brain's reward centers. , 2001, Journal of substance abuse treatment.

[56]  J. Lubar,et al.  EEG Coherence Effects of Audio-Visual Stimulation (AVS) at Dominant and Twice Dominant Alpha Frequency , 2005 .

[57]  Rex L. Cannon,et al.  EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research , 2008, Applied psychophysiology and biofeedback.

[58]  C. G. Watson,et al.  Alpha wave biofeedback training therapy in alcoholics. , 1977, Journal of clinical psychology.

[59]  David M. Lovinger,et al.  It could be habit forming: drugs of abuse and striatal synaptic plasticity , 2003, Trends in Neurosciences.

[60]  N. Salansky,et al.  Responses of the Nervous System to Low Frequency Stimulation and EEG Rhythms: Clinical Implications , 1998, Neuroscience & Biobehavioral Reviews.

[61]  Werner Lutzenberger,et al.  Neurofeedback Treatment for Attention-Deficit/Hyperactivity Disorder in Children: A Comparison with Methylphenidate , 2003, Applied psychophysiology and biofeedback.

[62]  J. Johnstone,et al.  Neurofeedback and the Brain , 2005 .

[63]  N. Birbaumer,et al.  Self-regulation of slow cortical potentials in psychiatric patients: Depression , 1992, Biofeedback and self-regulation.

[64]  P. Rabins,et al.  Emotional disturbance in multiple sclerosis patients: validity of the General Health Questionnaire (GHQ) , 1981, Psychological Medicine.

[65]  Poster Presentation Abstracts , 2004 .

[66]  A. Ardila,et al.  Neuropsychological deficits in chronic cocaine abusers. , 1991, The International journal of neuroscience.

[67]  Eugenia Bodenhamer-Davis,et al.  Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience Long-Term Follow-Up of a Clinical Replication of the Peniston Protocol for Chemical Dependency , 2016 .

[68]  David L Trudeau,et al.  Applicability of brain wave biofeedback to substance use disorder in adolescents. , 2005, Child and adolescent psychiatric clinics of North America.

[69]  D. Goldberg The detection of psychiatric illness by questionnaire : a technique for the identification and assessment of non-psychotic psychiatric illness , 1972 .

[70]  Tobias Egner,et al.  EEG Signature and Phenomenology of Alpha/theta Neurofeedback Training Versus Mock Feedback , 2002, Applied psychophysiology and biofeedback.

[71]  Cocaine dependence , 1988 .