Using TMS to Break Free of Substance Addiction

Transcranial magnetic stimulation (TMS) does not use medication. No new substances are added to your body. TMS has very few side effects, just mild headache and slight tiredness. TMS is approved by the FDA to treat nicotine addiction. There are also many medical studies showing TMS to be effective in treating other forms of substance addiction, though these uses are still considered “off-label” by the FDA.

Symptoms

Substance addiction is the persistent, excessive use of a substance, such as nicotine, alcohol, or prescription or illicit drugs, to achieve a desired physical or emotional effect . It becomes a diagnosable psychological disorder when it is an overall detriment to an individual’s health, causes distress, or is disruptive to everyday life.

Risk Behavior

Actively risking health in order to participate in drugs.

Behavior Changes

Stealing, lying and doing whatever it takes to use the substance.

Failure to Stop

The inability to change your behavior, despite trying multiple times.

Inability to regulate Dosage

Taking more of the substance than you originally intended.

Regular Urges

Feeling as if you have to indulge in the substance multiple times a day.

How we are treating
depression with TMS?

Step 1

Contact us and provide your history of substance addiction and any other coexisting illnesses, including your treatment history. We will interview you at no cost and help you obtain health insurance approval if possible. Unfortunately, TMS treatment for addictions other than nicotine is currently classified as “off-label.”

Step 2

Come to our clinic for about 15 minutes, five times per week, for six weeks. Your treatment will only take about three minutes of your visit, and once it’s finished, you can return immediately to work or family life. No medication is used.

Step 3

Participate in our life skills classes, acupuncture or acupressure, and our biofeedback program sessions at no added cost. TMS works best as part of a comprehensive care package. Weekly psychotherapy with your own therapist is also strongly encouraged and typically leads to better outcomes.

Our experts

Doctor Profile
John l Fleming, MD. DLFAPA.

Medical Director of SCTMSC, LLC, John is a Board Certified Psychiatrist and a Distinguished Life Fellow of the American Psychiatric Association. He has over 40 years’ experience treating depression and related conditions and is recognized as a leader in the psychiatric profession. Since 2011 he has been a certified Provider Trainer and TMS provider for three different TMS treatment systems. His experience base includes psychopharmacology of complex conditions. psychotherapy of individuals and couples and the medical aspects of psychiatric illness. He has annually been selected by his peers as one of America’s Best Doctors since 2005.

Melissa Hammock, M.A., M.Ed., LMFT

Services Director of SCTMSC, LLC, Melissa received her master’s degree in Marriage and Family Therapy from Azusa Pacific University and her master’s in special education from California State University, Los Angeles. Melissa is a Certified Life Coach and a member of the International Positive Psychology Association. Melissa is also a Certified TMS Provider.

Melissa has been in private practice in Colorado Springs since 1981, working with adults, adolescents, and couples. Melissa specializes in the treatment of depression, anxiety, ADHD, and trauma-based disorders. She has received training in EMDR, Cognitive Therapy, Family Systems Therapy, Energy Therapies, Interpersonal Therapy and Accudetox. Melissa is a Licensed Marriage and Family Therapist. She has been involved with TMS treatment since 2011.

Joe Hammock, M.A., PhD, Licensed Clinical Psychologist

Clinical Director of SCTMSC, LLC and Certified TMS Provider since 2011, Joe is a licensed psychologist and member of the American Psychological Association. He is a graduate of Fuller Graduate School of Psychology, and additionally holds an MA from Fuller Theological Seminary. He is certified by the International EMDR Association and is a Certified TMS Provider.In his thirty years of practice in Colorado, he has specialized in the treatment of trauma-based disorders, depression, anxiety disorders, and dissociative disorders. He also has extensive experience in psychological evaluations, CBT, EMDR, forensic psychology, and is frequently consulted as an expert witness.

FAQ

Human beings take substances all the time to alter how they feel. Caffeine is  a common, relatively low-impact example. Depending on the substance and its ability to bind with certain receptors in the brain, this use can set up a cycle of reward, craving, and repeat use. This is not the fault of the person affected; it’s basic biology. 

For some substances, the cycle of addiction emerges after just a few exposures to a potent substance that impacts the brain. One example is opiate addiction, which can begin during legitimate medical treatment. Withdrawal from opiate treatment can trigger the onset of depression, causing the patient to seek out further medication to stave off symptoms. Other individuals turn to substances to “self-medicate” or relieve the pain of already existing depression, anxiety, trauma, PTSD, or other illnesses. Sadly, while the substance may provide some temporary relief or distraction during intoxication, addictive behaviors will ultimately worsen rather than help the underlying condition. This can lead to an increased desire for relief, leading to more intoxication. This is the addictive cycle.

When a substance is used regularly, it provokes changes in areas of the brain that control thinking, judgement, learning, and mood. These changes are long-lasting and extend well beyond the period of intoxication. Over time, the substance use leads to growing impairment in four areas: 

  1. Decreased self-control over the use of the substance, accompanied by frequent or constant thoughts about using again, often referred to as cravings.
  2. Social problems caused by substance use, including inability to complete tasks at work or school, inability to be emotionally available in personal relationships, and cutting back on activities and relationships that are not part of substance use.
  3. Denial, or disregard of the harm and risks associated with continued use.l
  4. Increased use motivated by withdrawal avoidance and/or increased tolerance (needing more of the substance to achieve the same effect).

TMS is never the primary or only treatment used for these conditions. However, TMS can play a very important role in helping the individual establish and maintain sobriety.

TMS targets the cravings that make sobriety so challenging, and can also treat associated conditions, including depression, anxiety and PTSD, which either trigger the use of substances or have come about as a result of substance abuse. Experts agree that adequate treatment of these mood conditions is necessary for success in overcoming addiction.

TMS has been studied in the treatment of nicotine, alcohol, cocaine, and methamphetamine addiction. The evidence shows that between 15 and 20 treatments of TMS can reduce cravings for up to six months. Accelerated TMS (aTMS) shows an even greater impact on craving than standard TMS. During aTMS treatment, TMS is administered multiple times over the course of the day, instead of once per day. In the majority of studies, addiction patients treated with aTMS self-reported reduced craving intensity, reduced substance use, and increased life satisfaction and stability, compared with their usual substance abuse treatment.

TMS treatments vary by the frequency of the magnetic pulses, the region of the brain that is targeted, and a number of other factors. Research is ongoing to determine the best protocols for TMS addiction treatment. It may be that, over time, different protocols will emerge for treating different types of substances. One of the most recent surveys of TMS research examined 218 published studies and selected 50 of these as high-quality studies. The majority of these high-quality studies used the standard treatments and the standard targeting of the dorsolateral prefrontal cortex (DLPFC) that are used when treating depression. Another recent review looked at 618 published articles and found 18 to be of high quality. Both reviews found evidence that TMS can be helpful in treating addiction. 

The safety profile of TMS is equally excellent whether it is used in the treatment of addiction or depression. However, it is important to understand that people who receive treatment while intoxicated or suffering from withdrawals may have an increased risk of seizure. Active substance use during a course of TMS treatment may also lower its overall effectiveness. It is critical that there be clear and accurate communication between the TMS team and the patient regarding the extent of recent and current usage. 

Although the idea remains controversial outside of medical circles, from a neuropsychological perspective, addiction to certain non-drug-use behaviors appears to be the same as other addictions. Problematic gambling, sexual behavior, internet use, food consumption, and food restriction all can be looked at as types of addiction. Significant medical research supports this view. TMS has been studied as a treatment for each of the above addictions and has shown promise in some cases. Other studies showed no impact. It may be that TMS helps relieve these addictions in certain individuals by treating underlying conditions that contribute to them. Since depression, if present, often makes managing addiction more difficult, adequate treatment of depression is strongly recommended for any individual struggling with addiction. 

Health insurance coverage is typically available only for FDA approved indications. For TMS, this currently includes depression, OCD, and nicotine addiction. Not all plans of insurance recognize these FDA cleared indications, however, and some deny coverage. Federal appeals courts have determined that insurance companies are violating the law when they set up their own standards (separate from FDA approval or professional medical society standards) to limit approval for TMS. Despite these clear legal rulings, it sometimes takes considerable effort to obtain Prior Authorization for TMS treatment. We are willing to work with prospective patients to gain necessary authorization. 

If a patient’s history clearly establishes that depression was present before substance use began or became a problem, it is sometimes possible to obtain insurance company approval for treatment under the depression standards. Other companies try to use their own standards to deny TMS coverage if there is a history of substance use. 

We do offer both “on-label” and “off-label” TMS treatments, as well as both insurance-covered and non-insurance-covered treatments. If we can’t help you obtain insurance coverage, we’ll work with you to arrange for self-pay TMS treatment. We’re also constantly following the latest research and will keep you up to date on any new medical findings relevant to your substance use treatment options.

Mental Health Assessment

Do you believe that you suffer from depression or anxiety? Check out our online assessments for a quick online self-assessment to see if you suffer from a mental health related issue and to see if you qualify for treatment with TMS.

What the Patients Think

Cindy – 22

The Southern Colorado TMS Center is truly the most caring, compassionate mental health facility I have ever known. You always hear stories about why people have gone into the mental health field, but these folks truly live it. Everyone who works for SCTMSC (and I mean everyone), exudes warmth and empathy. They walk the walk. One of my family members utilized several of their services, and I got to witness firsthand how they deal with patients. I would highly recommend them to anyone suffering from depression, because they not only offer treatments but expect patients to participate fully in their recovery.

Pam – 25

Dear TMS staff, I want to express my thanks for all your sincere help while I went through a very difficult time. Every time I went to the center the staff was so kind and understanding. The educational classes in the evening were wonderful and I have learned so much about depression. I still look at the handouts you provided. I have gotten into meditation and continue to educate myself about depression and anxiety. If I watch “Friends” on the TV, I will always think of my experience at the Southern Colorado TMS Center!! Thank you for doing your job so well.

Barb – 46

All the staff at SCTMSC are very caring during all of the components of the TMS treatment. From dealing with insurance companies to adjusting one’s treatment time due to conflicts with your schedule; they are all wonderful. I would recommend TMS treatments to any person suffering MDD, as I have for many years. From my experience, TMS helped me far more than an anti-depression medication or CBT.

FB – 35

Dear TMS Team, I just wanted to say that 6 months after treatment, I am doing well. I have a new life and I am living it up. It is like being young again as I am finding my way again. I am so grateful to Dr. Fleming, Camice, Dawn and all the folks who helped me to get here! But especially to Dr Fleming.

Michelle – 37

Dear Dr. Hammock, I am so incredibly grateful and appreciative for all the time and attention you gave to my husband and me. Thank you, thank you for caring so much abut the individual person. I am also grateful that you took the time to help us separate out how we view ourselves in relation to our understanding of God’s love for us verses our symptoms of major depression; neither of us had realized or thought about that. That was incredibly insightful of you and so thoughtful of you to help us get to the root of it. Thank you for helping so many people. I can tell, that you and your team do a lot of good with very sincere hearts. It shines through unmistakably.

Drug free solutions for optimized brain function

Do you believe that you suffer from depression or anxiety? Check out our online assessments for a quick online self-assessment to see if you suffer from a mental health related issue and to see if you qualify for treatment with TMS.

Other Conditions

Depression in Adults

TMS treats depression without medication or medication side effects.

Depression in Adults

Many people suffer from depression. However, through the application of TMS they may find relief.

Post Partum
depression

Many mothers can suffer depression as a result of hormonal changes during or after pregnancy. TMS can help treat this type of depression effectively.

Post Partum
depression

TMS effectively treats depression during and after pregnancy, without the use of medication.

Depression in
Adolescents

TMS can effectively treat depression in teens.

Depression in
Adolescents

As a teen goes through difficult changes in their adolescent years, they can experience serious depression. TMS can help teens who suffer from depression.