Could Focused Ultrasound Help Treat Substance Use Disorder? What Researchers Are Learning

For people living with substance use disorder, finding an effective treatment can take time.

Medications, counseling and behavioral therapies can help many people. But substance use disorder affects everyone differently, and not every treatment works the same way for every person. For some people, effective treatment options remain limited.

Researchers at UVA Health are exploring whether a technology that uses precisely targeted sound waves could eventually give these patients another option.

The approach is called low-intensity focused ultrasound, a form of neuromodulation that researchers are studying for its potential to influence brain circuits involved in reward, motivation and substance use.

The research is still in its early stages. Focused ultrasound is not currently an established treatment for substance use disorder, and more clinical trials are needed to determine whether it is safe and effective and which patients might benefit most.

“The long-term goal is to make this treatment scalable, so that FUS can be accessible to patients in need, and be used alongside the available treatments, such as medication and counseling,” says James Mahoney, PhD, a clinical neuropsychologist and Director of the Center for Neuromodulation Research at UVA Health.

How Could Focused Ultrasound Change the Brain?

With that future in mind, researchers are studying how focused ultrasound might influence the brain’s reward circuitry — and whether those changes could ultimately help people stop using drugs entirely.

How Could Sound Waves Help?

Focused ultrasound may sound futuristic, but ultrasound is already widely used in medicine. UVA Health has been a pioneer in using high-intensity focused ultrasound to treat movement disorders such as essential tremor and Parkinson’s disease. With high-intensity focused ultrasound, heat is used to precisely remove the area of the brain causing the tremor, while leaving the other healthy areas of the brain unaffected.

The approach being studied for substance use disorder is different. Low-intensity focused ultrasound does not involve heating or removing, but rather uses the soundwaves to “reset” areas of the brain which have been affected by substance use.

What Part of the Brain Are Researchers Targeting?

During the trials, researchers will target the nucleus accumbens, an important part of the brain’s reward circuitry.

Researchers want to see whether gently using soundwaves in this area can help shift patterns of activity associated with substance use while allowing people to continue experiencing the everyday rewards and enjoyment that are part of a healthy life.

That distinction is important. The brain’s reward system helps us respond to many things — from food and exercise to relationships and other experiences that bring meaning and enjoyment to our lives. In preliminary research, targeting the nucleus accumbens did not interfere with experiencing these normal rewards. In fact, these natural rewards appeared to increase.

Researchers are continuing to study whether this approach can help reduce problematic substance use without disrupting everyday rewards.

The Goal Is More Than Fewer Cravings

Cravings are an important part of substance use disorder, but researchers are looking beyond whether a treatment simply makes cravings less intense.

The broader goal is to help people regain functioning, improve their well-being and return to the parts of life that matter to them. Reducing or eliminating substance use is an important part of that goal.

“We work closely with patients in the trials, and seeing the actual change in a patient even after just one treatment is amazing,” says Daisy Thompson-Lake, PhD, Associate Director of the Center for Neuromodulation Research.

Individual experiences can be encouraging, but clinical trials are needed to determine whether a treatment is safe and effective for a broader group of patients.

Could It Offer Another Option for People Who Need One?

Substance use disorder doesn’t look the same for everyone. Some people use more than one substance, and treatment needs can change over time. For some people, the medications and other treatments currently available may not be enough.

“Neuromodulation provides another treatment option for those who don’t have success with the standard of care, especially for those with stimulant use disorder, which doesn’t currently have any medication treatments available,” says Mahoney.

Researchers are looking for additional ways to help. Behavioral therapies and other forms of support can be important parts of treatment, and researchers are studying whether neuromodulation could eventually offer another tool to use alongside them.

Where Does the Research Go from Here?

At UVA Health, the Center for Neuromodulation Research is building a broader research program around noninvasive approaches to treating conditions that affect the brain and nervous system. Focused ultrasound studies are projected to begin in 2027, but the Center is already recruiting for other studies, including vagus nerve stimulation.

In this study, participants wear a small device on their ear every day for one hour that stimulates a nerve going into the brain. “Vagus nerve stimulation has already helped thousands of people with depression and improves sleep,” says Thompson-Lake, “We hope that we will see these effects in substance use disorder too. If we can improve depression and sleep, people will be able to focus on more their recovery and rebuilding their lives.”

There is still much to learn about whether focused ultrasound can meaningfully change the patterns of brain activity involved in substance use. But if researchers can find a way to do that while preserving the everyday rewards that make life worth living, it could open a new chapter in how substance use disorder is treated.

“We started with substance use disorder, but our ambition is much larger,” says Thompson-Lake. “We want to bring the same rigorous science to other psychiatric conditions where people are too often left without options that work.”

Interested in participating in research? Complete the screening survey to learn whether you may qualify for UVA Health's vagus nerve stimulation study. Learn more about the Center for Neuromodulation Research at UVA.