Ethical, social and clinical challenges in using Deep Brain Stimulation to treat addiction and other impulsive and compulsive disorders

Addiction to alcohol, tobacco and other drugs, and other compulsive disorders, such as pathological gambling and overeating, are major causes of preventable disease burden globally. Addictions also cause significant personal distress to individuals and their loved ones. Effective long-term treatments for most addictions remain elusive, with the possible exception of substituting a drug of addiction with a similar less harmful drug (e.g. methadone for heroin addiction). Growing interest in the neurobiological mechanisms of addiction, and the successful application of deep brain stimulation (DBS) for neurological disorders, such as Parkinson?s disease and dystonia, as well as some psychiatric disorders (e.g. depression), has led to calls for trials of DBS to treat addictive and compulsive disorders