A 40-year-old man in northern Israel went into a medical scanner one morning taking roughly 130 opioid pills a day and came out an hour later with no craving for them at all. The procedure itself lasted 20 minutes. No incision was made. No anesthesia was required. Nothing in his brain was cut or burned. His doctors used sound.
The patient, referred to publicly only as “H.,” had suffered a neck injury years earlier and was prescribed opioid painkillers to manage the pain. He was a family man in his forties from northern Israel who had relied on painkillers after his injury, and over time, even as the pain lessened, he couldn’t break free – his doses kept climbing until they peaked at around 130 pills a day, according to Dr. Amir Minerbi, director of the Pain Medicine Institute at Rambam Health Care Campus in Haifa, Israel. At that point, Minerbi noted, “he was no longer suffering from pain” – he simply needed the substance in his bloodstream to remain calm and function.
That distinction matters more than it might seem. Opioid dependence and opioid pain relief are two entirely different biological states, and by the time H. arrived at Rambam, his brain had reorganized itself around the drug. Standard medical withdrawal would have meant days of severe physical symptoms, powerful cravings, and a high probability of relapse. What the team at Rambam offered instead was something that had never been tried in Israel before, and had only a handful of precedents worldwide.
What Ultrasound Opioid Addiction Treatment Actually Involves
During the procedure, specialists at the Haifa medical center intervened in the electrical activity of an area of the patient’s brain called the nucleus accumbens – the core of the brain system responsible for feelings of satisfaction, pleasure, and reward. The nucleus accumbens is, in plain terms, the brain’s reward hub. A growing body of evidence shows that dysfunction of dopamine activity within the nucleus accumbens is a common factor in the abuse-related neurochemical and behavioral effects of most psychoactive drugs, including opioids. When opioids flood this region repeatedly, the brain stops generating its own sense of reward and starts demanding the drug to feel anything at all. That is the trap H. was in.
The treatment used a new technology that performs noninvasive neuromodulation – without heating or burning tissue – and allows stimulation in the same area of the brain to either increase or suppress activity. This is the key distinction between this experimental approach and older focused ultrasound procedures. Unlike conventional focused ultrasound procedures that rely on heat to destroy tissue, the new approach uses noninvasive neuromodulation to either increase or suppress brain activity in specific regions.
The technology comes from Insightec, an Israeli medical company whose Exablate Neuro device is already FDA-approved for neurological conditions. Using focused ultrasound waves, the Exablate Neuro platform has received FDA approval for medication-refractory essential tremor (first approved in 2016) and tremor-dominant Parkinson’s disease (approved in 2018), according to Insightec. For those conditions, the device uses heat to precisely ablate – destroy – a small area of malfunctioning brain tissue. The addiction application works differently: instead of destroying tissue, it modulates the electrical behavior of the target cells without causing any permanent structural damage.
Each participant in this treatment protocol received 20 minutes of low-intensity focused ultrasound neuromodulation applied simultaneously to both sides of the nucleus accumbens, performed with Insightec’s ExAblate Neuro Type 2 device under MRI guidance.
The Clinical Evidence Behind the Approach
The Rambam procedure didn’t emerge from nowhere. A prospective clinical trial investigating the effects of low-intensity focused ultrasound neuromodulation in participants with severe opioid use disorder was conducted at West Virginia University’s Rockefeller Neuroscience Institute between February and November 2023. The intervention significantly reduced substance cravings, and most participants did not use opioids or other substances during the 90-day follow-up period, according to results published in Biological Psychiatry in July 2025.
The first-of-its-kind treatment in Israel was performed at Rambam Health Care Campus as part of an international study being conducted at select U.S. medical centers – and now also at Rambam. Dr. Lior Lev-Tov, director of Rambam’s Functional Neurosurgery Unit and principal investigator of the study, said the patient’s craving for opioids declined during the procedure itself.
H. was also notable for another reason. The therapy remains experimental, and further clinical studies will be needed to establish its long-term safety and effectiveness across a broader patient population – but H. was the first participant worldwide to receive the focused ultrasound treatment while actively experiencing opioid withdrawal, adding an important new data point to the trial. The Exablate Neuro performs incisionless procedures guided by MR imaging, which means the entire intervention happens inside a scanner with no surgical entry into the skull at any point.
The results for H. held up beyond the treatment room. Follow-up testing confirmed what H. reported feeling: one week after the procedure, tests came back negative for opioids and other substances, and H. reported a craving score of zero out of ten.
Why Opioid Dependence Is So Hard to Break
Understanding why a 20-minute brain procedure could matter so much requires understanding just how thoroughly opioids reshape the brain’s wiring. The CDC reports that in 2023, nearly 8.6 million Americans aged 12 and older reported misusing prescription opioids in the past year. Among people being treated with opioids for chronic pain, estimates suggest that 3% to 12% will develop an opioid addiction, and about half of those who take opioids long-term meet the clinical criteria for opioid use disorder (a formal diagnosis capturing the full range of dependence and dysfunction that sustained opioid use can cause).
Withdrawal is one reason people stay stuck.opioid withdrawal symptoms typically peak 2 to 3 days after cessation and usually resolve within 5 to 7 days, according to Australian government health guidance – but for someone at H.’s level of consumption, those days represent an almost unbearable physiological crisis. The cravings alone can override rational decision-making.
Even when people do reach treatment, access is limited. Current pharmacological treatments, using methadone and buprenorphine, can cause adverse side effects, and patients often relapse, necessitating alternative treatment strategies. A 2024 study in JAMA found that in 2022, only 25.1% of U.S. adults with opioid use disorder received any medications for the condition – meaning nearly three quarters of people who needed pharmaceutical treatment never got it.
The broader overdose picture has improved somewhat. According to the American Medical Association’s 2025 report on substance use, overdose deaths declined from more than 110,000 in 2023 to about 75,000 in 2024. Opioid prescriptions have also dropped dramatically – falling 52% since 2012, from 260.5 million to 125.7 million in 2024. Preliminary CDC data project 69,147 drug overdose deaths for the 12 months ending January 2026, a 13.2% decline. Progress is real, but the scale of the problem – and the inadequacy of existing treatments for those already dependent – is what makes a 20-minute, non-damaging brain intervention so significant as a research direction.
What Comes Next for This Technology
Dr. Lev-Tov has stated that Rambam has become a leading center in focused ultrasound research and intends to expand access to the treatment as evidence accumulates. The research team also has its eye on conditions well beyond addiction. Researchers hope the technology could eventually be applied to cognitive areas of the brain to help treat attention deficit disorders, Alzheimer’s, and Parkinson’s disease – an ambition grounded in the fact that the same Insightec platform already has a regulatory track record in Parkinson’s tremor treatment.
Where the beams converge, focused ultrasound can produce neuromodulation, which alters the nervous activity of the target cells in ways that may decrease craving for the substance being sought, according to the Focused Ultrasound Foundation. The foundation currently lists multiple active clinical trials targeting different aspects of addiction, including separate studies at the U.S. Department of Veterans Affairs and Virginia Polytechnic Institute. The breadth of that research activity suggests focused ultrasound for addiction is no longer a single-lab curiosity – it’s becoming a legitimate field.
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What This Means for You
The case of H. is a single patient in an early-stage international trial, not a proven, scalable cure. Clinical researchers are careful to say that much larger, controlled studies will be required before focused ultrasound could become a standard treatment option for opioid dependence. Long-term follow-up data – beyond months – does not yet exist. The procedure also requires an MRI facility, specialized equipment, and trained neurosurgeons, which means it won’t be available at a neighborhood clinic anytime soon.
What the Rambam result does confirm is that the nucleus accumbens can be targeted safely with focused sound waves in a way that interrupts active craving – even during acute withdrawal – without cutting, burning, or permanently altering brain tissue. For patients like H., who have tried and failed conventional approaches, that proof of concept is medically meaningful. If you or someone you know is managing opioid use disorder, the most immediately actionable step remains asking a physician specifically about medication-assisted treatment options: buprenorphine and methadone remain the most evidence-backed tools currently available, even as the next generation of therapies catches up.
Disclaimer: The author is not a licensed medical professional. The information provided is for general informational and educational purposes only and is based on research from publicly available, reputable sources. It is not intended to constitute, and should not be relied upon as, medical advice, diagnosis, or treatment. Always consult a licensed physician or other qualified healthcare provider regarding any medical condition, symptoms, or medications. Do not disregard, avoid, or delay seeking professional medical advice or treatment because of information contained herein.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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