Companies tout tech to curb addiction, pain; critics cite risks

(From left) Ryan Lakin of Chicago health care company Abbott,
Matthew Thomas of international medical device maker Medtronic, Dr. David Caraway, MD, of California medical device maker Nevro, and Rafael Carbunaru of Massachusetts medical device maker Boston Scientific spoke at a panel discussion at CES on Tuesday about neuromodulation. Panel moderator Steven Falowski, MD, is not pictured. (Matthew Niksa/Boston University News Service)

By Matt Niksa
BU News Service

Representatives from medical device and health care companies led a panel discussion at CES on Tuesday about neuromodulation, the direct stimulation of the nervous system with electrical signals to help wean opioid addicts off of the drugs or prevent them from becoming addicted in the first place.

Dr. David Caraway, chief medical officer of Nevro, a medical device company headquartered in California, said Tuesday that neuromodulation can help people who are vulnerable to becoming addicted to heroin and fentanyl, which he said now causes most opioid-related deaths.

“What we’re offering is a therapy that can get people on opioids off of their opioids or reduce their dosage to safer levels,” Caraway said. “There is good data associated with that (neuromodulation) that say we can get their pain markedly reduced.”

However, critics say that while such devices have helped some patients, others have been injured by them. An investigation by the Associated Press published last year noted that patients have reported being shocked by the devices and some have suffered nerve damage and muscle weakness.

Ryan Lakin, divisional vice president of research and development for Abbott, a health care company, said while neuromodulation is still a relatively new form of treatment, its impact on treating people suffering from chronic pain is significant.

“There are three clinical trials that have been published, two by Abbott and one by Nevro, that shows neuromodulation fundamentally changes the communication pathway of pain, so, therefore, people no longer get the sense of pain, which enables them to no longer need opioids,” said Lakin.

Boston Scientific’s Vercise pulse generator is implanted into a person’s clavicle and runs an electric current through an attached wire into a specific nucleus in a person’s brain. It is used to provide therapy for patients with Parkinson’s disease. (Matthew Niksa/BU News Service).

Around 68 percent of the more than 70,200 drug overdose deaths in 2017 involved an opioid, according to Centers for Disease Control and Prevention data. On average, 130 Americans die every day from an opioid overdose.

Massachusetts medical device maker Boston Scientific produces spinal cord stimulation systems, which aim to prevent pain signals from reaching the brain, and last year began offering a treatment system that combines multiple forms of spinal cord stimulation therapy to better address each patient’s pain relief needs.

The company claims that the results of th new treatment have so far been successful; 87 percent of patients who entered into the treatment reported getting better than 50 percent pain relief at their most recent follow-up appointment, and 22 percent of these patients reported feeling no more pain at their most recent follow-up, according to Rafael Carbunaru, vice president of research and development for Boston Scientific.

Even though the results of their neuromodulation treatments have exceeded expectations, Carbunaru said there is a lack of awareness of the availability of this type of therapy for opioid addicts and the 100 million U.S. adults who suffer from chronic pain.

“To me it’s incredible when you hear about the people who suffer from chronic pain in the U.S. and you see, between the different companies that provide medical devices, only 60,000 (neuromodulation) implants a year,” Carbunaru said. “The neuromodulation field is growing significantly because of the great outcomes we’re getting and the great need for patients to receive this therapy.”

“The main causes of long-term disabilities tend to be neurological conditions, such as stroke, dementia, migraines and depression. I think we are going to be able to develop better and better neuromodulation therapies that are going to help these patients,” Carbunaru said.

Despite the optimism of the device manufacturers, the treatment is not without risks. The AP’s investigation of the industry shed light on injuries as well as documenting $22 million spent on lobbying by the top spinal cord stimulation manufacturers since 2017.

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