Drug Addicts Swear by Brain Surgery

Originally published in The Moscow Times on March 18, 2000

ST. PETERSBURG — Sitting on the sofa, smiling and relaxed in her track suit and slippers, Yelena, 22, looks as if she is enjoying a holiday break. Only the snow-white bandage on her shaved head shows that this jovial economics major underwent a brain operation just two days earlier.

"There was no alternative," she said firmly. "It was that or the cemetery. ... Or an overdose."

Yelena had been shooting up half a gram of heroin every day since 1998.

Earlier this year, she and her husband, Igor, 20, both decided to go for a costly, relatively new type of surgery — a bilateral cryocingulotomy — at St. Petersburg's renowned Institute of the Human Brain in hopes of putting an end to their drug addiction.

Now Yelena has plenty of plans: After her one-month stay at the institute, she is set on finding a job, buying her parents a new apartment and going on vacation.

The operation - first performed in 1998 - aims to help people kick the habit by destroying a tiny part of the brain that researchers at the institute have identified as central to addiction.

Although this method is well established as a treatment for epilepsy, Parkinson's disease, brain tumors, depression and other ills, the Health Ministry's chief toxicologist, Alexander Karpov, stressed that - in terms of treating drug addiction - the operations are still at the highly experimental stage and official studies have yet to be conducted.

"You need a long trial period before you can draw conclusions. ... So it's too early to say how effective [the operation] can be."

The technical side of the procedure does indeed smack of science fiction: After a small hole has been drilled in the patient's skull under local anesthesia, a metal frame bearing a mobile "wand" is attached to the head. The tip of the wand, which has been immersed in carbon dioxide at a temperature of minus 70 degrees C, is passed through the hole to freeze the isolated area of the brain - located in the cingulum - with the help of computerized images.

"We look at what part of the brain is activated when you are craving something," explained the institute's director, Svyatoslav Medvedev. "And then we destroy that part by freezing it. The patient remembers what it's like to take drugs but he doesn't have the desire for it anymore."

Asked if she has felt any craving for heroin in the two days since her operation, Yelena's face goes blank: "No, nothing."

The institute, founded under the auspices of the Academy of Sciences in 1990, has a strict admissions policy. The patient must be at least 17 with a history of abusing hard drugs - such as heroin or other opiates - for at least three years and must display a real desire to be cured. Patients come from all over Russia and, also, from "good families," according to the institute's deputy director, Andrei Anichkov.

Twenty-year-old Sveta, one of the first drug users to have had the operation at the end of 1998, has faith in the cure.

"It was a total success," she said. "I haven't had any cravings since then. And it wasn't very painful. It couldn't have been worse than what I had gone through already."

Read the full text at The Moscow Times.