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Opioids, a class of pain-relieving drugs, can refer to:

  • opiates like morphine and codeine (from opioid poppies)
  • synthetic opioids like tramadol and fentanyl (made in labs)
  • Synthetic opioids are similar to natural opioids.

These drugs act on your brain to make you feel sleepy. They can provide short-term relief from pain.

Your body has grown used to opioids, which means you have a higher chance of physical dependence. If you use a lot of opioids, you can progress to a mental health problem called Opioid Use Disorders.

In the case of both physical dependence and OUD, cutting back or stopping opioid use can cause withdrawal symptoms.

The most severe symptoms are usually the first 5 days after you stop using drugs. They usually improve after a week.

Severe withdrawal symptoms can make it difficult to abstain, and many people begin using opioids again to get relief. But the NSS-2 Bridge, an electrical nerve stimulator device recently approved by the Food and Drug Administration (FDA) shows promise as a way to help ease uncomfortable withdrawal symptoms during that initial stage.

This device may be an important part of OUD recovery and what to know about it.

The battery-powered chip in the bridge sends gentle electrical impulses that can be used to help with memory. The nerves are connected to other parts of the body.

Research suggests people who use opioids experience a loss of neural connections in the amygdala — a part of the brain involved in the emotional aspects of pain processing. Impulses from the NSS-2 Bridge target this region.

According to Shoshana Church, a certified physician assistant at RecoverUs, stimulating these cranial nerves can block pain signals coming into the brain and reduce withdrawal symptoms.

This process, called neurostimulation, is believed to help the brain and body adjust to the absence of opioids during the first 5 days of tapering off and withdrawal, according to Jacob Hascalovici, MD, Chief Medical Officer of Clearing.

Neurological stimulation is used to treat a variety of painful spine conditions, movement disorders, and other medical conditions.

How to use it

You’ll place the NSS-2 Bridge, which resembles a large hearing aid, behind your ear and anchor it with double-sided tape. Three electrodes connected to the device attach on and near your ear.

You can use this device for up to 5 days during the initial phase of treatment. After that, your body will typically be clear of opioids, and the worst of the withdrawal symptoms will have passed.

The NSS-2 Bridge may reduce many of the symptoms of opiate withdrawal.

The opioid agonist methadone also treats acute symptoms of opioid withdrawal.

Buprenorphine, a similar medication used to treat OUD, can also help shorten the duration and lessen the severity of withdrawal symptoms. But you can only begin taking this medication 6 to 72 hours after your last dose of opioids, depending on the type of opioids used.

“The NSS-2 Bridge treats withdrawal symptoms continuously from the beginning of treatment. You don’t need to take a daily dose of medication.”

It can be difficult to make it through the first 5 days after quitting opiate drugs, when the symptoms of withdrawal can be more severe. It is possible that this device will help people during the transition period.

“This device is non-invasive and can be used at home. If you can’t participate in an in-patient treatment program, it may be an ideal solution.”

“I think it will be particularly helpful for people in the early phase who have not yet gotten access to medication to assist with their withdrawal,” says Laura Purdy, MD, a board certified family medicine physician and National Medical Director for Rise Medical. “It’s also a great option for people who may be sensitive to medication-assisted therapy.”

This device may work well for people who need help transitioning into long-acting monthly naltrexone injections, says Christopher Johnston, MD, Chief Medical Officer at Pinnacle Treatment Centers.

“You can’t start taking naltrexone for at least 7 days after your last dose of opioids. The NSS-2 Bridge could help lower the rates of relapse during the withdrawal period since it is incredibly difficult to go through opiate withdrawal without any treatment.”

Hascalovici says that experts are exploring the benefits of the bridge, such as its ability to relieve pain after surgery.

Does it work for everyone?

Hascalovici thinks that this device may not be a good fit for people.

Also, Johnston notes that people in recovery from alcohol use or sedative use may need an alternative treatment to prevent seizures and delirium tremens.

The FDA’s approval of the NSS-2 Bridge was based on a small 2017 study of 73 people, who all used the device as part of treatment for moderate opioid withdrawal.

Researchers measured participants withdrawal symptoms using a scale that ranged from mild to severe before attaching the device. They measured the symptoms again and again. The results were reported according to them.

  • The severity of symptoms dropped in the first 20 minutes.
  • Symptom severity decreased by 85% by the 60-minute mark.
  • The first dose of maintenance medication was given to 89% of participants.

According to a 2020 review, electrical stimulation — like the kind provided by the NSS-2 Bridge — can effectively help treat opioid withdrawal symptoms along with medication, with a low risk of side effects.

It’s worth noting that researchers have yet to conduct any randomized controlled trials where participants receive either the actual NSS-2 Bridge or a fake device that does nothing. These studies are less likely to produce a placebo effect.

Hascalovici says it is a low risk device, and that there are promising results from previous studies.

Benefits for postsurgery pain

The NSS-2 Bridge may be an alternative to opioids for dealing with post surgery pain.

A small 2021 study found that people who used the NSS-2 Bridge after kidney donor surgery experienced a 73.3% reduction in pain after 48 hours. They also needed 75.4% less opioid medication following surgery, compared to those in the control group.

In another small 2021 study, people who used the NSS-2 Bridge after gastric bypass surgery experienced a 28% reduction in pain after 24 hours. They took 60.2% less opioid pain medication than those who didn’t use the device.

Hascalovici recommends talking with your doctor or another healthcare professional if you are interested in trying the NSS-2 Bridge to manage opiate withdrawal symptoms. They can prescribe it or help you find a local clinic that offers it.

“The bridge costs $600. Church says that most insurance plans don’t cover it. If research continues to show the benefits of this device, that may change.”

Some clinics may offer payment plans or sliding-scale costs based on your income.

You may be able to use the bridge with other treatments for opiate withdrawal. Other treatment options include:

  • buprenorphine can be taken via oral medication or injection.
  • It is a drug called methadone.
  • over-the-counter (OTC) pain relievers, like acetaminophen or ibuprofen
  • OTC anti-nausea medications, like hydroxyzine

Combining treatments may provide more powerful relief from withdrawal symptoms. You can only take buprenorphine after the effects wear off.

The withdrawal phase of recovery from opiate use can cause a number of health problems. It can be difficult to stop using opioids if you have these symptoms.

The FDA-approved NSS-2 Bridge can block pain signals by stimulating certain brain areas, which may help ease the early withdrawal symptoms.

There is limited research on this device, but it is believed to be able to treat opiate withdrawal symptoms. Future randomized control trials may add more support for its effectiveness and accessibility.

Rebecca Strong is a Boston-based writer who writes about health and fitness, food, lifestyle, and beauty. Her work has appeared in a number of publications.