Rear view of person with shaved head holding hands up against ears 2Share on Pinterest
Ildar Abulkhanov/Getty Images

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)
  • semi-synthetic opioids, like oxycodone, heroin, and hydrocodone (synthesized from natural opioids)

These drugs act on your brain to produce temporary feelings of euphoria, numbness, and drowsiness. They can also provide short-term relief from pain or anxiety.

Even short-term opioid use can increase your chances of physical dependence, which means your body has grown used to opioids. If you use opioids in large amounts, over a long period of time, physical dependence can progress to opioid use disorder (OUD).

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

These symptoms are usually most severe in the first 5 days after you stop using opioids. After a week, they usually begin to improve.

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.

Here’s how this device may play an important role in OUD recovery and what to know about accessing it.

The NSS-2 Bridge contains a battery-powered chip, which sends gentle electrical impulses that stimulate certain nerves in the brain. These nerves are connected to many other areas 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.

“Neurostimulation/modulation is far from new science and is used to treat a variety of painful spine conditions, movement disorders, and other medical conditions,” Hascalovici says.

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.

According to Hascalovici, the neurostimulation provided by the NSS-2 Bridge may reduce many opioid withdrawal symptoms, including:

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, on the other hand, treats withdrawal symptoms continuously, from the beginning of treatment, for 5 full days. In short, you don’t need to take a daily dose of medication.

“It can be especially challenging to make it through the first 5 days after quitting opioids when the symptoms of withdrawal can be at their most severe,” says Hascalovici. “This device may help support people during that challenging transition period, making it more likely they will succeed.”

Not only is this device noninvasive but you can also use it at home. So, it may offer an ideal solution if you can’t participate in an inpatient treatment program.

“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 begin taking naltrexone for at least 7 days after your last dose of opioids — including the opioid agonists buprenorphine and methadone. Since going through opioid withdrawal without any treatment can be incredibly difficult, the NSS-2 Bridge could go a long way toward helping lower rates of relapse during the withdrawal period.

Experts continue to explore other benefits of the NSS-2 Bridge, such as its potential to help relieve pain after surgery, adds Hascalovici.

Does it work for everyone?

According to Hascalovici, this device may not be a good fit for people with:

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, moderate, moderately severe, to severe — before they attached the device. They measured symptoms again 20, 30, and 60 minutes afterward. According to the results:

  • The severity of symptoms dropped approximately 63% within the first 20 minutes.
  • By the 60-minute mark, symptom severity had decreased by 85%.
  • 89% of participants also returned to the clinic days later to receive their first dose of maintenance medication.

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.

That said, Hascalovici says it’s considered a low risk device, and existing studies have shown promising results.

Benefits for postsurgery pain

More recent research suggests the NSS-2 Bridge may offer an alternative to opioids for coping with postsurgery 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.

Was this helpful?

If you’re interested in trying the NSS-2 Bridge to manage opioid withdrawal symptoms, Hascalovici recommends talking with your doctor or another healthcare professional. They may be able to prescribe this treatment or help you find a local clinic that offers it.

The NSS-2 Bridge costs $595. Currently, most insurance plans don’t cover it, according to Church. But that may change if research continues to highlight the benefits of this device.

Church also notes that some clinics may offer payment plans or sliding-scale costs based on your income.

You may be able to use the NSS-2 Bridge alongside other treatments for opioid withdrawal, according to Purdy. Other treatment options include:

  • buprenorphine, via oral medication or injection
  • methadone
  • over-the-counter (OTC) pain relievers, like acetaminophen or ibuprofen
  • OTC anti-nausea medications, like hydroxyzine

Combining treatments may provide even more powerful relief from withdrawal symptoms, says Purdy. Remember, you can only take buprenorphine after the opioid’s effects wear off.

The withdrawal phase of recovery from opioid use can cause a number of uncomfortable physical and mental health symptoms. These symptoms can make it harder to stop using opioids and complicate treatment.

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

Research on this device remains limited, but existing evidence does suggest it can treat opioid withdrawal symptoms. Future randomized control trials may add more support for its effectiveness and boost its accessibility, in turn.

Rebecca Strong is a Boston-based freelance writer covering health and wellness, fitness, food, lifestyle, and beauty. Her work has also appeared in Insider, Bustle, StyleCaster, Eat This Not That, AskMen, and Elite Daily.