TMS for Addiction Recovery in Arizona

Content Medically Reviewed By: Dr. Robbie Westerman, DNP-PMHNP – Chief Medical Officer

Repetitive transcranial magnetic stimulation (rTMS) delivers repeated magnetic pulses according to a specific treatment protocol. In addiction research, scientists are studying how this form of brain stimulation may influence neural circuits involved in cognitive control, craving, reward, and responses to substance-related cues.

Key Brain Regions Studied in Addiction Recovery

Addiction research has examined several brain regions and neural circuits involved in reward, self-regulation, decision-making, and responses to substance-related cues.

Prefrontal Cortex & Dorsolateral Prefrontal Cortex (DLPFC): The prefrontal cortex, including the DLPFC, plays an important role in executive functions such as attention, decision-making, and cognitive control. Researchers are studying whether stimulating this region may influence craving and cognitive control in people with substance use disorders.

Anterior Cingulate Cortex & Insula: These regions are involved in attention, emotional processing, interoception, and responses to salient stimuli. Their role within the broader neural networks associated with addiction and craving is an area of ongoing research.

Reward Networks: Chronic substance use can alter brain systems involved in reward, motivation, and reinforcement. Researchers are investigating whether TMS can influence these networks and potentially reduce craving or substance use in certain populations.

FDA Clearance and TMS for Addiction

TMS is not broadly FDA-cleared for every form of addiction. The BrainsWay Deep TMS System received FDA clearance as an aid for short-term smoking cessation in adults. Applications involving alcohol, opioids, cocaine, and other substance use disorders remain under study and are not FDA-cleared for those indications. See the FDA’s official clearance documentation for more information.

While research into TMS for addiction continues to develop, it does not guarantee abstinence and should not replace evidence-based addiction treatment, behavioral therapy, medications when appropriate, or comprehensive recovery support.

TMS Is Not a Cure for Addiction

Addiction recovery usually requires more than one intervention. Transcranial magnetic stimulation may be considered as one component of a comprehensive treatment plan. TMS may be used alongside:

• Behavioral Therapy: Individual, group, and cognitive behavioral therapy (CBT).
• Medication-Assisted Treatment (MAT): FDA-approved medications may be used to treat alcohol use disorder or opioid use disorder when clinically appropriate.
• Medical & Psychiatric Care: Ongoing physician monitoring, psychiatric evaluation, and medication management when needed.
• Structured Levels of Care: Partial hospitalization programs (PHP) or intensive outpatient programs (IOP) may provide additional structure and support during recovery.
• Relapse Prevention & Support: Peer support groups, family therapy, and lifestyle planning can help reinforce long-term recovery.

TMS cannot manage acute withdrawal, teach coping strategies, repair relationships, or build a recovery support system on its own. When medical detox, counseling, or structured rehabilitation is necessary, TMS should enhance, not replace, those services.

TMS for Substance Use vs. a Co-Occurring Condition

There is an important clinical distinction between using TMS to address substance-related cravings and using it to treat a separately diagnosed mental health condition.

Many people in recovery also experience depression, anxiety, obsessive-compulsive disorder, trauma-related symptoms, or other mental health concerns. In some cases, TMS may have a clearer clinical rationale when the primary treatment target is a co-occurring mental health condition. The specific diagnosis can affect the treatment protocol, supporting evidence, eligibility criteria, and informed-consent process.

If you are navigating both mental health and addiction concerns, explore our condition-specific TMS approaches:

•  TMS Therapy for Depression
•  TMS Therapy for Anxiety
•  TMS Therapy for OCD

Coverage and eligibility for TMS vary based on the diagnosis, treatment criteria, insurance plan, and other individual factors.

Substance use disorders can alter brain circuits involved in reward learning, stress response, and impulse control. These changes can contribute to intense cravings, even when someone is strongly committed to recovery. Addiction is not a lack of willpower; biological, psychological, and environmental factors can all influence recovery.

Environmental triggers, such as a person, place, emotion, or situation associated with past substance use, can also contribute to sudden, cue-induced cravings.

TMS research examines whether magnetic stimulation may influence neural circuits involved in self-regulation, attention, and responses to substance-related cues.

Managing Cravings: Researchers are studying whether TMS may influence how the brain responds to substance-related triggers and support cognitive control during recovery.

While early research suggests TMS may influence craving and cue responses, modulating neural activity does not guarantee abstinence or eliminate relapse risk.

Clinical researchers have evaluated repetitive TMS (rTMS) and deep TMS in substance use disorders, including their potential effects on:

• Craving intensity
• Cigarette consumption
• Alcohol and stimulant use
• Treatment participation and cognitive control
• Co-occurring mood symptoms

Results vary based on the substance, device, stimulation target, treatment protocol, and participant population. Research has not established a single TMS approach that applies to every substance use disorder.

TMS for Smoking Cessation

The FDA has cleared the BrainsWay Deep TMS System as an aid for short-term smoking cessation in adults. This clearance applies to a specific device and treatment protocol. It does not mean that every TMS system has the same clearance or that TMS is broadly FDA-cleared for all substance use disorders.

TMS for Alcohol, Opioid, and Stimulant Use Disorders

Research on TMS for alcohol, opioid, cocaine, and methamphetamine use disorders remains ongoing. Some clinical studies and systematic reviews, such as a meta-analysis published in Addiction (PubMed), have reported reductions in craving or substance use in certain populations, while other findings have been limited or inconsistent.

Organizations like the National Institute on Drug Abuse (NIDA) are actively studying rTMS protocols for methamphetamine and cocaine use disorders. Researchers have not established a universal protocol for these conditions, and questions remain regarding the optimal stimulation target, session frequency, duration of benefit, and potential role of maintenance treatment.

You may consider an evaluation if you:

• Continue to experience cravings during treatment
• Have a co-occurring condition that may be appropriate for TMS
• Have struggled to tolerate certain medications
• Want to explore an additional non-invasive treatment option
• Have returned to substance use despite structured care
• Need coordinated addiction and psychiatric services

An evaluation does not guarantee that TMS will be recommended. Your care team will determine whether it is appropriate based on your medical history, current circumstances, treatment goals, and safety considerations.

Candidate & Safety Screening

Before starting treatment, our clinical team conducts a medical, psychiatric, and safety assessment. Factors such as certain implanted metal or electronic devices in or near the head, seizure risk, neurological conditions, current intoxication, or severe withdrawal may affect whether TMS is safe or appropriate.

Your evaluation may also consider your substance use history, previous treatment or detox, current medications, co-occurring mental health conditions, recovery environment, and participation in ongoing care.

When a Higher Level of Care May Be Needed

TMS does not treat acute withdrawal or provide continuous medical supervision. Medical detox, residential treatment, or another higher level of care may be necessary when there is severe withdrawal, significant medical instability, immediate safety concerns, or an unsafe recovery environment.

TMS is intended to complement appropriate addiction and mental health care, not replace the level of treatment needed to maintain your safety.

Safety is our primary clinical priority. Certain medical, neurological, or treatment-related factors may affect whether TMS is safe or appropriate for you.

Important screening considerations include:

Metal or Electronic Implants: Certain metal objects or implanted electronic devices in or around the head may make TMS unsafe. Our clinical team will review any implants, medical devices, or previous procedures before treatment.

Seizure Risk and Neurological Conditions: A history of seizures, certain neurological conditions, or other factors that may increase seizure risk will be considered during your evaluation.

Active Substance Use and Withdrawal: Active intoxication, significant withdrawal, polysubstance use, or severe sleep deprivation may affect treatment safety. You may need medical stabilization or another level of care before TMS can be considered.

Medications and Medical Stability: Certain medications, medical conditions, or recent changes to your treatment may affect seizure risk or overall safety.

Our clinical team completes an individualized safety assessment before recommending treatment. If TMS is not appropriate, we will help you identify a level of care or another form of support that may be better suited to your current needs.

TMS may complement, but should not replace, core addiction and mental health care. A comprehensive recovery plan may include medical and psychiatric care, structured outpatient treatment, behavioral therapy, medication when appropriate, family and peer support, and relapse-prevention planning.

Our broader substance abuse treatment services can provide additional medical, psychiatric, and therapeutic support as part of a comprehensive recovery plan.

Medication-Assisted Treatment (MAT) and TMS

FDA-approved medications remain an important part of treatment for certain substance use disorders. Depending on the condition and individual needs, care may include medications for opioid use disorder or alcohol use disorder. For opioid use disorder, FDA-approved medications include buprenorphine, methadone, and naltrexone, as detailed in SAMHSA guidance on medications for opioid use disorder.

General treatment guidance from the National Institute on Drug Abuse (NIDA) highlights that effective care often integrates medications, counseling, behavioral therapies, and ongoing medical support.

TMS should not replace medications when they are clinically appropriate. Decisions about medication treatment and TMS require separate clinical evaluations based on the person’s diagnosis, medical history, and treatment needs.

Therapy and Recovery Skills

TMS cannot teach the skills needed for long-term recovery. Behavioral therapy and structured treatment can help you:

• Identify and manage triggers
• Develop healthy coping strategies
• Improve emotional regulation
• Build a consistent recovery routine
• Strengthen support systems and relationships

When appropriate, TMS may be considered as an additional component of care while you actively participate in therapy and other recovery services.

We begin with an addiction and mental health assessment that reviews your substance use, current symptoms, treatment history, medications, and recovery goals. When substance use and psychiatric symptoms occur together, our outpatient mental health services may provide additional therapy, psychiatric care, medication management, and structured support.

Next, we complete a medical and safety screening that considers seizure risk, implants, neurological history, withdrawal status, recent substance use, and current medications.

If TMS is appropriate, we identify the specific condition or symptom being targeted. We clarify whether the proposed use is FDA-cleared, off-label, or investigational, and discuss alternatives, limitations, and realistic treatment goals.

During a TMS Treatment Session

• An electromagnetic coil is positioned against your scalp.
• You remain awake during treatment without anesthesia or sedation.
• You may hear clicking sounds and feel tapping or pulsing sensations during stimulation.
• Session length and treatment frequency depend on the device and specific protocol.

Throughout treatment, we monitor symptoms, substance use, mood, side effects, and treatment response to determine whether continuing TMS remains safe and appropriate.

Potential Benefits, Risks, and Realistic Expectations

Research has explored whether TMS may influence craving intensity, responses to substance-related cues, mood symptoms, or engagement in treatment. Potential benefits may be small, temporary, or absent depending on the individual and the treatment protocol.

Reduced cravings do not necessarily mean recovery or guarantee abstinence. TMS does not replace addiction treatment, counseling, withdrawal management, or ongoing recovery support.

TMS Safety, Side Effects, and Limitations

Common side effects may include temporary headache, scalp discomfort, tingling, facial muscle sensations, or sensitivity to treatment sounds. Rare but serious risks, including seizures, require appropriate clinical screening.

FDA clearance is device-specific and indication-specific. The BrainsWay Deep TMS System is cleared as an aid for short-term smoking cessation in adults. This does not establish TMS as an FDA-cleared treatment for alcohol, opioid, cocaine, methamphetamine, or other substance use disorders.

Cost, Insurance, and Access to Phoenix TMS

Insurance coverage depends on the condition being treated, medical necessity criteria, treatment protocol, network status, and prior-authorization requirements.

Coverage for TMS may be available for certain FDA-cleared mental health indications when plan-specific eligibility criteria are met. Coverage for addiction-related applications may vary and is not guaranteed.

Visit our insurance verification page to securely submit your policy details and learn whether your plan may cover an eligible treatment.

TMS may offer an additional option within a comprehensive recovery plan, but it is not a stand-alone addiction treatment. A responsible recommendation requires withdrawal screening, medical and psychiatric review, realistic expectations, and coordination with established care.

Call (480) 631-9623 or submit a secure online inquiry to request a confidential assessment with our Phoenix clinical team.

• Food and Drug Administration. (2020). BrainsWay Deep TMS System: 510(k) premarket notification K200957. U.S. Department of Health and Human Services.
• National Institute on Drug Abuse. (n.d.). Treatment. National Institutes of Health.
• National Institute on Drug Abuse. (n.d.). Transcranial magnetic stimulation for the treatment of methamphetamine and cocaine use disorder. National Institutes of Health.
• Substance Abuse and Mental Health Services Administration. (2021). Medications for opioid use disorder: Treatment Improvement Protocol 63. U.S. Department of Health and Human Services.
• Zhang, J. J. Q., Fong, K. N. K., Ouyang, R. G., Siu, A. M. H., & Kranz, G. S. (2019). Effects of repetitive transcranial magnetic stimulation on craving and substance consumption in patients with substance dependence: A systematic review and meta-analysis. Addiction, 114(12), 2137–2149.