Scientist Undergoes Brain Treatment for Alcoholism

By Avis Favaro Medical Correspondent and Alexandra Mae Jones CTV News writer
Published  Sunday, December 15, 2019 on CTV National News

TORONTO – Like millions of Canadians, Dr. Frank Plummer used alcohol simply to relax after work. Or so he told himself.

Only after he became ill with liver failure was he forced to confront a painful reality: he suffered from alcohol-use disorder.

“I guess I was in denial,” Plummer told CTV News. “It’s pretty obvious now that I look back that I had a problem.”

Plummer had an illustrious career as a physician, researcher and the scientific director of Canada’s National Microbiology Lab in Winnipeg. He worked on the front lines of medical crises such as the AIDS epidemic. His groundbreaking work studying HIV/AIDS in Nairobi revealed that the disease did not only affect gay men, as was thought at the time, but could impact heterosexuals and women. He guided Canadian public health through Ebola scares, SARS and the arrival of the pandemic swine flu strain, H1N1, in 2009. As a result of his decades of work the 67 year old has won multiple awards, including the Order of Canada.

But while he was working tirelessly to improve the lives of others, Plummer was also using whiskey — up to 20 ounces a night — to deal with the resulting stress.

“I used to think about alcohol all the time,” he said, admitting that part of his brain used to be constantly planning how he’d get more. He thought he was managing it because he never drank on the job.

“I think I was a high-functioning person with a problem with alcohol,” he said.

In 2012, he suddenly became sick: “My belly blew up, and I found I had cirrhosis and end-stage liver disease.”

He was given a liver transplant in 2014. The new organ was “magical,” he said, but the then-retired scientist soon discovered that without “that adrenaline from responding to some pandemic somewhere,” to distract him, he couldn’t stop himself from returning to drinking. And the problem simply became worse and worse from there.

His wife Jo Kennely told CTV News that at first she couldn’t comprehend it.

“I kept on thinking as we went through this, you know, he’s the smartest man in Canada,” she said. “He’ll be able to figure this out, we’ll get through this, he’ll want to survive, he’ll want to stop, he’ll want to do these things.”

Eventually, she realized “it doesn’t matter how smart you are, doesn’t matter how educated you are. It affects everyone. No one is immune from this disease.”

Plummer underwent therapy, alcohol treatment programs, AA meetings. Nothing, he says, worked for long, and he was not a candidate for a second liver.

“If I didn’t get the drinking under control, I was going to die,” Plummer said. “And I didn’t want to die.”

With his options running out, Plummer agreed to be the first person in North America to test an entirely new way of stopping alcohol addiction — by treating it with deep brain stimulation.

The Treatment

In December of 2018, doctors at Sunnybrook Health Sciences Centre implanted two electrodes into Plummer’s brain while he was still awake. He was able to talk and answer questions during the surgery.

The electrodes are connected to a device similar to a pacemaker in the upper right side of his chest. It sends electrical impulses deep into the brain to an area called the nucleus accumbens, which is linked to addiction and alcoholism and plays a central role in the brain’s reward circuitry.

“So we’re inserting electrodes directly into that region of the brain in an effort to reset its activity, to recalibrate it in some way,” Lipsman said. The device is controlled by an external monitor that Plummer and his doctors can adjust and turn on and off.

To watch several videos on the subject, go to the CTV article by clicking on the image above.

The study’s goal, Lipsman says, is to raise awareness of the disease, and to validate the growing awareness that alcohol addiction is likely “a brain-based illness.”

“And there should be no better way to treat a brain-based illness than a brain-based intervention.”

According to Lipsman, the pilot study now underway will test six patients like Plummer who have treatment resistant alcohol-use disorder, and for whom all other therapies have failed.

Alcohol addiction is a problem that affects hundreds of thousands of Canadians. According to a report by the Canadian Centre on Substance Use and Addiction (CCSA), more Canadians were hospitalized in 2017 due to alcohol-related causes than were hospitalized for heart attacks.

It’s also the top cause for hospitalization linked to substance abuse across the entire country, accounting for more than half of hospital stays caused by substance abuse. Ten Canadians die in hospitals per day due to substance abuse — and three out of four of those deaths are due to alcohol, according to figures from the Canadian Institute for Health Information.

For Plummer, this new trial didn’t just mean a chance to get help for himself, but a chance to contribute to the science aimed at minimizing those deaths.

“I spent my whole life doing research, and here’s a different way of doing research,” he said. “Be a participant, rather than the study director.”

The Impact

A year later, the stimulator is on 24-7 and Plummer reports that he no longer is obsessed with thoughts of drinking.

“It’s given me my life back,” he said.

His wife said that while the treatment may not be a “cure,” it has acted as one for the family as a whole.

“It’s a cure for us,” she said.

Before, she said, the need for alcohol was like “an itch,” that Plummer was compelled to scratch at, and had to address before he could think about anything else, but “now … that itch is gone.”

“It’s like night and day.”

Lipsman said that their test trial only sought out subjects whose alcohol addiction had gotten so bad that it was verging on fatal.

“Frank is really a typical example,” he said. “Somebody that has been through a transplant, been through medical treatment and despite that is still affected by his addiction. So those are the kind of patients that we enroll for this particular trial.”

There are risks of infection and bleeding with brain surgery, but so far researchers say the treatment seems to be relatively safe and the first three patients treated are doing well.

“There are encouraging signs that we’re having a meaningful impact on their drinking behavior and on their mood as well,” Lipsman said.

Currently, Sunnybrook is the only centre in the world actively performing deep brain stimulation on patients with treatment-resistant alcohol-use disorder. As the study continues, researchers will also be monitoring changes in brain structures and activity. The study is currently being funded by philanthropic grants, which cover the cost of medical care and follow-up as well as the cost of the equipment. The stimulator alone can run anywhere from $15,000 to $20,000.

Deep brain stimulation is widely used to treat Parkinson’s disease and also depression. It’s also being tested for eating disorders, obsessive compulsive disorders and Alzheimers. Dr. Lipsman says there may soon be attempts to try DBS as a treatment for other forms of addiction outside of alcohol use disorder.

Plummer is a prime example that addiction can strike anywhere — it targets not only those who are visibly struggling, but also those who appear to be successful in all avenues of their lives. The misconceptions surrounding who is affected by addiction are just one of the reasons that Plummer says “it’s important to talk about alcohol-use disorder.”

He told CTV News that there is “a stigma,” surrounding the illness.

“Training as a medical doctor, I didn’t think much of people that had problems with alcohol,” he said. “And I never thought of myself like that.”

Although he admitted to judging those who struggled with addiction in the past, he said his experience was eye-opening.

“[Alcohol addiction] will ultimately kill you if you don’t deal with it,” he said. “It just about killed me.” He added that he thought long and hard about taking his story public, but decided to talk about his struggle with alcohol-use disorder, “to try to destigmatize it.”

These days, Plummer, who now lives in Toronto, says he has a new zest for life. He has reconnected with family and — most importantly — is diving back into his passion: infectious diseases.

He is preparing to push ahead with an experimental vaccine against HIV infection, and is working on writing a memoir.

“I’m happier than I’ve been in many, many years,” he said.


 

21 Responses

  1. Mike O says:

    I am SO happy to see REAL science and medicine applied to alcoholism. Is it a “cure”, an end-all/be-all for recovery for all people? Obviously not. However, it appears to be a more promising and solid tool than simply appealing to “spiritualism” and a “Higher Power”. I’d be fascinated to see more longitudinal studies done on brain chemistry and circuitry in reward centers of the brain. These types of studies NEED to get broader press and attention.

  2. John B. says:

    It’s encouraging that a Canadian health sciences center is conducting research which may help to treat alcoholism, maybe even provide an element of prevention. What is discouraging to me is that it took the tragedy and travails of a world renowned research doctor to motivate the study. According to the posting, alcohol problems result in more hospitalizations than heart attacks.

    I wonder how much money is spent on research designed to prevent and treat heart disease compared to the amount of financial backing for prevention and treatment of alcoholism in Canada or the USA? We can hope for the best, but so far pharmaceutical and surgical attempts to influence the reward circuitry of the brain hasn’t done much to inhibit the spread of addiction.

    The doc engages in some in some clever denial-classic reductionism – claiming adrenalin deficit as the cause for returning to the bottle?? Apparently the adrenalin produced by his previous work on pandemics didn’t prevent alcoholic level drinking so why would a new liver change anything? I hope we will be updated on the results of this study but I wave a flag of caution to the doc: “diving back” into a life style that led to “20 ounces a night” in order to “deal with the stress” deserves a high level of wariness.This surgical technique may be a success, but anyone of us can engage in our own “brain based intervention” for a lot less than $20,000.

    Just read Ray B’s reply. That is an intervention that has already proven to be effective for those willing to make the necessary commitment. John B.

    • Bob K says:

      The great Christian, Reverend Justin Edwards, offered a solution to alcoholism almost exactly 200 years ago. “Give drunkards all the liquor they want. In time, they will all die off, and the problem will be solved.”

      The current Fentanyl crisis reminds me of that. I wonder how many fine citizens would echo Edward’s thinking, and apply it to that killer drug?

  3. Neve says:

    Sign me up.

  4. Rich on Maui says:

    Glad it’s working for him. I have no problem with whatever works for someone. I don’t believe all alcoholics are the same. We are on different continuums, psychologically, socially, medically and spiritually. Different things work for different people. I don’t begrudge or question anybody’s success at sobriety. I do like to watch those whose paths vary from the traditional in hopes that I might learn something from them that might be able to help somebody else. Congratulations Doctor and thank you for being a pioneer.

  5. Steve b says:

    This is a beautiful descriptions of scientific progress. I hope there’s more to come, and there probably is.

  6. Bob K says:

    AA gets some things wrong, but it gets things right too, most especially regarding the poor decision-making in alcoholics where liquor is concerned.

    “The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing.”

    A smart guy drinks until he needs a liver transplant, gets one, then starts drinking again. AA predicts that sort of behavior. What Dr. Plummer calls an “itch,” is something familiar to serious problem drinkers.

    Of course, our emotions, thoughts and desires are not independent of the human body. There is no soul nor inner homunculus pulling levers.

    • Dee says:

      There is a better self and a worse self. One’s conscience is one’s soul. Jiminy Cricket. 😉

      • Bob K says:

        Do you like good music
        That sweet soul music
        Just as long as it’s swingin’
        Oh yeah oh yeah!

        — Arthur Conley

        • Bobby Freaken Beach says:

          Comin’ to you on a dust road
          Good lovin’, I got a truck load
          And when you get it, you got something
          So don’t worry, ’cause I’m coming
          I’m a soul man, I’m a soul man
          I’m a soul man, I’m a soul man, I’ve got it all

          — Sam and Dave

  7. Lon McCanne says:

    “A year later, … he no longer is obsessed with thoughts of drinking.”

    I, too, have experienced this result; but it did not come through skillful placements of electrodes in my nucleus accumbens. It appeared to come through a sustained abstinence from alcohol that I came to believe was necessary through my exposure to AA, even though I was forced to reject religion-based convictions … and instead focused on getting back to the business of living and enjoying life with absolute avoidance of alcohol. I also am a physician, trained in scientific method, which is reinforced with a healthy skepticism that shuns any belief in unsupported supernatural mechanisms. So far this has appeared to keep me comfortably sober for 36 years now; and has provided an additional benefit that I have no desire to test my current status with alcohol.

    Even though there are likely numerous mechanisms involved in alcoholism, I do wonder if some learned behavior or medicinal influence could affect the nucleus accumbens to respond in the more physiological manner with which we were likely born. Good luck to Dr. Plummer and his family.

  8. Martin T says:

    Doctors “suffer from alcohol-use disorder”, the rest of us are just plain drunks and alcoholics.

    • Al says:

      As the medical establishment moves away from dominant religious mores, the terminology in the diagnostic codes changes with it. Just look at the evolution of terminology for sexual identity re: mental illness!

      It’s progress.

      “Alcoholic” has come to label a person, not just a facet of their behavior, which I think is wrong. We each are so much more individually.

      Besides, ‘disordered use’ covers the whole spectrum of occasional idiocy to physical dependence. I find it more conducive to therapeutic success to focus on one facet of behavior instead of damning the entire individual. Or as the enlightened religious people term it, “hate the sin, not the sinner’. Let’s not forget that many other neurological disorders (like epilepsy) used to be considered “devil possession” and “judgements by god”. Even the Latinized word for being left handed comes from ‘sinister’.

      I know many of us get stuck on the term “alcoholic” because of our own definitions and the disdain with which it is usually used. We are more open to therapy that focuses on an action vs label. I doubt the guy in the story was fooling anybody but himself: 20 oz of whiskey a day is going to stink out of the pores 24/7. Just still highly functioning… until he wasn’t.

      Wishing everyone a happy accumbens!

  9. Bobby Freaken Beach says:

    Wouldn’t have it been simpler to just ask Baby Jesus to perform spiritual freaken surgery??

  10. Ray Baker says:

    Of course alcohol is a brain-based disease. But it is also behavioural and psychosocial – a disease manifested by disconnection. That’s why I do things to change my brain through neurogenesis, neuroplasticity and epigenetics: connection/intimacy with others, altruistic acts, exercise, lifelong learning, meditation and great care in what I choose to eat and not to eat. But since it is a chronic disease, like diabetes or heart disease, I have to keep taking my treatment. I fear standalone treatments, like medication or surgery that promise the magic bullet. They don’t work very well with the other chronic lifestyle diseases like coronary artery disease, obesity, type 2 diabetes or (many types of) cancer.

    • Daran N. says:

      Thank you for your perspective, Ray. This is surely important and promising research, and the ‘quick fix’ is always intriguing. I’m delighted that he is getting these results. But trying to nail down addiction/alcoholism as “brain-based disease” without considering other factors is like AA’s attempt to reduce it to a “spiritual malady.”

      From the We Agnostics chapter in the Big Book: “…you may be suffering from an illness which only a spiritual experience will conquer.” Reductionism at its finest.

      Your comments remind me that continuous abstinence, verifiable positive change, for me, is the result of considerable investment into the efforts to reprogram a faulty operating system.

      In the article “alcohol-use disorder” is described as “treatment-resistant”. Really? To some degree or another, aren’t we all “treatment-resistant”?

  11. Question: Does “now … that itch is gone” mean he’s abstinent or is he now drinking in moderation?

    • Mike O says:

      It seems to indicate that he’s abstinent. Goodness knows given his extreme history he has no business at this point trying to “moderate” his drinking. Of all the parts of AA doctrine that I don’t agree with the notion I still find solid is that the “first drink” gets you drunk. I may not believe alcoholism is a “spiritual” disease and other than the first step I find the rest of the 12 Steps shaky and superstitious mid-century Evangelical moralism but not drinking if you’re an alcoholic, especially an extreme one at death’s door, is still imperative to survival. It certainly doesn’t cost you anything.

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