A first-of-its-kind treatment in Israel for opioid dependence using sound wave technology was recently performed at Rambam Health Care Campus (Rambam), in Haifa, Israel. The procedure was made possible by a unique Israeli technology developed by Insightec as part of an international study conducted at select US medical centers and now at Rambam.
H., a family man in his forties, suffered a neck injury several years ago. To manage the pain, he was prescribed opioid pain medication. Over time, the pain diminished, but he was unable to break free from the medication. Eventually, he was taking around 130 pills per day. Dr. Amir Minerbi, Director of the Rambam Institute for Pain Medicine, who runs a specialized clinic for opioid withdrawal and addiction treatment, explains that H. was no longer experiencing physical pain but still required the same substance in his bloodstream simply to feel calm and maintain normal functioning.
As part of the innovative treatment, Rambam’s multidisciplinary team modulated the electrical activity of a brain region known as the nucleus accumbens (NAc), the core component of the brain’s reward system, responsible for feelings of pleasure, satisfaction, and reinforcement. Based on Insightec's technology, the treatment is similar to that used for treating symptoms of essential tremor and Parkinsonian tremor performed under MRI guidance. However, in this case, the treatment uses a new technology that enables noninvasive neuromodulation, without heating or ablating tissue, allowing targeted stimulation of the same brain region, either to activate additional activity or suppress it.
This new technology makes it possible to intervene directly in the brain’s electrical activity in a highly targeted way and to influence specific control centers depending on the condition being treated, explains Dr. Lior Lev-Tov, Director of the Functional Neurosurgery Unit at Rambam, and the study’s principal investigator. During the treatment itself, a reduction in the patient’s craving for opioids was already observed. One week later, tests came back negative for opioids and other substances, and the patient reported a craving score of zero out of ten. He also experienced an unexpected effect: a dramatic drop in cigarette use, from three packs a day to just a few cigarettes, along with no desire to consume alcohol.
In effect, after a 20-minute treatment, the patient reported being free of the craving associated with the severe dependency that had dominated his life for years, marking what Lev-Tov describes as nothing short of a medical and therapeutic breakthrough.
A Prescription-Driven Global Epidemic
Opioid addiction has been recognized as a global public health crisis. In the United States alone, it has claimed hundreds of thousands of lives, with economic damages estimated at approximately $60 billion annually. In Israel, which only a few years ago ranked first worldwide in growth of opioid consumption, the trend has since been halted and is now declining.
Opioid pain medications are highly effective for short-term pain management and remain an important medical tool, Minerbi emphasizes. However, a small yet significant proportion of patients develop opioid addiction, meaning they continue to seek the medication repeatedly regardless of its impact on their pain.
Among long-term users, opioids become less effective for pain control while contributing to a growing range of adverse effects, including declining health, increased risk of premature mortality, reduced ability to function in daily life, and a significant decrease in quality of life.
Currently, opioid withdrawal treatment generally follows one of two approaches. The first involves gradual dose reduction until complete cessation, with success rates of only about 5 percent and persistent risks even among those who successfully discontinue use. The second approach relies on substitute medications that act on the same biological mechanisms as the addictive substance.
Addiction treatment involves both physical withdrawal and psychological withdrawal, the latter of which can persist for a long time, explains Minerbi. This new treatment directly targets the brain regions involved in addiction, and it is hoped that it will offer a safer and less traumatic solution for thousands of people dependent on opioids.
Beyond Opioids: A New Therapeutic Platform
Ongoing trials show excellent results in preserving the gains achieved through treatment and opioid withdrawal. Some participants had even been addicted to heroin, a substance from which recovery can take years.
H., the first Israeli participant and the twenty-second patient enrolled in the study, was also the first to undergo treatment while experiencing active withdrawal symptoms, a unique challenge that yielded important insights for the international research team.
From the day of treatment until the present, he has remained completely free of the opioid medication, reports Lev-Tov. His craving for opioids disappeared entirely, and he described feeling as though he had regained his life. Medical tests confirm that he is opioid-free, and his physical and functional condition is excellent.
According to Lev-Tov, the significance of the work reaches far beyond the treatment of addiction. It represents the emergence of a new, non‑invasive way to access deep and highly sensitive regions of the brain—areas responsible for reward, motivation, desire, and impulse control—and to meaningfully alter activity within those networks. In his view, nothing currently available in modern medicine offers a comparable level of precision without surgical intervention. He sees this breakthrough as opening a path toward treating some of the most complex and persistent conditions in medicine.
Disorders such as OCD, PTSD, eating disorders, and severe depression could potentially be addressed using this approach, alongside other forms of addiction and chronic pain syndromes. Looking ahead, he also envisions applications in cognitive and neurodegenerative conditions, including ADHD, Alzheimer’s disease, and Parkinson’s disease. At its core, the technology represents a completely new therapeutic platform, one that could make non‑invasive treatment possible across a broad spectrum of illnesses affecting millions of people worldwide.
Lev-Tov regards it as a major scientific advancement with the potential to reshape how medicine approaches disease. Beyond the science, he emphasizes the human impact. Patients who currently struggle with these conditions may one day have a real chance at full rehabilitation—returning to work, building families, and contributing meaningfully to society. Rambam, he notes, has already positioned itself as a global leader in the application of focused ultrasound technology, establishing a center of excellence that continues to push the field forward and expand access to these emerging treatments.
Ultimately, for Lev‑Tov, the work carries an ethical dimension as well. It reflects a commitment to make the most of existing technologies, to identify patients who can benefit, and to push beyond established limits. Innovation, he suggests, is not only a scientific pursuit but a responsibility—one that guides the work being done each day.
Learn more about the procedure. Click on the picture below.
