TMS Treatment for Alcohol Addiction

Overcoming alcohol addiction is never easy, and a number of treatments are often needed to reduce cravings. For some people, medication, therapy, and support groups can help support long-term recovery, but for others, these treatments may not be enough.

One therapy that’s being explored for alcohol addiction is transcranial magnetic stimulation (TMS). This non-invasive brain stimulation treatment is best known for treating depression and other mental health conditions, but it’s also showing promise in reducing alcohol cravings and supporting long-term sobriety.

In this article, we explore what alcohol addiction is, symptoms of alcohol dependency, how alcohol affects the brain, and how TMS therapy may help improve outcomes.

Understanding alcohol dependence

Alcohol dependence, or alcohol use disorder (AUD), is a medical condition that makes it difficult to control or stop drinking, even when it’s harming your health, relationships, or daily life. Some people may start drinking as a way to unwind or cope with stress, and over time, their brain starts relying on alcohol to function normally. This leads to cravings, increased tolerance, and withdrawal symptoms when they reduce or stop drinking alcohol.

There’s no single cause for alcohol dependence, and it can develop from a combination of genetic, environmental, and psychological factors. Things like trauma, stressful events, a family history of addiction, and mental health conditions like anxiety or major depressive disorder can all increase the risk of alcohol addiction. The way it develops can differ too – some people might gradually drink more over time while others might experience a triggering event that quickly shifts their relationship with alcohol.

Over time, alcohol addiction can change the way a person’s brain functions and contribute to physical health problems such as liver disease, heart problems, or digestive issues.

How much alcohol is too much?

There’s a difference between enjoying the occasional drink and being dependent on alcohol. So at what point does drinking alcohol start to become unhealthy?

The American Medical Association (AMA) recommends an alcohol limit of two drinks per day for men. In this population, having five or more drinks in one day, or fifteen or more drinks in a week, is considered heavy drinking. For women, the AMA recommends a limit of one drink per day, and heavy drinking is considered four or more drinks per day or eight drinks in a week.

When we talk about ‘a drink’, this is defined by the National Institute on Alcohol Abuse and Alcoholism as being:

• 12 ounces (355 ml) of regular beer (about 5% alcohol)
• 8 to 9 ounces (237-266 ml) of malt liquor (about 7% alcohol)
• 5 ounces (148 ml) of wine (about 12% alcohol)
• 5 ounces (44 ml) of hard liquor or distilled spirits (about 40% alcohol).

Signs of alcohol addiction

Signs and symptoms of alcohol addiction can look different for each person. Some common signs that you may be dependent on alcohol include:

• Craving alcohol or spending a lot of time thinking about your next drink
• Finding it hard to stop once you’ve started drinking
• Increased tolerance, so you need more alcohol to feel the same effects
• Drinking earlier in the day, such as before lunch
• Withdrawal symptoms like shaking, sweating, or nausea when not drinking
• Neglecting responsibilities at home, work, or school due to drinking
• Continuing to drink despite negative consequences, like health issues or strained relationships
• Feeling anxious, low, or irritable, especially between drinks or when trying to cut down
• Avoiding social activities that don’t involve alcohol.

If any of these signs feel familiar, know that alcohol addiction is a medical condition that can be treated with the right care and support.

See: How Successful is TMS Therapy?

How to treat alcohol addiction

The right treatment for alcohol use disorder will depend on the individual, the severity of their dependence, and any co-occurring mental health conditions. Some common treatments for alcohol addiction include:

Detox and withdrawal support

The first step for many people with alcohol addiction is a medically supervised detox, usually done in a hospital or inpatient treatment center. Detoxes can last between 2 to 7 days and are designed to help manage the physical symptoms of withdrawal, which can range anywhere from mild discomfort to severe health complications depending on the individual.

Sometimes, sedative medications are used to reduce symptoms and ensure you withdraw from alcohol safely.

Medication-assisted treatment (MAT)

There are several FDA-approved medications that can support long-term recovery from alcohol, including:

• Naltrexone, which blocks the pleasurable effects of alcohol and helps reduce cravings
• Acamprosate, which helps restore brain balance after you’ve stopped drinking
• Disulfiram, which acts as a deterrent by creating unpleasant symptoms when you consume alcohol.

Counseling and behavioral therapies

Evidence-based therapies like Cognitive Behavioral Therapy (CBT) and 12-step programs can play a key role in healing from alcoholism, whether done individually or in a group setting. Counseling can help you address the underlying reasons for alcohol use and teach you how to build new coping strategies.

Integrated mental health support

Many people with alcohol addiction also have conditions like depression or anxiety. In these cases, treating alcohol dependence can involve medication management and psychotherapy to address these co-occurring disorders.

Aftercare and support

Recovering from alcohol successfully often requires ongoing care, including outpatient therapy, peer support groups (like alcoholics anonymous), family or couple’s therapy, and relapse prevention planning.

Ongoing support is important –  it’s believed that 60% of people who remain sober for two years will remain alcohol free, and the chances are even higher for those who remain sober for five years. So don’t underestimate the value of surrounding yourself with supportive treatments and care in the years following your initial detox.

What is TMS therapy?

Transcranial magnetic stimulation (TMS) therapy is a non-invasive, FDA-approved treatment that uses magnetic pulses to stimulate specific regions of the brain associated with mood, behavior, and cognitive function. The treatment was originally developed for treatment-resistant depression, but it has shown to be effective in addressing a range of mental health conditions, including anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and more recently, substance use disorders like alcohol or cocaine addiction.

TMS works by delivering gentle, targeted electromagnetic pulses to the prefrontal cortex, a part of the brain that’s often underactive in people struggling with depression or addiction. These pulses help simulate dormant neural circuits to promote healthier brain activity patterns. Over time, this stimulation can lead to lasting changes in how the brain regulates mood, cravings, and impulse control.

TMS treatment for alcohol use often involves daily repetitive transcranial magnetic stimulation (rTMS) sessions given over the course of several weeks. Each of these sessions lasts around 20 to 30 minutes and is conducted on an outpatient basis. No anesthesia is required – patients remain awake and alert throughout the procedure and can return to normal daily activities immediately afterwards.

Currently, TMS is only FDA-approved for treating depression, OCD, migraines, and smoking cessation, however it is also used off-label for numerous other conditions. Studies show that TMS may help reduce the intensity of alcohol cravings and support long-term outcomes when combined with other forms of treatment.

See: What is Brain Mapping for Transcranial Magnetic Stimulation (TMS)?

How does alcohol addiction affect the brain?

To understand how TMS can help with alcohol addiction, it helps to know how alcohol affects the brain.

When alcohol enters the system, it triggers a surge of dopamine, the brain’s ‘feel good’ chemical that’s linked to reward and pleasure. In a healthy brain, dopamine is released in response to natural rewards like eating, social connection, or achievement, then quickly reabsorbed to keep everything in balance.

Alcohol disrupts this process by preventing dopamine from being recycled. This causes the chemical to build up between brain cells, leading to the euphoric ‘high’ people often associate with drinking. Over time, the brain adapts to these unnatural dopamine spikes by becoming less sensitive to it. This means that more alcohol is needed to feel the same effect, one of the main symptoms of alcohol dependence.

When alcohol hijacks the brain’s reward system, it also affects areas involved in judgement, impulse control, and emotional regulation. The result is a cycle of cravings, withdrawal symptoms, and increased tolerance that fuels continued drinking. This cycle is difficult to break, even when it starts causing harm to a person’s life.

How can TMS therapy help with addiction?

TMS delivers targeted magnetic pulses to specific regions of the brain, usually the prefrontal cortex, which plays an important role in decision-making, emotional regulation, and impulse control. These pulses stimulate the brain’s neurons to increase activity and promote healthier patterns of communication between different brain regions.

As we mentioned above, when someone has an addiction, their brain’s reward system becomes imbalanced. Changes in dopamine signaling and reduced connectivity in circuits related to self-control start to fuel cravings and compulsive behaviors. TMS helps to restore balance by increasing cortical excitability, enhancing neuroplasticity (the brain’s ability to rewire and form new connections), and encouraging dopamine to be released in a more natural and regulated way.

Over time, this stimulation can reach deeper parts of the brain involved in craving and habit formation. In short, TMS supports healthier brain activity, which can reduce the urge to use substances and help people feel more in control of their behavior. It’s not a cure for substance addiction, but can help increase the chances of recovery when used alongside therapy, medication, and other forms of support.

Learn More: How to Maximize the Results of TMS Therapy

TMS treatment for alcohol addiction: What the research says

There have been several clinical trials and reviews that demonstrate TMS’s effectiveness in reducing cravings and alcohol consumption.

One study by Mishra et al. (2010) found that 10 sessions of repetitive transcranial magnetic stimulation (rTMS) produced large reductions in alcohol cravings scores. Similarly, Belgers et al. (2022) found that high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC) reduced both cravings and alcohol use, with results lasting up to three months after treatment.

These findings were confirmed in a 2022 meta-analysis by Sorkhou et al., who showed that active rTMS to the DLPFC led to small but meaningful reductions in cravings. Che et al. (2021) also observed that high-frequency rTMS stimulating the DLPFC could strengthen cognitive control and reduce the urge to drink.

More recently, a comprehensive review by Treiber et al. (2024) examined 12 studies involving 475 patients. These studies used varying TMS protocols, ranging from 10-20 sessions and targeting different areas such as the left or right DLPFC, medial prefrontal cortex, and insular cortex. Despite the differences in targeted areas, the overall findings were consistent. TMS was found to significantly reduce alcohol cravings with improvements lasting up to three months after treatment.

Deep TMS (dTMS), a type of TMS that targets deeper brain regions, also shows promise in alcohol addiction. One proof-of-concept trial by Harel et al. (2022) used dTMS to stimulate brain circuits involved in addiction, including the medial prefrontal cortex and anterior cingulate cortex. Those who received dTMS had fewer heavy drinking days and lower craving levels compared to those who received sham stimulation treatments. Brain imaging results also showed meaningful changes in functional connectivity, which suggests that TMS can support long-term changes in the brain’s addiction pathways.

Even though TMS is yet to be FDA-approved for alcohol addiction, these studies indicate that it can be a safe, effective, and well-tolerated option for reducing alcohol cravings and supporting sobriety.

Explore TMS therapy for alcohol addiction

Alcohol addiction is a complex condition, but recovery is possible with the right support and a comprehensive treatment plan that’s tailored to your individual needs and circumstances. If you or a loved one are struggling with alcohol use or drug addiction and want to explore your options, our team at BestMind Behavioral Health is here to help.

We specialize in a range of evidence-based solutions, including medication management, telepsychiatry, and innovative therapies like TMS and esketamine (SPRAVATO). With clinics in Colorado, Oregon, and Washington, our team is here to support your journey to recovery with compassionate care. Contact us today to learn whether TMS therapy might be suitable for you.