By Meredith WadmanAug. 29, 2017 , 3:30 PM

Luca Rossi tried to hang himself in a bedroom in Perugia, Italy, in 2012. Suspended by his belt from a wardrobe, he had begun to choke when his fiancée unexpectedly walked in. He struggled to safety, defeated even in this intended last act. 

The 35-year-old physician had everything to live for: a medical career, plans for a family, and supportive parents. But Rossi* was addicted to crack cocaine. He had begun his habit not long after medical school, confidently assuming that he could control the drug. Now, it owned him. Once ebullient and passionate, he no longer smiled or cried. He knew he might be endangering his patients, but even that didn’t matter. He was indifferent to all except obtaining his next fix. “It pushes you to suicide because it fills you with your own emptiness,” he says. In the first months after his near suicide, Rossi didn’t drop his $3500-a-month habit. Early in 2013, he learned that his fiancée was pregnant. Frightened by impending fatherhood, he smoked even more. He didn’t—couldn’t—stop.

Then, in April 2013, Rossi’s father, a chemist, happened upon a local newspaper article describing work just published in Nature. Neuroscientists led by Antonello Bonci and Billy Chen at the National Institute on Drug Abuse (NIDA) in Baltimore, Maryland, had studied rats trained to seek cocaine compulsively—animals so powerfully addicted that they tolerated repeated electric shocks to their feet to get their fixes. The rats had also been genetically engineered so that their neurons could be controlled with light. When the researchers stimulated the animals’ brains in an area that regulates impulse control, the rats essentially kicked their habit. “They would almost instantaneously stop searching for cocaine,” Bonci says.

He and his Nature co-authors suggested that targeted stimulation of the analogous region in the human brain—an area in the prefrontal cortex, which sits behind the forehead—could help compulsive cocaine users. In that Italian newspaper article, Bonci explained that transcranial magnetic stimulation (TMS), a noninvasive method of triggering neural activity, might do the job.

Rossi’s father began a frenetic quest for help that led him to Luigi Gallimberti, a prominent Italian addiction physician who runs the private Villa Maria Clinic in Padua. Father and son presented themselves there, and the father handed Gallimberti the article. “My son is a cocaine addict,” he said. “Can you help him?”

In the years since Rossi visited that Italian clinic, TMS has attracted interest among a small cadre of researchers and physicians who are using it to target cocaine addiction, even as skeptics raise their eyebrows. After an initial study of 32 people hooked on the drug yielded encouraging results, Gallimberti began offering the treatment in his clinic; he and his colleagues have now treated more than 300 addicted people.

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