A new line of research from Dr. Mark Greenwald at Wayne State University, and colleagues, offers a fresh perspective on this longstanding challenge. In a pair of studies, Dr. Greenwald and his colleagues explored the potential of a deceptively simple-looking medical device, the NET Device™, to ease withdrawal in the residential setting and influence post-discharge longer-term recovery in people with opioid use disorder. Their results introduce something rare in addiction science: a non-medication option that shows evidence of meaningful clinical benefit.

The opioid crisis in North America is driven heavily by synthetic opioids such as fentanyl, which bind tightly to the brain’s receptors and create dependence with unprecedented speed. Withdrawal from these substances tends to be more severe, and relapse risk is extremely high.

Medications for opioid use disorder, such as buprenorphine or methadone, are highly effective. They reduce overdose risk, help regulate withdrawal symptoms, and stabilize people entering recovery. Yet many individuals do not choose them. Some face logistical difficulties. Others fear stigma or worry that taking medication means they are not fully “clean.” Still others simply want a different approach.

Dr. Greenwald’s research highlights that within residential programs, a significant subset of patients arrive specifically stating they wish to withdraw without starting medications. Historically, clinicians have had few evidence-based options for supporting people who decline medication. Comfort medications help somewhat to reduce symptoms of withdrawal but do not fundamentally change its underlying neurobiology. The NET Device was created to help fill precisely this gap.

The NET Device is small, portable, and non-invasive. It uses transcranial alternating current stimulation to deliver extremely mild electrical currents through electrodes placed behind the ears. These currents do not create any perceptible “shock,” nor do they incapacitate or sedate the person wearing the device. Instead, they subtly modulate neural circuits believed to underlie withdrawal symptoms.

Earlier generations of similar devices had shown promise in open-label studies. But until recently, the technology had not been tested in the rigorous, blinded, sham-controlled manner that modern regulatory standards require. Dr. Greenwald’s first study provided that missing piece.

The first of the two studies, published in early 2025, details a randomized, double-blind, sham-controlled trial conducted in a residential treatment center. More than one hundred adults with opioid use disorder, most of whom tested positive for fentanyl at admission, agreed to undergo opioid discontinuation without the aid of medications. Each person was randomly assigned either an active NET Device or a sham device that looked like the real one but delivered no electrical stimulation.

From the outset, the goal was to see whether active stimulation could rapidly reduce withdrawal severity. The results were striking. Within one hour of initiating active stimulation, withdrawal scores were reduced significantly. On average, the active group experienced a 61 percent reduction in symptoms, moving them from moderate withdrawal into the mild range. Nearly every participant in the active group, 98 percent, achieved a clinically meaningful reduction, far surpassing expectations.

The sham group also improved somewhat, as often happens in trials involving subjective symptoms, but the active group improved significantly more. Participants did not know which version they had received, yet those with active stimulation voluntarily kept the device on for longer periods, suggesting that they experienced noticeable relief. They were also more willing to say they would consider using the device again in the future.

One of the most revealing findings was that the active group was far less likely to request medications for opioid use disorder (or MOUD) during detox. Only about a quarter of the active group eventually requested MOUD, compared with nearly half of the sham group. The researchers, including Dr. Greenwald, were careful to emphasize that MOUD remains the gold standard of care. The point was not to show that a device should replace medications, but rather that for individuals who want to stop using opioids without medication, the device can help them stay on course during the critical early days.

The inpatient trial established that the NET Device could meaningfully reduce withdrawal symptoms. But withdrawal is only the beginning of recovery. The second paper, published in late 2025, takes the next step and examines what happens once patients leave the residential setting.

For twelve weeks after discharge, participants were contacted weekly and asked about their use of opioids, psychostimulants, and MOUD. This type of follow-up paints a picture not just of physical withdrawal relief, but of how individuals navigate the fragile period of early recovery outside a structured environment.

At the broadest level, the researchers found no statistically significant difference between the entire active group and the entire sham group in terms of the percentage of days using drugs. However, when the team looked at a finer level of detail, specifically, at how long each participant had used the device during the inpatient period, a very different pattern emerged.

Individuals who used active stimulation for more than 24 hours had outcomes that were dramatically better than everyone else. Their average percentage of days using opioids or psychostimulants was extremely low, close to zero in many cases, and they were far more likely to remain completely abstinent during the entire 12-week period. Those who had used the device for shorter durations, or who had received sham stimulation, showed substantially higher rates of use.

This suggests that the self-determined amount of stimulation matters. It also suggests that the individuals who felt the device was helpful enough to keep using it experienced benefits that extended beyond the walls of the treatment facility. While the authors, including Dr. Greenwald, caution that these post-discharge findings require replication, the signal is compelling: sustained engagement with the active device during detox might shape the trajectory of early recovery.

The picture that emerges is of a device that provides real relief during one of the most punishing stages of recovery, and that may help some individuals maintain abstinence beyond discharge. It does not replace medications, counseling, or other evidence-based tools. But for people who decline medications, or for whom additional support is needed, the NET Device represents a new and potentially transformative option.

Though the findings are remarkable, they also raise important questions for future research. Why do some people use the device for longer periods than others? How might clinicians encourage more sustained use during detox? Would combining the NET Device with medications or counseling amplify the benefits?

These questions do not diminish the significance of what has already been shown. Rather, they point the way forward for the next wave of studies, studies that will help clarify the device’s full potential and its place within the broader treatment landscape.

The opioid crisis will never have a single solution. It demands a spectrum of tools: medications, harm reduction services, behavioral therapy, social support, and compassionate policy. Dr. Mark Greenwald’s studies contribute one more tool to that spectrum, one that is grounded in neuroscience, accessible in practice, and humane in its effect.