This study explores a new technique called Focused Ultrasound (FUS) to help people who have problems with opioid use or other substances. It targets a specific part of the brain known as the NAc/VC, which may be involved in craving and substance use behaviors. The study aims to see if this method can reduce the craving for drugs in these individuals. This research is important because it could lead to new ways to treat substance use disorders, which are challenging to manage with current methods. Participants in the study will first go through a screening process to ensure they are suitable for the treatment. Once eligible, they will receive the FUS treatment targeting both sides of the NAc/VC area of the brain. During the study, there will be assessments to measure their behavior and cravings before, during, and after the treatment. Follow-up visits are scheduled for Day 1, and at Weeks 1, 4, 8, and 12 to monitor changes and gather data on the treatment's effects. The study does not specify particular benefits or risks, but it aims to provide insight into the potential of FUS as a treatment for substance use disorders.
Inclusion Criteria: * Aged 22 - 60 years at time of enrollment. * Fulfill current DSM-5 diagnostic criteria for OUD and/or other SUDs with at least a 2-year history. * Currently receiving outpatient treatment from the WVU Comprehensive Opioid Addiction * Treatment Program (COAT), Intensive Outpatient Program (IOP) or any other program which implements the COAT model; or receiving outpatient/inpatient/residential treatment from similar SUD treatment programs. * Currently are under the care of a licensed psychiatrist or other mental health care provider, or a licensed addiction medicine specialist and agrees to promptly inform the investigator or the study staff of any change in these providers. * Agrees to allow any and all forms of communication between the investigators/study staff and any healthcare provider who currently provides and/or has provided service to the patient/subject within at least two years of study enrollment for the purposes of eligibility confirmation or in case of a safety event. Exclusion Criteria: * Unable to undergo MR-imaging because of non-MR compatible implants or if candidates are uncomfortable in small spaces (have claustrophobia). * History of any clinically significant neurological disorder. * History of stroke or brain lesion with observable structural abnormalities in the targeted brain region. * Clinically significant MRI abnormality indicative of a neurological condition or abnormality that may jeopardize the participant's safety, study conduct, or confound the participant's diagnostic assessments. * An abnormal screening result that is considered clinically significant by a medically qualified research team member (i.e., laboratory tests, imaging findings). * More than 30% of the skull area traversed by the sonication pathway is covered by scars, scalp disorders (e.g., eczema), or atrophy of the scalp. * Past or present diagnosis of schizophrenia or psychotic disorder (assessed via SCID- * History of medically verified suicide attempt within the past year. * Meet the criteria for Cluster A or B Personality Disorders (assessed via SCID-5-PD). * Current substance use treatment mandated by court of law. * Subject who is currently participating in another clinical investigation with an active * treatment arm. * Subject is considered to be a poor surgical or study candidate, which may include, but is not limited to the following: any medical, social, or psychological problem that could complicate the required procedures and evaluations of the study in the judgment of the investigator
is designated in this study