About This Study
This is a research study — not treatment. If you are randomized to a TMS group, it will be in addition to your treatment as usual (TAU) at Another Chance. Participation is completely voluntary.
We are inviting people currently in treatment at Another Chance Drug and Alcohol Rehabilitation Center – Portland, OR to take part in a research study led by Washington State University (WSU).
The goal is to learn whether Transcranial Magnetic Stimulation (TMS) — a safe, non-invasive brain stimulation technique — can help improve recovery outcomes when added to standard addiction treatment. We are specifically studying its effects on people with Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD).
What Are We Trying to Learn?
- Can TMS reduce withdrawal symptoms and cravings?
- Does TMS improve physical health, mental health, and sleep during recovery?
- Does TMS support better thinking and memory while recovering?
- Is there a difference between a shorter (3-min) and longer (9-min) daily TMS dose?
Who Is Running This Study?
- Principal Investigator: Matthew Layton, MD, PhD — Clinical Professor, WSU College of Medicine, Spokane, WA
- Study Site: Another Chance Drug & Alcohol Rehabilitation Center, Portland, OR
- Funded by: RecoveryWorksNW (non-profit organization)
- IRB Approved: WSU IRB #25-0427-001 — Valid through 02/18/2027
Interested? We are enrolling up to 60 participants. Speak with a staff member or contact Dr. Layton directly — contact details are at the bottom of this screen.
Funding & Conflict of Interest
This study is funded and the TMS equipment is provided by RecoveryWorksNW, a non-profit organization led by Dr. Ben Schwartz. Dr. Schwartz is also a Co-Investigator on this study and could benefit financially if results are positive. To manage this conflict of interest, Dr. Schwartz and anyone employed by RecoveryWorksNW will not take part in the informed consent process.
What is TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique that uses magnetic pulses to gently stimulate specific areas of the brain. No surgery, anesthesia, or sedation required — you remain fully awake and alert throughout.
How it works: A coil held near your scalp generates a brief magnetic field that passes harmlessly through the skull, creating a small electrical current in the targeted brain region and influencing how those brain cells communicate.
Theta Burst Stimulation (TBS)
This study uses a specific type of TMS called Theta Burst Stimulation (TBS) — a highly efficient pattern of magnetic pulses that delivers the therapeutic effect in just 3 or 9 minutes, compared to the 20–40 minutes used in older TMS protocols.
Why the Prefrontal Cortex?
TMS in this study is targeted at the Dorsolateral Prefrontal Cortex (DLPFC) — the area at the side of the forehead. This brain region is closely connected to:
- Impulse control and decision-making
- Craving and reward responses linked to addiction
- Emotional regulation during recovery
Research suggests that stimulating the DLPFC may help people manage cravings and support recovery from opioid and alcohol use disorders.
Is TMS Safe?
- No surgery, needles, or anesthesia required
- You are fully awake and can speak during treatment
- Side effects are generally minor and temporary
- No history of TMS causing death in clinical use
- The doses used in this study are well within established safety guidelines
What Would I Do?
Here is a clear picture of what participation involves from start to finish.
Step 1 — Sign Up & Consent
You will receive a study overview (5–10 min). If interested, a researcher will screen you for eligibility (5 min), then walk you through this consent form (20–30 min). You can ask any questions before deciding. Women of reproductive age will be asked for a urine pregnancy test at baseline and before each TMS session.
Step 2 — Baseline Surveys (~45 minutes)
Before any TMS begins, you will complete surveys covering: withdrawal symptoms, cravings, physical and mental health, sleep quality, and cognitive health (thinking and memory).
Step 3 — Randomization Into One of Three Groups
You will be randomly assigned — like a coin flip — to one of these groups:
Group 1: TAU Only
Continue your regular treatment at Another Chance. No TMS sessions. Complete surveys 6 times over 6 weeks.
Group 2: TAU + 3-Min TMS
Regular treatment plus 3 minutes of TMS each morning, Mon–Fri, for 4 weeks (20 sessions total).
Group 3: TAU + 9-Min TMS
Regular treatment plus 9 minutes of TMS each morning, Mon–Fri, for 4 weeks (20 sessions total).
Your 6-Week Timeline
Each TMS Session (Groups 2 & 3)
Sessions take approximately 10–15 minutes and happen each morning Monday–Friday at Another Chance.
Before each session, provide a urine sample. This checks for substances that make TMS unsafe that day. A positive result means that day's session is skipped.
You'll be fitted with a head cap that helps the technician position the TMS coil accurately over the DLPFC.
Sit comfortably in a clinical chair. A trained technician places the coil at the side of your head and delivers 3 or 9 minutes of Theta Burst Stimulation (TBS). You may feel a mild tapping or scalp sensation.
After the session, return directly to your regularly scheduled treatment activities at Another Chance.
Surveys (All Three Groups)
Everyone — including the TAU-only group — completes surveys 6 times over the study. Each survey takes 30–45 minutes and covers the same areas as the baseline: withdrawal, cravings, physical health, mental health, sleep, and cognition.
Compensation: You may receive up to $100 in gift cards for completing the study. Note: there may be personal travel costs if you need to arrive at Another Chance earlier than your usual treatment start time.
Am I Eligible?
We are enrolling up to 60 participants currently in treatment at Another Chance in Portland. Here is a quick overview of who can and cannot take part.
You may qualify if you:
- Have a diagnosis of Opioid Use Disorder (OUD) or Alcohol Use Disorder (AUD)
- Are between 18 and 65 years old
- Are enrolled in comprehensive outpatient (PHP) treatment at Another Chance – Portland
- Can read, write, and communicate in English
You are likely not eligible if you:
- Are pregnant or nursing
- Currently take prescribed benzodiazepines, or test positive for benzodiazepines or illicit substances
- Have been diagnosed with bipolar disorder or psychosis
- Have a history of seizures or fainting episodes of unknown cause
- Have had a stroke, brain surgery, or brain lesions
- Had a head injury causing loss of consciousness lasting longer than 30 minutes, or experienced related problems lasting longer than one month
- Have a history of heart attack, angina, heart failure, cardiomyopathy, stroke, or TIA
- Have a first-degree family member with epilepsy or multiple sclerosis
- Have a pacemaker, neural stimulator, implantable defibrillator, implanted medication pump or sensor, or unstable heart disease; or have any intracranial implant (e.g. aneurysm clips, shunts, cochlear implants, or electrodes) or any metal object in your body
- Currently take medication with anti-convulsive or pro-convulsive actions (e.g. anti-seizure drugs or stimulants)
- Have any other TMS contraindications, including noise-induced hearing loss or tinnitus
- Are scheduled for discharge before all 20 TMS sessions can be completed
Not sure if you qualify? A brief 5-minute screening with a researcher will determine eligibility before any commitment is made. Just let a staff member know you're interested, or contact Dr. Layton directly using the details below.
Urine Drug Screening During the Study
If you are in a TMS group, a urine sample is required before each morning session to confirm it is safe to proceed. Three positive results for unprescribed benzodiazepines or illicit substances during the study will result in removal from the study.
Risks, Benefits & Your Rights
Side Effects of TMS
TMS side effects in this study are expected to be minor and temporary. The most common are:
- Headache — mild to moderate; usually resolves on its own
- Scalp discomfort or tingling — during or just after the session
- Nausea or dizziness — mild and short-lived
- Clicking or tapping sensation — from the coil during treatment
There is no history of TMS causing death in clinical use. The proposed doses are conservative and well-established in the literature.
Benefits
There are no guaranteed direct benefits to you personally. TMS is an experimental add-on treatment for OUD and AUD — we do not yet know for certain if it helps. Any benefit may be indirect: knowledge gained from this study may help others with your condition in the future.
Your Privacy & Confidentiality
- Your data is stored using participant codes (TAU01, 3min01, 9min01, etc.) — not your name — on password-protected computers
- Paper records are kept in locked rooms at Another Chance, then transferred to WSU–Spokane after study completion
- Your records at Another Chance are accessed only under a formal agreement, and are protected by federal SAMHSA law (42 CFR 2.31)
- Records are accessed only while you are enrolled and for up to 90 days after completion
- Your urine drug screen results are shared only with you and the research team
- Your information may not be shared with anyone else without your written permission
Your Rights as a Participant
- Participation is completely voluntary. You can say no or withdraw at any time without penalty or loss of benefits.
- You do not have to answer any specific question you don't want to answer.
- If you withdraw, the lead researcher will meet with you to discuss how already-collected data is handled.
- You will receive a signed copy of the consent form for your own records.
- Any new findings that might affect your willingness to continue will be shared with you promptly.
Questions about your rights as a participant? Contact the WSU Institutional Review Board (IRB) at irb@wsu.edu — they are independent of the study team and exist specifically to protect research participants.