"This device helped me within 30 minutes, I didn’t have any cravings." – Michelle Warfield, recovering from opioid addiction.
A novel device offering potential relief from opioid withdrawal symptoms is drawing significant attention and investment from counties grappling with the opioid crisis. However, as this technology, known as the NET device, rapidly consumes substantial opioid settlement funds, a debate is emerging about its efficacy and the broader implications for addiction treatment strategies. While proponents highlight anecdotal successes and potential for choice in recovery, critics and researchers caution against overreliance on unproven technologies and emphasize the continued importance of evidence-based treatments.
Kentucky Woman Finds Solace in New Addiction Technology Amidst Opioid Settlement Debate
LOUISVILLE, Ky. — In the early 2000s, Michelle Warfield’s life was marked by the physically demanding work of hauling heavy seats for Ford trucks on an assembly line. The daily aches in her back and hips led her doctor to prescribe opioid painkillers, a common pathway into the grips of addiction for many. While initially effective, the medication’s relief was fleeting. By 2011, Warfield found herself struggling to walk, a stark indicator of her escalating dependence. “By that time, I was addicted,” she recalled, now residing in Shelbyville, Kentucky.
The loss of her health insurance compounded her challenges, forcing her to seek pills on the street. Repeated attempts to quit were thwarted by debilitating withdrawal symptoms, so severe she described being unable to leave her bed. These agonizing experiences consistently drove her back to drug use, a cycle that continued until last year.
A turning point came through her church, where she learned about the NET device. This cellphone-sized apparatus, connected to gel electrodes placed near the ear, delivers low-level electrical pulses to the brain. For Warfield, the impact was immediate. “Once I got set up on the device, within 30 minutes, I didn’t have any cravings” for opioids, she stated. After three days of use in August, Warfield reported that she stopped using drugs altogether.
Warfield’s treatment was funded by her county’s allocation of opioid settlement dollars—funds derived from legal actions against pharmaceutical companies accused of fueling the nation’s overdose crisis. Across the United States, state and local governments are receiving billions of dollars over nearly two decades, earmarked for addiction treatment and prevention initiatives.
The promise of the NET device has led Warfield to advocate for a significant portion of these settlement funds to be directed towards its adoption. The device, which costs counties approximately $5,500 per person, appears to be gaining traction. NET Recovery, the company behind the device, reports having secured about $1.2 million in contracts with over a dozen counties and cities in Kentucky.
However, this rapid acquisition of opioid settlement funds by NET Recovery has raised concerns among some researchers and recovery advocates. They view the NET device as the latest in a line of products marketed as panaceas for the addiction crisis, potentially exploiting the desperation of individuals and capitalizing on the influx of settlement money. Historically, many such products, from high-dose overdose reversal medications to body scanners for jails, have been promoted with grand claims but limited empirical evidence. This has not deterred sales representatives from actively lobbying elected officials and providing them with pre-written templates to secure settlement funding for their products.
A similar device, known as the Bridge, experienced a surge in popularity several years ago, receiving over $215,000 in opioid settlement funds nationwide. However, serious questions regarding the study that underpinned its effectiveness emerged, ultimately leading to its removal from the market.
Tricia Christensen, a national expert on opioid settlements based in Tennessee, observes that NET Recovery’s current trajectory “fits the national trends of these industry money grabs.” While acknowledging that the device “could be helpful for some,” she cautions that “it’s being sold as a silver bullet.” Reinforcing these concerns, 237 organizations dedicated to ending overdoses, including Christensen’s consulting firm, published a roadmap this year to guide officials managing opioid settlement funds. Their document specifically identifies the NET device as an example of problematic spending on unproven treatments.
Distinguishing Withdrawal Management from Addiction Treatment
The Food and Drug Administration (FDA) has cleared the NET device for a specific indication: the reduction of drug withdrawal symptoms. Crucially, it has not received approval for the treatment of addiction itself. This distinction is vital, according to Eric Hulsey, executive director of the Institute for Research, Education and Training in Addictions. Hulsey, who co-authored a recent report evaluating neuromodulation devices like NET, explained, “The term ‘treatment’ becomes confusing. These devices were cleared to treat opioid withdrawal symptoms, not to treat an opioid use disorder.”
NET Recovery CEO Joe Winston maintains that the company adheres to FDA regulations and markets the device solely for withdrawal management. However, he also noted that "we are finding that physicians are prescribing this to folks for long-term behavior based on the results of our study."
Winston is referring to a study published in October, which he co-authored and NET Recovery funded. The research followed two groups of addiction patients in Kentucky for 12 weeks. One group received the NET device for up to seven days, while the control group received a sham treatment. The study found no statistically significant difference in outcomes between the two groups. Participants who used the NET device were just as likely to use illicit drugs after treatment as those who received the sham intervention.
Hulsey, who was not involved in the study, stated that the findings clearly indicate "They didn’t find that was effective." However, a subgroup of participants who chose to use the NET device for more than 24 consecutive hours did report using illicit drugs less frequently than other participants. The study authors themselves acknowledged that this subgroup might have been more motivated to engage with any form of treatment, suggesting the observed effect might not be directly attributable to the device’s efficacy.
Rapid Expansion and Commercial Ambitions
Despite these findings, Winston expressed optimism about the subgroup’s results, calling them “intriguing and outstanding.” This perceived success has spurred NET Recovery to open a brick-and-mortar facility in Miami, where the device will be available for a self-pay price of $8,000, significantly higher than the cost to county governments. The company has also applied for Kentucky state opioid settlement funds to conduct a larger research study and plans to expand the NET device’s availability into metropolitan areas like Louisville and Lexington.
In a move that has drawn particular scrutiny, NET Recovery hired a magistrate from Franklin County, Kentucky, to lead its state operations. Magistrates in Kentucky function similarly to county commissioners. Kelly Dycus, who also holds a credential as a mental health clinician, has been actively promoting the device to various counties, encouraging officials to contract with NET Recovery. Notably, her own county awarded $75,000 to NET Recovery prior to her employment with the company. Dycus has stated she will recuse herself from any future contract votes in her county.
Christensen, the opioid settlement expert, described Dycus’s new role as "extremely strategic" for NET Recovery and an "obvious conflict of interest" for a public official.
Prioritizing Evidence-Based Recovery Options
Jennifer Twyman, who has a personal history of opioid addiction and now works with Vocal-KY, a nonprofit advocating for an end to homelessness and the war on drugs, believes that increasing recovery options is generally beneficial. However, she raised concerns that finite settlement funds invested in new technologies like the NET device could divert resources from established, evidence-based services. These critical services include mental health treatment, housing assistance, and transportation programs, which are essential for many individuals struggling with addiction.
"People slip through these big, huge gaps we have and they die," Twyman stated, gesturing to photographs of deceased friends displayed in her office. She emphasized the importance of medication-assisted treatment (MAT), such as methadone and buprenorphine, which national data indicates is the gold standard for treating opioid addiction, yet only one in four individuals with opioid addiction receive it.
Twyman noted that many individuals face barriers to MAT, including cost, difficulty finding prescribing physicians, and lack of transportation. Furthermore, stigma persists, with some critics unfairly characterizing medication-assisted treatment as merely "swapping one drug for another." This stigmatizing narrative is sometimes amplified by companies like NET Recovery. For instance, Derran Broyles, jailer of Scott County, Kentucky, and considered a key proponent of the NET device by the company, publicly stated at a meeting that medication treatment is simply “swapping one drug for another.” This viewpoint is widely refuted by many researchers and clinicians.
Joe Winston of NET Recovery stated that his company supports all recovery pathways but believes the NET device serves an "underserved population" of individuals who prefer not to use medication.
Mark Greenwald, a seasoned addiction researcher who has conducted studies for NET Recovery and consults for Indivior, a major producer of medications for opioid use disorder, sees value in both approaches. He believes the most effective strategy depends on the individual patient. For those who inject drugs or have a history of high fentanyl use, and are at a higher risk of returning to drug use after residential treatment, Greenwald expressed hesitation in recommending the NET device, noting that abstinence-only approaches can increase their mortality risk. However, for individuals who are "highly motivated to stay abstinent," the NET device might be a suitable option. Ultimately, he concluded, "Giving people choices is the right thing to do."
The Role of Community in Sustaining Recovery
Michelle Warfield, who has remained opioid-free since August, credits her recovery not solely to the NET device but also to the robust support system she has built. She acknowledges that the device is "not a miracle cure" and that managing triggers remains a challenge, but she finds it significantly easier. Warfield actively participates in individual and group therapy to address childhood trauma, has forged strong friendships within her church community, and has reconnected with her daughter. She has even installed a car seat in her vehicle, enabling her to drive her grandson to preschool, a tangible sign of her renewed engagement with life.
Warfield’s simple yet profound hope for the allocation of opioid settlement funds is to "help people get as much help as they can," reflecting a deep desire for her community to benefit from the resources that have aided her own journey toward lasting recovery.