Neurostimulation for addiction: a scoping review on mapping the evidence on TMS applications in substance use treatment

Background Substance use disorders (SUDs) pose a significant global health challenge, contributing to high morbidity, mortality, and societal costs. Despite existing treatments, long-term success remains limited, highlighting the need for innovative interventions. Transcranial Magnetic Stimulation (TMS), has emerged as a promising approach for modulating neural circuits involved in craving and addiction.Objectives This review systematically maps the application of TMS in the treatment of various substance use disorders.Methods A comprehensive literature search was conducted across multiple databases covering studies from 2000 to 2025. Inclusion criteria encompassed peer-reviewed, full-text articles investigating TMS for substance misuse, with data extraction and quality assessment performed independently by two reviewers.Results Out of 197 initial records, 10 studies met the inclusion criteria – most employed high-frequency rTMS targeting the prefrontal cortex, with protocols involving multiple sessions and pulse doses. Findings consistently demonstrated reductions in craving, substance intake, and relapse rates, alongside neural connectivity changes. TMS was generally well tolerated with minimal adverse effects, and protocols were feasible in clinical settings.Conclusion TMS shows potential as a safe, effective tool for reducing craving and consumption across various SUDs. Future research should focus on protocol standardization, the identification of objective biomarkers, and integration with existing therapies to facilitate clinical translation.