A surgical implant that reduces cravings for alcohol is helping free patients and their families from the pain of addiction.
Under bright surgical lights, a surgeon makes a steady incision just over a centimeter long in Yuan Qizhi’s navel before implanting 10 white pellets — each the size of a soybean, weighing about 1.5 grams — into the subcutaneous tissue.
The entire process takes less than 20 minutes, but it could just save this 56-year-old’s life.
For more than 30 years, Yuan has been fighting a losing battle with alcohol. The implants he’s just received are sustained-release naltrexone hydrochloride, also known as the “sobriety chip,” a prescription medication used to treat alcoholic disorder.
The drug will circulate his body before eventually crossing the blood-brain barrier, ultimately inhibiting the surges in dopamine and other pleasure-related neurotransmitters that come from consuming alcohol. Theoretically, it can block a person’s neural reward mechanism for up to 150 days.
Naltrexone was originally developed to help opioid addicts. Its use in the treatment of alcohol dependence is off-label, meaning that it’s being prescribed for a different purpose than what was approved.
For patients like Yuan and their families, the drug offers hope of a fresh start. However, while the implants will reduce a person’s cravings, clinicians explain that they cannot address the underlying psychological issues that cause addiction, such as anxiety, trauma, or interpersonal difficulties. A permanent cure requires a holistic approach, with support from loved ones, the health care system, and the broader community.
Left: A naltrexone hydrochloride implantation surgery. Courtesy of the interviewees; right: Naltrexone hydrochloride implants. Courtesy of the Shiyan Hospital of Traditional Chinese Medicine
Natural progression
Five months on, Yuan, who is slightly overweight, with thinning hair, says he’s noticed a significant decrease in his appetite and alcohol cravings. “I used to be restless, always itching to go out for a drink,” he says. “Now I wake up at 8 a.m. every day, make breakfast for my daughter, take her out for exercise, and spend my free time reading or watching TV.”
He can still feel some hardness where the implants were placed in his abdomen, and believes the medication is continuing to release into his body.
Yuan, who grew up in China’s central Hunan province, started drinking when he left high school and began working as a mechanic at a state-owned factory. His older colleagues would drink at mealtimes, and he says alcohol just became a natural part of his work and social life.
When he switched jobs to become a security guard at a different site in 2001, he developed a habit of starting each day with a shot or two of baijiu, the high-strength Chinese liquor, “just to feel alive,” and would sneak more during break times. He couldn’t see it at the time, but alcohol was starting to consume his life.
Then, in 2016, his 16-year-old daughter was diagnosed with schizophrenia, having displayed signs of emotional instability and delusions. Alcohol became a way to numb the pain, Yuan says, but it soon got out of hand. He would travel several kilometers late at night just to buy baijiu at a 24-hour gas station, and he once drank so much he suffered alcohol poisoning, which took him three days to recover from. “Looking back, I was completely out of my mind,” he says, shaking his head.
Yuan was first admitted into an alcohol rehabilitation program six years ago. By this point, he was drinking nonstop and rarely eating. Desperate, his wife, Chen Lijun, tricked him into receiving help by saying she’d booked him a health check. He was kept on a ward for eight days, following a regimen of medication, injections, recreational activities, and reading in the library.
He made a firm resolution to quit when he was discharged, but relapsed within months. “It felt like an unbearable itch inside,” he says.
Yuan Qizhi was photographed by his wife after a relapse. Courtesy of the interviewees
This sensation is extremely common among alcoholics, and often drives them back to the drink. According to Sun Hongqiang, vice president of the Peking University Sixth Hospital, in Beijing, without consistent treatment, 60% to 80% of patients relapse.
Yuan’s continued excessive drinking eventually caused him to experience hallucinations, during which he would think he was in hell, or could see ghosts. This resulted in him being hospitalized again, this time of his own volition.
While there, a friend who was known for being able to down a half-liter bottle of liquor during one round of mahjong suddenly died. Still, it did not prevent Yuan from relapsing once more upon his return home. When Chen discovered that her husband was secretly buying alcohol online and hiding it in water bottles in the bathroom, she installed an iron door and locked him in a room for three days, passing him food through a small gap.
Later, she volunteered Yuan for a medical documentary about rehab for alcoholics that was being jointly produced by a local hospital and TV station. He was admitted to a cessation clinic along with six other heavy drinkers, and a camera crew followed the entire, weeks-long treatment process, from acute withdrawal — where doctors will prescribe drug-substitutes to reduce cravings, depending on a patient’s behaviors — to group therapy, individual counseling, desensitization therapy, and eventually sobriety.
Li Ruihua, a doctor specializing in addiction medicine at the Shandong Mental Health Center, in Jinan, capital of the eastern Shandong province, explains that some people with alcohol disorders will attempt to treat themselves by stopping entirely and “going cold turkey.” However, this can be dangerous for those with long-term dependency.
Alcohol-dependent patients need a stable blood alcohol level for normal brain function. Stopping suddenly can trigger severe withdrawal symptoms, such as delirium tremens, better known as “the DTs,” which is characterized by physical tremors and brain dysfunction, and can be fatal. Hence, medical supervision during detoxification is essential, Li says.
Yuan was discharged from the clinic once filming was completed, and he subsequently relapsed again. Last December, he agreed to undergo the free, off-label treatment to implant naltrexone hydrochloride at Hunan Brain Hospital in Changsha, the provincial capital.
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Zhou Xuhui, director of the hospital’s Addiction Medicine Center and chairman of the Chinese Association of Drug Abuse and Treatment, has been working in addiction treatment since 2008. She says that in the past, alcoholism was seen as merely a habit, resulting in few people seeking help. Even when they did, the limited treatment options meant patients would usually relapse soon after being discharged from rehab, causing a “revolving door” effect.
“The cycle of relapse and rehospitalization leaves patients despondent, families feeling frustrated over wasted money, and doctors feeling helpless,” she says.
In 2014, Zhou contributed to the writing of China’s first Alcohol Use Disorders Treatment Guidelines. While reviewing data, she found that the United States Food and Drug Administration had approved several treatments, including naltrexone. However, China lacked both long-acting naltrexone injections and basic tablets.
Naltrexone implants were initially developed to treat opioid addiction, and later received a “breakthrough therapy” designation from China’s Center for Drug Evaluation, exempting the treatment from Phase III clinical trials. It was approved by the central government in July last year, but its use for treating alcohol dependence remains off-label.
In 2023, Phase II clinical trials were conducted nationwide to support the approval of naltrexone implants for alcoholics, enrolling 210 patients with moderate to severe dependency. The Hunan Brain Hospital and Shandong Mental Health Center both participated.
Zhou recalls that one patient — a man who had been admitted to her department more than 10 times and had a track record of relapsing after just 20 days — reported in a post-surgery follow-up interview, “I don’t know what happened, but this time I really don’t want to drink — even thinking about alcohol makes me feel nauseous.”
Unfortunately, he restarted drinking after a year, “but not as severe as before,” she says, and now he was engaging in diverse activities, no longer consumed by thoughts of alcohol.
Zhou explains that, while achieving 100% abstinence is ideal, it’s difficult to quantify other kinds of improvements following treatment. Evaluations of recovering patients are based on factors such as the number of sober days and drinking days, social functionality, and enhanced quality of life.
Zhou Xuhui gives a speech during a New Year’s gala held for inpatients. Courtesy of the interviewees
Implanting hope
Clinicians warn that alcoholism never affects only the patient, and often has the potential to turn an entire family’s life upside down. Long-term alcohol abuse can fundamentally alter someone’s personality, leading to paranoia, violent outbursts, and other antisocial behaviors.
“Some use alcohol as a coping mechanism,” Zhou says, as Yuan did after his daughter’s diagnosis. It offers an escape from reality, a temporary reprieve from their problems.
Wang Lu, who lives in the eastern Jiangxi province, started working from home early this year to care for her alcoholic husband, who is in his 40s. For him, what started as an occasional drink 15 years ago escalated into weekend binges in recent years, leading to work absences ranging from half a day to a week.
When Wang worked in an office for a media outlet, before leaving the house, she would confiscate her husband’s phone to stop him ordering alcohol online, but she was still afraid he’d find some way to drink alone. When sober, he was kind, upright, and responsible, and would read to their child. This made her confident that, with effort, their family could return to normal.
She began researching treatment options on the internet, where she learned about naltrexone implants, and convinced her husband to attend an Alcoholics Anonymous, or AA, meeting held at a massage clinic in an old residential community. Wang accompanied him and met several other recovering alcoholics — including the clinic’s owner, who had been sober for four years — and their family members.
She recalled that one 22-year-old man had made a six-hour round trip to attend a meeting. He revealed that his condition had gotten so bad that he’d spent time in intensive care, on the brink of death, but he was now one year sober.
Technology can provide tools, but real change is built on our collective perseverance.
AA provided Wang with significant psychological support and became her outlet for expression. However, her husband attended only one meeting, dismissing it as “a gathering of drunks,” and rejected the notion of showing up twice a day to “share his story.” He insisted that achieving sobriety was a solitary journey, and refused to see himself as a “patient,” Wang says.
Over time, the strain led to Wang developing severe insomnia and self-doubt, yet she didn’t give up. “I resented him, but I also understood him,” she admits, explaining that her next step was to contact the families of people who had received the naltrexone implants.
She found mixed results: some had stopped drinking for good; others had relapsed, and in the worst cases had even increased their consumption, as the alcohol no longer had an effect. Still, it was better than doing nothing, she thought. So, in March, her husband underwent the implant surgery.
Afterward, his emotions stabilized significantly, and he began spending more time with their child. So far, he hasn’t relapsed. But Wang knows that surgery is only half the battle — family support and psychological assistance are just as crucial.
“Technology can provide tools, but real change is built on our collective perseverance,” she says.
A box of naltrexone hydrochloride implants. Courtesy of the interviewees
Clearer days
China still lacks extensive clinical data on the lasting efficacy of the “sobriety chip.”
On Nov. 9, Hao Wei, a professor and director of the naltrexone prevention therapy project at Central South University’s Mental Health Institute, attended a conference in Changsha to present the Phase II clinical trial data on naltrexone’s role in reducing alcohol dependency. He reported that patients who received the implants showed significant reductions in heavy drinking days and total alcohol consumption compared with the control group.
Phase III clinical trials have yet to begin, but some hospitals in China are already offering the surgery as an off-label treatment. Eligible patients require a professional diagnosis of moderate to severe alcohol disorder, a strong motivation to quit, minimal liver damage, and no recent history of opioid use.
When asked about the procedure and its efficacy, Zhou tends to answer philosophically, explaining that, just as we all face mortality yet continue living meaningfully, treatment isn’t solely about cessation; it’s about facing relapse without shame, accepting failures, and repairing damaged relationships.
Beyond medication, treatment involves raising awareness of the complex causes of addiction and building a comprehensive support system across family and society, she says, adding that many addicts struggle to accept they actually have a disease.
Wang’s husband, for example, understood that his habit could kill him, but he blamed his relapses on a lack of willpower. He’d attempt to substitute alcohol with snacks and other beverages, but before long, he would be secretly drinking in the basement of his apartment block before returning home or running up large bar tabs, only to hurriedly pay them off when he was sober.
However, society’s understanding of addiction has evolved. Once stigmatized as a moral failing, it is now widely recognized as a chronic, complex brain disease, which has led to a shift in attitudes, especially among the families of patients. Zhou says this reflects the success in educating the public on alcoholism and how it can be triggered by stress and trauma.
While the naltrexone implants may aid recovery, long-term success still depends on the patient’s effort. For Wang, she hopes the treatment will continue working for as long as possible. It may not represent the finish line, but it has allowed her family to gain their footing on a better path.
(Due to privacy concerns, Wang Lu is a pseudonym.)
Reported by Li Cong.
A version of this article originally appeared in The Beijing News. It has been translated and edited for brevity and clarity, and is republished here with permission.
Translator: Chen Yue; editors: Wang Juyi and Hao Qibao.
(Header image: Visuals from VCG, reedited by Sixth Tone)