Public Perceptions of Treating Opioid Use Disorder With Deep Brain Stimulation: Comment Analysis Study.

Patricia Henegan, Jack Koczara, Robyn Bluhm, Laura Y Cabrera
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Abstract

Background: The number of opioid-related deaths in the United States has more than tripled over the past 7 years, with a steep increase beginning at the same time as the COVID-19 pandemic. There is an urgent need for novel treatment options that can help alleviate the individual and social effects of refractory opioid use disorder (OUD). Deep brain stimulation (DBS), an intervention that involves implanting electrodes in the brain to deliver electrical impulses, is one potential treatment. Currently in clinical trials for many psychiatric conditions, including OUD, DBS's use for psychiatric indications is not without controversy. Several studies have examined ethical issues raised by using DBS to counter treatment-resistant depression, obsessive-compulsive disorder, and eating disorders. In contrast, there has been limited literature regarding the use of DBS for OUD.

Objective: This study aims to gain empirical neuroethical insights into public perceptions regarding the use of DBS for OUD, specifically via the analysis of web-based comments on news media stories about the topic.

Methods: Qualitative thematic content analysis was performed on 2 Washington Post newspaper stories that described a case of DBS being used to treat OUD. A total of 292 comments were included in the analysis, 146 comments from each story, to identify predominant themes raised by commenters.

Results: Predominant themes raised by commenters across the 2 samples included the hopes and expectations with treatment outcomes, whether addiction is a mental health disorder, and issues related to resource allocation. Controversial comments regarding DBS as a treatment method for OUD seemingly decreased when comparing the first printed newspaper story to the second. In comparison, the number of comments relating to therapeutic need increased over time.

Conclusions: The general public's perspectives on DBS as a treatment method for OUD elucidated themes via this qualitative thematic content analysis that include overarching sociopolitical issues, positions on the use of technology, and technological and scientific issues. A better understanding of the public perceptions around the use of DBS for OUD can help address misinformation and misperceptions about the use of DBS for OUD, and identify similarities and differences regarding ethical concerns when DBS is used specifically for OUD compared to other psychiatric disorders.

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公众对使用脑深部刺激治疗阿片类药物使用障碍的看法:评论分析研究。
背景:在过去 7 年中,美国阿片类药物相关死亡人数增加了两倍多,与 COVID-19 大流行同时开始急剧增加。目前急需有助于减轻难治性阿片类药物使用障碍(OUD)对个人和社会影响的新型治疗方案。脑深部刺激疗法(DBS)是一种潜在的治疗方法,它通过在大脑中植入电极来传递电脉冲。目前,深部脑刺激疗法正在对包括 OUD 在内的多种精神疾病进行临床试验,但它在精神疾病方面的应用并非没有争议。一些研究探讨了使用 DBS 治疗耐药抑郁症、强迫症和饮食失调症所引发的伦理问题。相比之下,有关使用 DBS 治疗 OUD 的文献却很有限:本研究旨在通过分析网络上对有关该主题的新闻媒体报道的评论,从神经伦理学的角度了解公众对使用 DBS 治疗 OUD 的看法:对《华盛顿邮报》的两篇报道进行了定性主题内容分析,这两篇报道描述了使用 DBS 治疗 OUD 的案例。共有 292 条评论被纳入分析,每篇报道中包含 146 条评论,以确定评论者提出的主要议题:在两个样本中,评论者提出的主要议题包括对治疗结果的希望和期待、成瘾是否属于精神疾病以及与资源分配相关的问题。与第一份报纸印刷版报道相比,第二份报纸印刷版报道中有关 DBS 作为 OUD 治疗方法的争议性评论似乎有所减少。相比之下,与治疗需求相关的评论数量则随着时间的推移而增加:通过此次定性主题内容分析,公众对 DBS 作为治疗 OUD 方法的看法阐明了一些主题,其中包括首要的社会政治问题、对使用技术的立场以及技术和科学问题。更好地了解公众对使用 DBS 治疗 OUD 的看法有助于消除关于使用 DBS 治疗 OUD 的错误信息和误解,并确定 DBS 专门用于 OUD 时与其他精神疾病相比在伦理问题上的异同。
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