From the Department of Philosophy, University of Washington, Seattle, WA (EV, EK, SG); Center for Neurotechnology, University of Washington, Seattle, WA (EV, EK, SG); Department of Neurology, Oregon Health and Science University School of Medicine, Portland, OR (EK); Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN (QN, KG); College of Computing, Massachusetts Institute of Technology, Cambridge, MA (MB); Department of Philosophy, Fordham University, New York, NY (LSS); Department of Neuroscience, University of Minnesota, Minneapolis, MN (MJT); Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN (MJT, ASW); and Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN (ASW).
J Addict Med. 2023;17(4):e246-e254. doi: 10.1097/ADM.0000000000001150. Epub 2023 Mar 3.
Although previous studies have discussed the promise of deep brain stimulation (DBS) as a possible treatment for substance use disorders (SUDs) and collected researcher perspectives on possible ethical issues surrounding it, none have consulted people with SUDs themselves. We addressed this gap by interviewing people with SUDs.
Participants viewed a short video introducing DBS, followed by a 1.5-hour semistructured interview on their experiences with SUDs and their perspective on DBS as a possible treatment option. Interviews were analyzed by multiple coders who iteratively identified salient themes.
We interviewed 20 people in 12-step-based, inpatient treatment programs (10 [50%] White/Caucasian, 7 Black/African American [35%], 2 Asian [10%], 1 Hispanic/Latino [5%], and 1 [5%] Alaska Native/American Indian; 9 women [45%], 11 men [55%]). Interviewees described a variety of barriers they currently faced through the course of their disease that mirrored barriers often associated with DBS (stigma, invasiveness, maintenance burdens, privacy risks) and thus made them more open to the possibility of DBS as a future treatment option.
Individuals with SUDs gave relatively less weight to surgical risks and clinical burdens associated with DBS than previous surveys of provider attitudes anticipated. These differences derived largely from their experiences living with an often-fatal disease and encountering limitations of current treatment options. These findings support the study of DBS as a treatment option for SUDs, with extensive input from people with SUDs and advocates.
虽然先前的研究已经讨论了深部脑刺激（DBS）作为治疗物质使用障碍（SUD）的一种可能方法，并收集了研究人员对其潜在伦理问题的看法，但没有人咨询过患有 SUD 的人本身。我们通过采访患有 SUD 的人来解决这一差距。
参与者观看了一段介绍 DBS 的短视频，然后进行了 1.5 小时的半结构化访谈，内容涉及他们的 SUD 经历以及他们对 DBS 作为一种可能治疗选择的看法。访谈由多名编码员进行分析，他们反复确定突出的主题。
我们采访了 12 步治疗计划中的 20 名住院患者（10 名[50%]白人/白种人，7 名黑人/非裔美国人[35%]，2 名亚洲人[10%]，1 名西班牙裔/拉丁裔[5%]，1 名[5%]阿拉斯加原住民/美洲印第安人；9 名女性[45%]，11 名男性[55%]）。受访者描述了他们在疾病过程中目前面临的各种障碍，这些障碍与 DBS 通常相关的障碍（耻辱感、侵入性、维护负担、隐私风险）相吻合，因此使他们更愿意接受 DBS 作为未来的治疗选择。
与先前对提供者态度的调查预期相比，患有 SUD 的个体对 DBS 相关的手术风险和临床负担的重视程度相对较低。这些差异主要源于他们在患有常致命疾病时的经历，以及遇到当前治疗选择的局限性。这些发现支持了将 DBS 作为 SUD 治疗选择的研究，需要广泛征求患有 SUD 的人和倡导者的意见。
