Henegan Patricia, Koczara Jack, Bluhm Robyn, Cabrera Laura Y
Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA, United States.
College of Natural Sciences, Michigan State University, East Lansing, MI, United States.
Online J Public Health Inform. 2024 Aug 16;16:e49924. doi: 10.2196/49924.
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.
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.
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.
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.
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.
在过去7年里,美国与阿片类药物相关的死亡人数增加了两倍多,且自新冠疫情开始以来急剧上升。迫切需要新的治疗方案来帮助减轻难治性阿片类药物使用障碍(OUD)对个人和社会造成的影响。深部脑刺激(DBS)是一种将电极植入大脑以传递电脉冲的干预措施,是一种潜在的治疗方法。目前DBS正在针对包括OUD在内的多种精神疾病进行临床试验,但其用于精神疾病适应症并非没有争议。几项研究探讨了使用DBS治疗难治性抑郁症、强迫症和饮食失调所引发的伦理问题。相比之下,关于DBS用于OUD的文献有限。
本研究旨在通过分析新闻媒体关于该主题报道的网络评论,获得关于公众对DBS用于OUD看法的实证性神经伦理见解。
对《华盛顿邮报》两篇描述DBS用于治疗OUD病例的新闻报道进行定性主题内容分析。分析共纳入292条评论,每个报道146条,以确定评论者提出的主要主题。
两个样本的评论者提出的主要主题包括对治疗结果的希望和期望、成瘾是否属于精神健康障碍以及资源分配问题。与第一篇印刷报纸报道相比,将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随时间增加。
通过这种定性主题内容分析,公众对DBS作为OUD治疗方法的看法阐明了一些主题,包括总体社会政治问题、对技术使用的立场以及技术和科学问题。更好地了解公众对DBS用于OUD的看法有助于解决关于DBS用于OUD的错误信息和误解,并确定与其他精神疾病相比,DBS专门用于OUD时在伦理问题上的异同。