背景:在过去的7年中,美国与阿片类药物相关的死亡人数增加了两倍多,与COVID-19大流行同时开始急剧增加。迫切需要新的治疗选择,可以帮助减轻难治性阿片类药物使用障碍(OUD)的个人和社会影响。深部脑刺激(DBS)一种干预措施,包括在大脑中植入电极以传递电脉冲,是一种潜在的治疗方法。目前在许多精神疾病的临床试验中,包括OUD,DBS用于精神病适应症并非没有争议。一些研究已经检查了使用DBS对抗治疗抵抗抑郁症引起的伦理问题,强迫症,和饮食失调。相比之下,关于将DBS用于OUD的文献有限。
目的:本研究旨在获得对公众对使用DBS进行OUD的看法的经验神经伦理学见解,特别是通过分析基于网络的关于新闻媒体故事的评论话题。
方法:对2篇《华盛顿邮报》报纸报道进行了定性主题内容分析,这些报道描述了DBS用于治疗OUD的情况。共有292条评论被纳入分析,每个故事的146条评论,确定评论者提出的主要主题。
结果: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,成瘾是否是一种精神健康障碍,以及与资源分配有关的问题。将第一份印刷报纸故事与第二份报纸故事进行比较时,关于DBS作为OUD治疗方法的有争议的评论似乎有所减少。相比之下,与治疗需求相关的评论数量随着时间的推移而增加.
结论:公众对DBS作为OUD治疗方法的观点通过这种定性的主题内容分析阐明了主题,包括总体的社会政治问题,关于技术使用的立场,以及技术和科学问题。更好地了解公众对使用DBS进行OUD的看法,可以帮助解决有关使用DBS进行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。
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.