пятница, 13 января 2012 г.

Content analysis of proprietary patented treatment methods for substance abuse and dependence

Content analysis of proprietary patented treatment methods for substance abuse and dependence disorders in USSR and Russia in 1925-2011 
If we will try to make a search in Google by keywords (in Russian) “treating alcoholism, narcotic abuse and dependence, narcological help” we’ll get thousands commercial web-sites (Fig. 1) with advertising offer services for instant treatment in one session. They call it “coding brain against dependence” or just “coding”. 
Fig. 1. The results of Google search for commercial offers about instant treating chemical dependencies in Russia. 
In the era of Evidence Based Medicine such interference calls scientific decorated shamanism (E. Krupitskiy 2008). In most part of these methods authors promise more than 80% positive effect (remission over 1 year) after their therapy. Very often they come up with pseudo-scientific terms, which often persist in the patient's community with support of  doctors. According to our estimates (S. Soshnikov 2009), Moscow has about 500 private narcologists which makes 60,000 monthly visits to patients for “coding” or “detox” the alcohol and/or drug abuse and dependence at clients’ homes. So these methods are very popular in Russia from 1993. Usually private narcologists do not count statistical data about their patients because they hiding from taxes and officials and we even don’t know how many patients died in their hands. The price of one visit with “detox and coding” started in Moscow from 250$. No guarantees, no feedback. Some of patients repeat “detox and coding” procedure over 10 times but it doesn’t works.
  • What about clinical trials for “coding” methods and according to principles of Good Clinical Practice? 
The search in main National Russian Scientific Library “E-library” (http://elibrary.ru) with keywords “coding brain against alcoholism, narcotics” gives only 118 papers for last 5 years. Some of them with criticism of “brain coding” (V. Mendelevich 2009-2011), some with discussions. There were no clinical trials for “coding” found. 
There is no such term “brain coding” in international medical practice (searched in PubMed).
  • What is inside the “brain coding” methods?
While the short-term treatment in order to correct a defect in the brain is very popular in Russia and prolongs for many years we were looking for documentary evidence of its existence. Due to the search in the Russian Federal Patent Service (ROSPATENT, www.fips.ru) data base we found that publication activity of narcologists was shifted to the patent activity. The probable reason is the lower barrier in the evaluation of the abstract of a patent in comparison to the review of the scientific article. We present the results of the qualitative analysis of  429 patented methods for treating addictive disorders which was invented in the late USSR and modern Russia. Research base for the analysis was served on the archive of ROSPATENT. Using frequency and proportions we designed the different types of methods considered separately conclusiveness of the proposed actions as well as the risk for patients and evidence-base for methods of treating. It was established that the most part of inventions was registered after 1985. In that year new type of drug treatment "coding against alcoholism and drug addiction" was founded. 
Fig. 2. Search in ROSPATENT Database for patents in narcology.
Conclusion
At the time as the national titles of scientific periodicals in generally corresponds to the content of international journals, patents analysis revealed a substantially different picture - the predominance of interventions aimed at a single application, drugs and drug-free therapy impacts targeted mainly on the central nervous system. A considerable part of interventions are bizarre, the vast majority are not justified in any randomized clinical researches ore justified by small series of cases. This pattern reflects not only the practice of "private narcologists" but the practice of Governmental agencies which can disturb the public and the medical community particularly because many patented methods pose as risky to patients.
  • Five examples of pseudoscientific treating methods
    • Patent # 2153882. "Patients with alcohol dependence receive the xeno-implant of donor fetal brain tissue with the use of cloth of bluish spots laboratory mammal in the amount of 15-25 mg. Transplantation is carried out under the patient skin distant in 6.5 intercostal space. The method reduces the expression of undesirable side effects of treatment and abstinence".
    • Patent # 1438783 "subcutaneous implant in the form of spherules to be filled in the zone located in the center distance between the special points # 1 Buy-Hui (20.III) and Sin-Hui".
    • Patent # 1279641 "The patient felt a" lightning strike to the head"... produced by procedure of application to the brain of the sinusoidal current with a frequency of 5000 Hz for 0.5-1 seconds "
    • Patent # 2159636 "Method of coding - give a verbal symbol "psychotronic weapons", and “alcohol is a super-substance". Suggestive effect enhances an atmosphere of mystery. Inspire "retribution" for violation of sobriety to the termination of anti-alcoholic code ... form the patient's psycho-emotional state out of the "miracle." It is also reported that the doctor has no right to disclose all the details of the process".
    • Patent # 2055602 "... the patient squeezes rubber roller teeth, head and the proposed location of the second electrode overlap cleaned with a solution of alcohol, the electrodes are applied using the technique of unilateral electroconvulsive therapy non-dominant hemisphere stimulation (right side for right-handers).


Fig. 3. The commercial addictologist  narcologist web-site with promising of fantastic results (http://www.gindin.ru/method.html). 


Research team: S. Soshnikov, V. Vlassov, S. Vladimirov, A. Smirnov, R. Sosunov, A. Granitsa


Publication:  DOWNLOAD (PDF in Russian)

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