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Deep Brain Stimulation for Substance Use Disorders? An Exploratory Qualitative Study of Perspectives of People
Erika Versalovic1, Eran Klein, Sara Goering
1From 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).
Objective:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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