

Controversial Surgery for Addiction Burns Away Part of the Brain - 4ad
http://healthland.time.com/2012/12/13/controversial-surgery-for-addiction-burns-away-brains-pleasure-center/

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achille
Some more insightful discussion on reddit.com/r/neuro/15jlxg

 _... read the abstract of this a while back, and it was bilateral ablation of
the nucleus accumbens, if memory serves. The nucleus accumbens, of course, is
not the "pleasure center" by any definition. It does not exclusively deal with
pleasure, and pleasure is not only the product of the nucleus accumbens. As
I'm sure many will know, the nucleus accumbens deals with lots of processes
such as motivation, reward and both "positive" and "negative" emotion. It is
pretty brutal, of course, and naturally this article was primarily concerned
with the ethics of the procedure..._

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Dirlewanger
Maybe it's just me and my warped mind, but there's a part of me that
incredibly fascinated with the amount of boundaries that countries like China
are pushing (medical, human rights, etc.) with a dearth of any kind of ethical
oversight whatsoever. They are rapidly approaching the West's level of
technological sophistication but yet they've come down a completely different
path...one devoid of any kind of power-checking, one that does not care of
what the public thinks/will think or even what groups in other countries
think. It's...quite the sight in the modern world.

~~~
zalew
> They are rapidly approaching the West's level of technological
> sophistication

really? a few months ago one of their rapid trains crashed into another
because a lightning strike disabled it's system and the following one didn't
even know the hit one slowed down. all other super rails have systems and
procedures to prevent such occurences (let's not even get started on the
Japanese one). say what you want, I wouldn't want to live or work in one of
those Chinese 'build in 14 days' buildings.

~~~
Dirlewanger
>I wouldn't want to live or work in one of those Chinese 'build in 14 days'
buildings.

Oh, neither would I. When I say they're rapidly approaching us, I mean they
are fast acquiring the means/funding to do so, but not in the sense that
everything they make is safe/ethical through a Western society's lenses. This
is the lack of oversight I'm talking about and is one of the tenets that sets
us apart from the BRIC countries and other developing ones.

~~~
zalew
Brasil and Russia both have various specific to their natures issues, but I
wouldn't put them in one line with China _trying too hard_ to become Jetsons
overnight.

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alxndr
"Within five years, 53% had relapsed and were addicted again to opiates,
leaving 47% drug free.

"Conventional treatment only results in significant recovery in about 30-40%
of cases, so the procedure apparently improves on that, but experts do not
believe that such a small increase in benefit is worth the tremendous risk the
surgery poses."

~~~
praxeologist
Since FDA-approved treatments for nicotine addiction can't crack 10% in real
studies, this 30-40% number seems quite dubious. Faulty studies for nicotine
give similarly high percentages.

~~~
betterunix
Not all treatments are medical. Substance abuse is a behavioral problem, and
approaches based on clinical psychology have been remarkably successful.

~~~
praxeologist
What % is "remarkably successful" though? Maybe with current therapy for drug
abuse we are fairly close to as good as we are ever going to get but I still
doubt 30-40% of people who go into treatment stop using. People just don't
change their behavior that easily.

I work in tobacco so can only really speak about that but a quick google is
showing similar single-digit success rates for drug treatment.

I'm with Szasz that addiction is not a disease but this is not conventional
wisdom. Obviously, drugs are not just given like how an antibiotic is, but
drugs such as for related ailments like depression can be given for people in
drug treatment AFAIK.

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gee_totes
Since we're talking about treatments for addiction, I'd like to give a shout-
out to ibogaine[0], a psychoactive substance.

Apparently after a successful treatment with ibogaine, it's like an "addiction
switch" has been turned off in your brain. I was interested to read this
article hoping there would be more about the "addiction switch", which I find
a fascinating concept.

Instead, maybe with this treatment, the switch simply gets burned away...

[0]
[http://en.wikipedia.org/wiki/Ibogaine#Treatment_for_opioid_a...](http://en.wikipedia.org/wiki/Ibogaine#Treatment_for_opioid_addiction)

~~~
jacoblyles
Psilocybin (magic mushrooms) are also being studied as a non-invasive
treatment for OCD and addiction:
<http://en.wikipedia.org/wiki/Psilocybin#Medical_research>

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michaelfeathers
I read the whole article expecting to find some report of patient opinions
post-surgery but it wasn't there.

~~~
jonathanwallace
This is exactly what I was looking for too. I'm disappointed not to find it.

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idm
Neuromancer; the drug-addicted protagonist had been the unwilling recipient of
surgery like this (if memory serves).

~~~
PotatoEngineer
And his solution was simply to find different drugs. Considering there's a 53%
failure rate for this surgery, the results sound similar.

------
debacle
It seems like the surgery is only marginally more effective than conventional
methods, and has drastic side effects.

The only scientists interested in this procedure seem to be sating a morbid
curiosity rather than trying to cure addiction.

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antihero
Thing is, the real issues with addiction are due to social factors - being
homeless, depressed and miserable.

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vegas
What could possibly go wrong?

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icegreentea
There is no information on how patients were selected for this treatment,
which does weigh in on the ethics and possibly the technical merits (assume
the numbers aren't fudged) of even studying this.

If the patient pool was drawn from consistent relapsers who failed to respond
to conventional treatment, then this could be significant.

If they just applied this procedure nilly-willy on first timers... then yeah,
this is pretty bad.

We can draw -some- parallels with various procedures designed to fight
obesity. Obviously screwing around with the brain is on a whole different
level from screwing around with your GI tract, but the purpose is the same -
to physically change your body to change your urges.

In fact, given the research raising the probability that the nervous system
supporting the GI tract has non-trivial effects on our mental states, the two
types of procedures may be closer than expected - though once again, obviously
acting on completely different degrees on magnitude in respect to effect on
your mind/being.

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foxhop
sounds like the methods used in a clockwork orange

~~~
photorized
I thought Clockwork Orange worked by forcefully building strong negative
associations

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lifebar
In comment section someone suggested using that on sex offenders... Nice, get
wrongly accused of rape (might not happen where you live, but where I live
it's common way to get money from a man) and be lobotomised. Some other
commenter suggests to find anger spot in brain and fix that... I suggest beter
surgery- lets behead every morron suggesting such crap.

~~~
betterunix
There are already proposals to castrate (chemically or even surgically) sex
offenders. It was not all that long ago that lobotomy was common practice, and
it was applied to prisoners.

~~~
lifebar
Yes, and I hopped that we grew out of "lets do unfixable damage to everyone we
don't like" age. And about castration - it might end up common practice, after
all radical feminists are pushing for castration of men (and their
extermination), feminism keeps fud that all women will be raped...

I would honestly take capital punishment rather than live lobotomised or
castrated.

~~~
king_jester
> And about castration - it might end up common practice, after all radical
> feminists are pushing for castration of men (and their extermination),
> feminism keeps fud that all women will be raped...

This is FUD, mandatory chemical or surgical castration for convicts is not a
popular thing and isn't being pushed for legislatively or by most activist
groups at this time. Feminism does not make a case for exterminating men, and
anyone who suggests that men should be exterminated is an idiot. Also, 1 in 4
women will be sexually assaulted in their lifetime, that is a very real
problem, but please get your facts straight.

~~~
betterunix
"Also, 1 in 4 women will be sexually assaulted in their lifetime"

That is a number that came from _one_ study, from the 1980s, which was
conducted by a feminist, and which includes _attempted_ attacks. I am not
saying that the problem of women being sexually assaulted should be ignored,
but the 1-in-4 figure is the second highest to have been reported (1-in-3 is
the highest; some studies have found less than 1-in-50) and was meant to be
shocking. The experimental methodology used to find that number was based on
the hypothesis that using words like "rape" would trigger a denial in the
women be surveyed; thus the study asks questions that fit a broad definition
of rape, and even the woman who created that survey later admitted that one of
the questions about rape was ambiguous and could cover consensual sex.

Don't just parrot numbers you read in feminists literature. Rape is a serious
crime; don't diminish its significance or the extent of its harm by claiming
that there are nearly a hundred million rape victims in America (which invites
people to ask, "Why aren't all those victims in counseling? Is rape really a
crime whose victims need counseling?").

~~~
king_jester
> That is a number that came from one study, from the 1980s, which was
> conducted by a feminist, and which includes attempted attacks.

Upon reading your comment, I went back to look for original source material.
You are right, I could not find a source or even mention or that fact.
Instead, I found citations for studies that show 1 in 4 women will experience
a sexual assault (not just rape) during an academic career, or that 1 in 4
women will experience sexual violence from a partner in their lifetime, or
that 1 in 6 American women have been the victim or an attempted or completed
rape in their lifetime. So I do apologize for having the wrong statistic.

Also, since when does being a feminist automatically disqualify your study or
paper?

> Rape is a serious crime; don't diminish its significance or the extent of
> its harm by claiming that there are nearly a hundred million rape victims in
> America (which invites people to ask, "Why aren't all those victims in
> counseling? Is rape really a crime whose victims need counseling?").

There are at least hundreds of thousands of sexual assault survivors in the
US, which is horrifying enough. As for what you said about counseling, those
kinds of comments are one of the more common kinds of derailment people trot
out and you and I both know is there is a large number of reasons why any
person is not in counseling (for anything, really): cost, stigma, lack of
access to counseling services, etc.

In any case, OPs paranoia about being castrated by angry feminists is
laughable and spreads FUD about feminism, esp. in regard to what rad fems
consider feminism to be.

~~~
supergauntlet
>Since when does being a feminist automatically diqualify your study or paper?

I think what he was trying to point out was that there might be a conflict of
interest with the researcher wanting to over-report rape. Still a bit of a
stretch, but possible.

