STATS ARTICLES 2005

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Rapid Detox Fails Clinical Trial
August 24, 2005
Maia Szalavitz
Media favorite no miracle cure; but will journalists cover negative findings?

The Journal of the American Medical Association today published the first controlled study to examine whether “rapid detox” programs offer the miracle cure for heroin and other opioid withdrawal and addiction that their promoters (and media like Wired, the Orlando Sentinel, 48 Hours and 20/20) have claimed.

The answer turns out to be no. According to the JAMA study, which had 106 subjects, simply anesthetizing a person and rapidly blasting their opioid receptors with antagonist drugs like naloxone is not more effective in relieving withdrawal or retaining people in treatment than two other commonly used methods.

The procedure is, however, expensive and dangerous—about a dozen people have died from complications over the years. Such complications aren’t associated with ordinary detox procedures—but three patients in the anesthesia-treatment group in the study developed potentially-life-threatening problems as a result of the intervention. None in the other groups had these problems.

Promoters of rapid detox claimed for the last 15 years that the risks were worth the benefits—that easier, more comfortable withdrawal would retain people in treatment for longer. That might well be true if the procedure actually made withdrawal less painful. But without controlled trials supporting these claims (and with abundant anecdotes from people who did not find that rapid detox was helpful), the media should have been far more skeptical.

Let’s see if reporters will now publicize the negative results as eagerly as they touted the early claims. After all, Wired quoted an expert who claimed that rapid detox was “one of the most innovative developments in the field since the advent of the 12 step program in the 1930s.” Readers and viewers deserve to know what the research actually finds. Science reporting must cover innovation—but it is mere advertising if it does not also report when it fails to live up to its promises.