The use of brain surgery to help drug addicts to detoxify has become an increasingly contentious issue in many parts of China, with the Ministry of Health (MOH) issuing a circular on November 2 suspending the technique.
The ministry has now instructed all use of the surgery to stop on the basis that, with over 500 procedures having already taken place, there is enough data to assess its effectiveness.
Although the surgery was still at an experimental stage, many hospitals in Guangdong, Shanghai, Chongqing, Shenyang and Beijing said they used it to meet demand from desperate patients and their families.
The MOH had at first concluded that such surgery could not be offered to patients as a clinical service until further research was completed. While results had so far indicated that the surgery may well offer an additional method to help detoxification, the risks had not been evaluated. The ministry's latest decision bans further clinical trials as well.
The ministry said that organizations in Sichuan and Guangdong provinces that had conducted most of the surgery should collate and evaluate the results. The MOH will then be able to move to the next stage of assessing overall findings and deciding whether to use the procedure in the future.
Medical opinion varies widely on the surgery itself and how it has been tested so far.
According to the director of Beijing Navy General Hospital, although there have been good results, some institutions rushed to provide the surgery in order to make money from patients willing to try anything to beat their addiction, resulting in accidents and ill-considered decision making.
Xu Dezhi, head of Guangdong's Sanjiu Cerebral Hospital, said that in all of the many instances they have utilized it there has been full informed consent on the part of patients, and they have only charged cost price for the procedure. Their methods and results have also been strictly monitored by the MOH as part of clinical trials. Xu concedes that other hospitals' use of the surgery has not been so well monitored and that they often don't have good enough equipment to carry it out safely.
The head of Xinan Reeducation Through Labor Center in Beijing, Wang Wencheng, said that most of their patients would have grave doubts about going for the procedure owing to as-yet undocumented side effects. Wang maintains that the only way to go through detoxification is with perseverance on the part of the patient and the right kinds of support from those around them.
Professor Li Yongjie, head of the Beijing Institute of Functional Neurosurgery, says that the technique was always too much of an unknown. "The structure and function of the brain is too complicated. It is very difficult to confirm which part is directly linked with drug addiction." Cells involved in drug dependence are not located in one area of the brain, but dispersed throughout. "The surgery cannot be reversed and the damage is too hard to remedy."
On November 4, an unidentified Ministry of Health official emphasized in an interview with Xinhua News Agency that this form of surgery has been suspended and is forbidden under any circumstances.
While the procedure had previously been approved for clinical trials, its use on 500 patients was sufficient to conduct follow-up studies.
Moreover, the official stated, using a procedure approved only for clinical trials as a clinical service for which patients are charged is unethical and immoral.
(China.org.cn by Wang Qian November 6, 2004)
