This release reports the findings from a small pilot study asking whether rTMS (repetitive transcranial magnetic stimulation) to certain parts of the brain in cocaine users can limit their use and affect their cravings for the drug. The results showed a decrease in both use and cravings for cocaine among the experimental group, as compared to a control group which only received medicinal drugs to address the effects of cocaine. The release did not address costs or the availability of rTMS treatments; otherwise it was a good, readable overview of an intriguing study.
While cocaine abuse is widespread in the developed world, there are no proven therapies for this addiction. Some pharmacologic approaches appear to be helpful but they are still under investigation. Medicines given to such patients are intended to affect the symptoms but not the underlying disease. If a non-invasive method such as rTMS proved effective in reducing cocaine use and if it were readily available, it would bring significant improvement to those users willing to take advantage of it.
While the release clearly labels this work as preliminary, the overall inference of the news is that this is a potential successful treatment for cocaine addiction. But there is no mention at all of the potential cost of using this new approach.The FDA approved rTMS for major depression in December 2008. A 2013 article in Scientific American said a typical rTMS therapy session cost $300. In this study, patient volunteers underwent eight sessions which would have totaled $2,400 if paying out of pocket.
The costs of the drugs used to treat persons in the control group are well-known so at least those costs could be compared to that of the magnetic stimulation treatments to give readers an idea of whether the two approaches were financially comparable.
The release does an adequate job of pointing to improvements in both a reduction of drug cravings and an apparent reduction in cocaine use, based on regular urine tests. In addition, the release points to a greater relapse rate among those in the control group versus those who received the brain stimulation — using absolute numbers to describe the differences.
The study is promising and exciting, but the findings are only a suggestion and not a conclusion. We think the news release makes the distinction clear.
The release states that the magnetic stimulation treatment is safe and non-invasive and is already in use to treat patients with depression and neuropathic pain.
This release does a good job of positioning the findings early as preliminary and stating that replication will be required among a much larger group of patients. It also points out that future larger studies should include a sham group as a control, rather than a group receiving pharmacological interventions. Moreover, it points out that participants were all patients who sought out treatment in a hospital setting, meaning that they were perhaps more motivated toward ceasing drug abuse than other users.
This release does not promote disease mongering.
The release fails to point out the funding sources for this work, or to address any possible information on potential conflicts of interest, even though that information is readily available in the research paper.
The published study states that funding was provided by several public and private sources in Italy and the National Institute on Alcohol Abuse (US), and that the study authors had no financial or potential conflicts of interest.
The release states, “There is no effective drug treatment for cocaine addiction, with behavioural therapies being the main element of any treatment regime.” The medicinal drugs used on members of the control group were intended to treat accompanying symptoms brought on by cocaine use. In addition, addiction specialists have found that some drugs do offer some small benefits clinically, but they are not FDA approved for cocaine addiction treatment.
While the release does state that this particular form of brain stimulation is being used to treat some other conditions, there is no suggestion that the treatment is readily available in most hospital or out-patient facilities, information which would help readers gauge the practicality of seeking such treatments.
The release states that, “As far as we know, this work represents the first clinical report indicating that rTMS treatment results in significant reduction in cocaine use.” That pretty clearly states the novel nature of the work, especially given the fact that there are no other effective treatments for cocaine addiction.
This release does not seem to use any language that appears unjustifiable.