Hole in the head to treat drug addiction

[sunyata]

This story was originally published in the Telegraph (UK)

'I was conscious as they pushed the needle deep into my brain'

(Filed: 22/11/2005)

China has resumed controversial brain surgery intended to cure drug users of their addiction, just a year after it was suspended.
It claims that the "hole in the head" operations are now being performed as part of a controlled experiment.
More than 500 of the operations, in which parts of a patient's brain are destroyed using a heated needle, were performed across China between 2000 and the end of last year - when the health ministry, faced with growing criticism, said their outcome was too uncertain for them to continue.
Side effects included loss of memory, weakened sex drive and extreme mood swings. Critics complained that there had been no proper scientific research into the treatment.
The health ministry said the operations would remain suspended until a proper medical evaluation was completed.
Now the leading expert in the field, who has overseen 262 of the operations, has been permitted to resume them.
Dr Gao Guodong, head of the medical research centre at Xian Tang Du Hospital in the central city of Xian, said his was the sole hospital allowed to start operating again.
"I will be in charge of the programme, which will be classified as a medical experimentation programme, unlike before, when it was classified as medical services," he said. It would exclude hospitals that had performed the surgery "driven purely by profit".
Chinese drug addicts and their desperate families had been willing to pay thousands of pounds for the treatment - pioneered, but then banned, in Russia - in the belief that it would cure them.
Dr Gao admitted that early attempts at treatment failed - one of his first patients went back on drugs within a week - but said the technique had now been vastly improved.
Patients who have stopped taking drugs for at least 15 days are given local anaesthetic in the top of the head before Dr Gao drills a half-inch diameter hole in their skull.
A thin surgical needle is slowly inserted deep into the brain, where it is heated to a temperature of up to 80C and kept inside for seven days by use of a surgical clamp applied around the head. The needle is removed, destroying - if all has gone to plan - that part of the brain linked to addictions and cravings.
Although the treatment is not an acupuncture technique, it has had a receptive audience in China, where the use of needles to cure ailments has a long tradition.
One of Mr Gao's satisfied patients is Liu Jie, 34, from Tianjin, who works in his father's packaging factory. He started taking heroin in 1996 and three years later was sentenced to 12 months in a camp dedicated to re-education through labour.
When released, Mr Liu resumed the habit, leaving him unable to work and facing divorce - until last year his parents urged him to sign up for the operation.
Mr Liu has not touched drugs since, but he has experienced some negative side effects. "My mood has changed and it's much easier for me to get angry than before," he said. "And I used to have a great memory. Now I forget things easily."
Despite that, he said his life had improved dramatically. "I can now work well and lead a normal life," he said. "My wife and I are happy together again. She's pregnant now."
Even more satisfied was Chen Xianfeng, 36, who lives near Shanghai. He sought treatment for a three-year habit. "It felt really strange," he said. "I was conscious when the needle went deep into my brain, I could feel it all the way. It was like a normal injection, but more painful."
Now, a few weeks later, he says he feels in perfect health - and has not experienced cravings for drugs since the operation.
Cases reported on state-run television have had less happy outcomes. One report focused on a 28-year-old woman whose father claimed she suffered dramatic mood changes after the operation.
Six months later, she started taking drugs again. After a few days, in a haze of frustration, she jumped from the window of her third-floor apartment, fracturing her spine.
The resumption of the operation has been criticised by some of Dr Gao's medical colleagues. Li Yongjie, director of neurosurgery in Xuanwu Hospital in Beijing, gave a warning last week that destroying one part of the brain would inevitably cause unpredictable side effects.
"If you turn down the brightness level on a TV set, all the channels will go darker," he said.
"In the same way, if you cut off the dependence on drugs in the brain there is also a strong chance of cutting off other things, such as control of emotions and sexual desire."
Related story: China: Hole in the Head surgery for addicts