How much do we know?

Clinical Evidence offers a pie chart that categorizes medical treatments (All medical treatments. This is not specific to addiction.) by their known effectiveness.

Use evidence-based approaches is important in all services, human and otherwise, but it’s easy to forget that the concept is not that simple–there are political factors, publication bias, research bias, real world vs. research considerations, individual client factors, practitioner factors, environmental factors, etc. When thinking about evidence-based approaches in the context of behavioral health, it’s also easy to lose sight of the larger medical context.

Figure 1 illustrates the percentage of treatments falling into each category. Dividing treatments into categories is never easy hence our reliance on our large team of experienced information specialists, editors, peer reviewers and expert authors. Categorisation always involves a degree of subjective judgement and is sometimes controversial. We do it because users tell us it is helpful, but judged by its own rules the categorisation is certainly of unknown effectiveness and may well have trade offs between benefits and harms. However, the figures above suggest that the research community has a large task ahead and that most decisions about treatments still rest on the individual judgements of clinicians and patients.

2 thoughts on “How much do we know?

  1. Thank you for your pie chart. The fact that sometimes treatment is not effective is a fact that hopefully in the future will be less true. The progression of medical treatment is moving forward. Technology is bringing us so much information at such a staggering rate that it looks as if in the next ten years there is sure to be some major breakthroughs. Thanks for keeping us informed.

  2. Research results on auricular acupuncture detox protocols have been mixed because the studies often focused on outcomes beyond the management of acute and post-acute withdrawal symptoms. However, many treatment programs using acupuncture have long maintained that the procedure successfully manages stress, craving, anxiety, sleep problems, and other classic withdrawal symptoms for virtually all program clients and for all classes of drugs, including preventing seizure in alcoholic and benzodiazepine patients. Researchers at the University of Rochester Medical Center have now identified a molecule, called adenosine, that seems to be involved in generating the physical effects seen in acupuncture. Adenosine is a natural substance known for helping to regulate sleep and for its anti-inflammatory properties. It is active in deep tissues and also acts as a natural painkiller, developing in the body after an injury to stop the transmission of pain signals. In the study, mice showed levels of adenosine that were 24 times greater than normal following a 30-minute acupuncture treatment. Acupuncture is not a stand-alone therapy in the treatment of substance use disorders. Withdrawal and post-acute withdrawal symptoms should be carefully monitored through a combination of self-reporting, observation, and urine testing, and if these symptoms cannot be successfully managed with acupuncture alone, pharmacotherapy should be used as a complement.

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