Abstract

This article expands on our Deciphering Drug Study Tricks-of-the-Trade post. Ironically, general studies have been done on the reliability of behavioral studies. This article provides additional examples such.

In our view, the factor of the unreliability in behavioral studies must be applied to the evaluation on Medication-Assisted Treatment (MAT) studies if we wish to adopt a scientific orientation to ensure studies and their interpretations are accurate and are asking questions that lead to actionable answers.

Published, even peer-reviewed behavioral studies are subject to problems that must be accounted for when analyzing study results. Many of the “tricks-of-the-trade” are covered in Deciphering Drug Study Tricks-of-the-Trade but, somewhat ironically, general studies have been done on the reliability of behavioral studies.

A study of psychological studies published in Science in 2015 entitled Estimating the reproducibility of psychological science, found that less than 40% of psychological studies stood up when attempts were made to replicate them.

A 2016 article in Nature entitled, 1,500 scientists lift the lid on reproducibility, confirms how widespread the reliability problem really is.

These general cautions must be applied to the evaluation on Medication-Assisted Treatment (MAT) studies if we wish to adopt  a scientific orientation to ensure studies and their interpretations are accurate and are asking questions that lead to actionable answers.

For example, some promoters of MAT have flatly said that abstinence-based programs (those that do not rely on drugs) do not work. On the basis of simple observation, how is that possibly reconciled with the tens of thousands of people who have used abstinence-based programs to achieve drug-free lives?

Another factor that needs to be closely examined when discussing research results are the research sponsors. Some people would to like pretend that sponsorship is irrelevant but in the real world, it has an impact. It is therefore important to know that pharmaceutical companies that make MAT drugs are a primary promoter of the “addiction as disease” model and related studies. Thus, sponsorship is another aspect that requires examination when we discuss proffered research.

Moreover, there is little doubt that pharmaceutical companies contributed to the current opioid crisis. Such behavior should caution us to carefully examine claims they now make that more drugs are the only solution. (For a chilling, fascinating study of the origins of the current crisis including the part played by prescribed opioids, see DreamLand by Sam Quinones.)

In summary, not all studies are created equal. A reasoned, scientific approach to the opioid crisis includes a responsibility to carefully analyze studies which are presented as the basis for public policy decisions.