Editor—Brewer is correct when he states1 that he invited us to collaborate on a trial of detoxification under anaesthesia2 and that we did not take up this offer. We would not normally report publicly on such preliminary discussions or our reasons for not going ahead, but his letter clearly requires a reply.
Selection of appropriate study design and of collaborators of appropriate objectivity and equipoise is of great importance, since, as Kleber and Riordan have reminded us, “the history of narcotic withdrawal treatment is filled with ‘cures’ enthusiastically received and then quietly dropped when they turn out to be either ineffective, dangerous, or both.”3 Consequently, “any claims for a new method should be put forward with modesty and viewed with scepticism until amply documented by careful experimental procedures.”
We chose not to collaborate with Brewer for various reasons. The professional reasons included our concern about the potential hazards of the procedure (several deaths have been reported, whether directly or indirectly related, including one under Brewer’s own care4) and our dislike of Brewer’s proposal that NHS funds should be diverted from the NHS into his private treatment business.
References
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