We direct you attention to the letters on pg 2 of Drink and Drugs News (pdf) (DDN). The authors of the letter refer to questions raised about the standards of Holford’s research by Dr Ben Goldacre, HolfordWatch and Holford Myths. The readers express regret that DDN should be so credulous and fail to ask the most obvious questions about standards of evidence.
Steve Eastwood wrote:
At a time when staff in the drugs field are being quite rightly directed to delivering evidence-based interventions, it’s rather disappointing that our trade paper perpetuates this kind of hokum. Are there properly published studies of this brain nutrition stuff? Clinical trials that other proper scientists can have a look at and ask questions about? I would rather doubt it…
N Scott wrote:
Obviously I am not disputing that a good diet is important but it seems to me more rigorous scrutiny should take place before allowing people to write articles promoting their wares.
There also seems to be a general lack of understanding or even disdain for standards of evidence that, unsurprisingly, matches Holford’s own agenda in this area and his recent ill-judged attempt to annex Sir Michael Rawlins critique of randomised controlled trials and hierarchies of evidence.
Addiction is a notoriously difficult area and there are inadequate resources; it is important that such scarce resources are not expended on interventions that have not been published and therefore can not be assessed by appropriate experts. Holford has yet to explain why his assertions should not be judged by appropriate standards.
Such assessment should be available for any form of intervention, including medications, techniques (e.g., auricular-acupuncture, far IR saunas), detox and drug policy interventions: where an appropriate body of evidence does not already exist then it should be collected and audited in a formal, systematic way.
For addiction interventions, as for other areas of medicine, we need to know:
- is the intervention plausible and does it fit in with other areas of knowledge in its mechanism of action
- is it effective
- is it safe
- is it cost-effective and scaleable?
When assessing the evidence (whether the basic research on which proposals for interventions are based or pilots for interventions) then peer-reviewed, well-respected publications are more relevant than strongly-held, self-serving assertions made in marketing seminars conducted in the guise of educational events, promotional material for the offerings of a treatment centre subsumed into a charity (Food for the Brain, parts 1, 2 and 3) or books for the popular market.
If people are making spending decisions for themselves or family member then perhaps they might want to purchase Holford’s supplements or recommended interventions.[a]</a However, it is wholly inappropriate to give these marketing devices credulous coverage, it would be very unwise to allow them to make inroads into the scant budget of NHS addiction services.
[a] There is an argument to be made that exposing people to interventions that don’t work makes them more suspicious of future interventions and perhaps less likely to respond to them: the inverse of the benefit shown by people who are compliant with interventions.