Health: Stop-smoking regimen that scares doctors
A $400 treatment touted as a sure way to quit smoking is being offered at a Nashville doctor’s office, even though medical experts say there’s no valid proof it’s effective — and can be dangerous.
Clinic offers a stop-smoking regimen that scares doctors. The couple say their experience backs experts’ worries
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A $400 treatment touted as a sure way to quit smoking is being offered at a Nashville doctor’s office, even though medical experts say there’s no valid proof it’s effective — and can be dangerous.
Advertised on the radio and offered at Covenant Family Practice on Dickerson Pike, the treatment includes injections of three drugs that are FDA- approved, but not for smoking cessation. The medications in the shot can cause hallucinations, heart palpitations, paranoia, and other serious side effects, including coma, experts say.
“It’s just incredible to me that they’re doing this,” said Dr. Christopher Holstege, one of the nation’s top toxicologists and the University of Virginia Health System’s director of the division of medical toxicology. “It just doesn’t make sense.
“I don’t know of any literature that says this is effective for quitting smoking. These drugs can cause hallucinations. They can make your heartbeat so fast that if you have heart problems it can cause you to have a heart attack.”
Dr. Robert A. Wilson, who administers the shots at Covenant Family Practice, did not return three phone calls seeking comment. Through a receptionist, he referred all questions to officials at a Tampa, Fla.-based company called Welplex — which has franchise agreements with doctors to offer the treatment at 23 clinics in 11 states, including the Nashville clinic that began offering the treatment in January.
Kendahl Maxwell, Wel-plex’s administrator in Florida, said the treatment is safe and effective. Listeners to the radio advertisements are guided to the Welplex Web site, where they can make appointments for treatment.
The site boasts “a better than the 8-out-of-10 chance of succeeding,” and lists an array of medical “references” supporting its claim.
But medical experts with the American Medical Association, the University of Virginia Health System and Vanderbilt University Medical Center who reviewed the Web site for The Tennessean found its claims dubious.
Dr. Ronald M. Davis, the president-elect of the American Medical Association, said he finds an eight-out-of-10 success rate “highly improbable.”
“The most effective smoking cessation programs typically achieve 1-year success rates of between 20 and 35 percent,” he said.
Welplex provided additional “research” to The Tennessean to support its claims. But independent medical experts found this equally questionable.
Shots, then hallucinations
Candy Pope, of Shelbyville, says when she heard an ad on the radio recently that a simple treatment could help her quit smoking she decided to try it. She persuaded her husband, Jim, to try it too.
The 58-year-old woman, who smokes more than a pack a day, went to the Web site to learn more and then called a number listed to set up an appointment.
Within days, Welplex officials sent the Popes a letter confirming a June 13 appointment and assuring them that “Patients will leave the clinic a nonsmoker.”
The only drawback mentioned is that they would “be a little lightheaded for five to six hours following treatment.” And the Popes were advised to bring a designated driver. Their friend, Judith Moore, a retired doctor, wanted them to quit smoking, and Moore said she was happy to oblige.
At the Covenant clinic, the Popes each received three injections and were given a supply of pills to take over the next two weeks.
Candy Pope said that on the drive home from the doctor’s office, she became disoriented, agitated, and tried to jump out of the back seat of the moving car.
“I could have died,” she said. “Judy was able to lock the doors so that I couldn’t jump out.”
Jim Pope said about 20 minutes after he got the shots in his neck and behind both ears, he too started experiencing strange sensations. The 68-year-old man, with high blood pressure, said he remembers his heart beating “like a drum” and trying to talk, but not being able to speak.
Once he got home, he said, hallucinations began. He said he saw things crawling on the ceiling and other things that didn’t exist.
“In my bedroom, I could see my dog that passed away two years ago,” Jim Pope said. “I reached out to him, but he wasn’t there.”
Moore, who is a retired family physician, said in all her years as a doctor she’s never seen patients act like this. The couple, she said, was “really out of it” — talking gibberish and displaying bizarre behavior.
None of them had any idea what was in the shots. And Moore said Welplex offered no emergency number to call.
“I was scared enough to stay the night with them,” Moore said.
And Moore is relieved she did because sometime after midnight Jim Pope decided to take a drive.
“He picked up the car keys and headed for the door,” Moore said. “I said, ‘Where are you going?’ And he said, ‘I’m going to the store to get my medication.’ Well, of course, the drugstore was closed at that hour. If he had gotten out there, there’s no telling what he would have done.”
Within a couple of days, Candy and Jim Pope were both smokings again, and they feel conned by Welplex and the doctor who gave them the shots.
“We’ve been brought up to trust doctors. To do what doctors say,” Candy Pope said. “There was nothing in the literature about hallucinations. If I had known, I never would have taken the stuff.”
Even small doses called risky:
Dr. Glenn Catalano, chief of mental health at the James A. Haley Veterans’ Hospital in Tampa, said he’s not surprised by what happened to the Popes. He co-wrote a paper that was published in the Annals of Clinical Psychiatry in 2004 about how smoking-cessation shots can cause people to experience a temporary mental break.
He said the paper was inspired by a 59-year-old man who received the shots and started hearing the voices of family members’ saying they were going to kill him for his “fortune.” As the voices become more frequent, he contemplated suicide and had “homicidal” urges towards his wife for her “betrayal.”
“We’ve seen at least three other patients who have come in with this since then,” Catalano said.
Catalano and other medical experts said the bottom line is that these drugs can be dangerous, even in small doses. Tolerance depends on several factors, including weight and genetic predisposition.
“If you are seeing things and you go out to drive or cook dinner, that’s not safe,” he said.
Still, Welplex insists the treatment is safe and effective.
The patented treatment includes three drugs — atropine, scopolamine, and chlorpromazine — that act “to block the central nicotine receptors in the brain,” according to documents sent to The Tennessean by Welplex’s Maxwell.
She said in an e-mail that the documentation should be “self-evident to one skilled in the art of pharmacology and toxicology.” She said in a subsequent interview that any doctor who disagreed “needs to go back for further training because they are really missing the boat on the knowledge that they obviously don’t have.”
Maxwell also sent The Tennessean a paper titled “Retrospective Study for Anticholinergic Blockade in Smoking Cessation,” by Dr. Ronald E. Perry. Perry says in this paper that 200 randomly selected patients who had been through the Welplex treatment were contacted. Of these, he reported 88 percent were smoke-free after 60 days and 56 percent were smoke-free at one year.
However, both the AMA’s Davis and Dr. David DiPersio, a clinical pharmacist at Vanderbilt University Medical Center’s medical intensive care unit, found this paper of questionable value.
“The retrospective study described in the paper by Dr. Perry does not provide valid evidence on the effectiveness of the treatment,” Davis said. “To establish the efficacy of a treatment, randomized controlled clinical trials are generally necessary. … The study described in the paper by Dr. Perry falls short of that, is subject to methodological biases, and would probably not be accepted for publication in good peer-reviewed journals.”
DiPersio said: “Retrospective studies cannot demonstrate proof. I can’t imagine anyone with a medical degree agreeing to the premise of this treatment.”
Dr. Tony George, an associate professor of psychiatry at Yale School of Medicine and the director for the Program for Research in Smokers with Mental Illness at Connecticut Mental Health Center in New Haven, said the underlying premise of the Welplex treatment is a mystery to him.
“Atropine and scopolamine … really do not bind to nicotinic acetylcholine receptor subtypes, so this claim is very puzzling to me,” George said. “As a clinical pharmacologist and tobacco treatment person, I … am just beside myself when I hear about folks that are just exploiting smokers to make a buck with untested and irrational treatments.”
Vanderbilt’s DiPersio warns the elderly are especially at risk.
“Older people tend to be highly sensitive to this. It can make them crazy,” DiPersio said. He noted that the elderly population typically takes other medications that might not mix well with atropine, scopolamine, and chlorpromazine.
Atropine is typically used to dilate the eyes, scopolamine for motion sickness and chlorpromazine for psychiatric illness. “These drugs are never used in combination for anything,” DiPersio said.
I did this treatment 14 years ago and it worked. I was a2 pack a day smoker. Atropine is use for many things like drug overdoses or pesticides poisoning so I’m not sure where drs get their information. I’m telling you it works.
My husband took these injections 15 years ago and has not picked up a cigarette since. After the injections, (one behind each ear and one in each arm) he basically slept for two days, waking only to eat and bathe but had no hallucinations or any other issues. He took the medication by mouth for two weeks after for withdrawal symptoms which caused dry mouth and kind of changed his taste buds while he was taking the medication, but no other issues. While he had no craving for a cigarette he still had to break the habit of having something to do with his mouth so he chewed gum for eight years after. He has since stopped chewing gum but no longer craves a cigarette and actually gets sick and nauseous at the smell of someone smoking around him. It is too bad that these shots are not offered anymore because they helped him when nothing else did. Are they not offered because they work??? Is it a conspiracy with the cigarette and tobacco industry??? Bring this back, THESE INJECTIONS WORK!!!!!
I got this shot in 2008 and I quit smoking immediately. It does in deed give you hallucinations for a few hours but hey, who never did a little acid in the 60’s? Most of the population did at that time. These people in this article act like the doctors are responsible for the people’s actions after takimg the drug. I mean HELLOOO when a doctor tells you that you need to have someone drive you hope from the appointment then guess what that means? It means you should not drive a vehicle after you get home either. What idiots. And yes I don’t doubt that they saw visions of their dead dog. That is a hallucination, which the doctor’s who perform this procedure tell you may be a side effect. Maybe these morons should have listened to everything the doctor told them. The appointment is about 2 hours long. They show a video that explains how the medicine in the shot closes the receptors in your brain that make you crave a cigarette. They do not close instantly it’s a process that takes a few days but it starts immediately and aides in the letting the craving pass. If you go home AND SLEEP LIKE THE DOCTOR TELLS YOU TO THEN YOU would know that when you wake up you feel normal again. And if you choose to continue taking the at-home pills that they suggest you take for 2 weeks to ensure the best possible results, then so be it. But i did not because i had to return to work the next day and my job did not provide the free spirit atmosphere for things like hallucination type behavior/episodes. Bottom line, I also referred my mom who went a few weeks later after she say that i quit and it worked for her too. Thank god, because lung cancer is so common these days, she would have been so much more vulnerable to it if she had continued to smoke. By the way i had smoked for 12 years, she had smoked for over 20. I had quit a few years previous as well, with chantix, which also gives you psychadelic/ hallucinogenic dreams while taking it. It made me stop smoking but a year later I started back. I have not smoke in over 12 years now because of the shot. I thank God for bringing this option before me and my mother as well
I highly recommend it and wish there was more advertising for it. Id love to see it on Billboard’s in every state and offered in every country.
I strongly agree. Thank you for speaking out about your success.
I went to the Tampa clinic for treatment, as did two of my uncle’s. All three of us are currently nonsmokers. They went year’s before me and had the injections behind the ears. Mine was one injection in my rear end. You are also given a consultation they check blood pressure and do an ekg. It’s not like you walk in and get a shot and walk out. It’s a lot of money but so worth it
I did this ten years ago in Cleveland, Ohio. I also know 12 people who did this around the same time as myself. One of the twelve went back to smoking, yes only one. The best thing I ever did.
Very subjectively written article SMH! There are far more people who have successfully been treated by these clinics than those who have had bad experiences. Did you bother reaching out to ANY of them for comment? News flash, we’re easy to find. Most of this company’s business comes from referrals of friends and family by those who have tried to quit smoking on there own, and couldn’t, but who’ve finally had success with wellplex. You could have at least tried to tell the positive side of the story instead of writing a fear mongering smear campaign against a company who without a doubt has helped far more people quit smoking than all of the medical “experts* quoted in your piece have combined.