Don’t Believe Everything You Read


IN THESE DAYS of unreliable journalism, articles that go behind the news to pose unanswered questions or parse statistics are more valuable than ever.  Two recent examples —the New York Times’s critical review of the alarmist link between light drinking and cancer; and the website STAT’s examination of FDA warnings against the herbal supplement kratom—helped calm alarms raised recently by headlines and reporting in The Washington Post.

“Cancer doctors call for cutting back on alcohol,” read the Post’s Nov. 14 headline, with the subhead: “Even light drinkers face an increased risk of disease, oncologists warn.”  The Post article details a “call to action” from the American Society of Clinical Oncology, specifying that “among women, light drinkers have a 4 percent increased risk of breast cancer.”

The New York Times “Upshot” piece, published (earlier) on Nov. 10, covered the same statistics but came to a different conclusion: while 3.5% of cancer deaths in the U.S. are attributed to alcohol, by eliminating heavy drinkers and smokers “the number of cancer deaths not attributable to alcohol approaches 100%.”

Sometimes statistics point to nothing more than a connection: “We still don’t know if the relationship is causal,” says the Times article.  But accepting that possibility, if the absolute risk increase of developing breast cancer over the next 10 years for a woman over 40 is 1.45 percent, for the light-drinking woman it’s .06 percent—which “could be interpreted such that if 1,667 40-year old women become light drinkers, one additional person might develop breast cancer.”

On top of that, the Times describes the results of a 2013 meta-analysis that examined all cancers and concluded that “over all, light drinking was protective.”  Specific studies have shown “light to moderate drinking can lead to a reduction in risk factors for heart disease, diabetes and stroke…more women die in the United States of heart disease than cancer.”

Among tips on how to interpret research, the Times warns against giving too much weight to observational data, focusing on one disease while ignoring others, cherry-picking which studies to focus on —and finally: “Acknowledge the harms, as well as the benefits, or recommendations. Consider both cost and joy.”

About the herbal supplement kratom—available online and elsewhere—taken for pain, anxiety and opioid withdrawal, the Post’s Nov. 20 front-page summary said, “The FDA has issued a warning against the herbal supplement kratom, which has been linked to 36 deaths.” Inside the paper, under the headline “FDA warns against using the herbal supplement kratom,” came the sentence: “Calls to U.S. poison control centers involving kratom increased tenfold between 2010 and 2015.”

Searching for the original Post article online led only to an earlier version, published on Nov 14 with a slightly different headline: “FDA warns of ‘deadly risks’ of the herb kratom, citing 36 deaths.”

Among questions to ask about kratom’s risks: tenfold compared to what—to the years before opioid abuse became a nationwide scandal?  Because once the numbers are put into a historical context—the tenfold increase in poison control center calls about kratom occurred between 2010 and 2015 —it makes sense that there would be a huge rise in something connected to both pain relief and opioid withdrawal, because it was during exactly those years that opioid abuse rose across the U.S., and death attributed to opioids nearly doubled from 16,651 to 33.091 (statistics compiled from CDC reports).

To its credit, the Post article goes on to compare risks of kratom and opioids, with an addiction specialist pointing out that “restricting or banning the substance could drive some people back to opioids.”  It also notes that “the herb is used recreationally because it produces symptoms such as euphoria.”  Most damning, the article quotes FDA Commissioner Scott Gottlieb saying, “there is no ‘reliable evidence’ to support [its use] as a treatment for opioid-use disorder.”  Turns out there might be an explanation for this evidence problem.

A 2016 article on the STAT website—with contributions from longtime science and medicine journalists—points out that although “the plant poses some risks,” scientists have been enthusiastically pursuing research on kratom’s properties as a painkiller with fewer side effects than opioids, and as an aid in opioid withdrawal.  Much of this research, however, was cut off by government restrictions (from the DEA) before answering the important question, according to Boston toxicologist Edward Boyer:  “Is it an effective treatment for opioid withdrawal or is it another pathway to addiction?”

When even trusted sources mislead, readers must take on more of the burden of looking behind the news.  This was the case with the alcohol story because women who drink lightly became concerned about the report on women and alcohol, but few considered questioning statistics from a reputable source like the Washington Post.

—Mary Carpenter

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Related link: The Effects of Drinking Increase as You Age

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