Stimulant betel quid dependence. How no treatment became the recommended treatment.

Stimulant Betel Quid, (SBQ) and SBQ with tobacco (SBQ+T) is chewed by hundreds of millions of people in Asia and the Pacific.Both SBQ and SBQ+T are addictive as determined by DSM-5 criteria and carcinogenic as determined by the International Agency for Research on Cancer monograph (IARC 2004).In light of these findings Asian governments and WHO advise abstinence as the recommended treatment for use and dependency.New human physiological research demonstrates that sections of the IARC monograph are incorrect and explain the chemical mechanism of the physiological stimulating action of SBQ.These findings suggest the possibility of the use of components of SBQ as a novel, culturally sensitive treatment and replacement therapy for SBQ dependency.Unfortunately, discussion of this topic remains marginalized because of an existing reverence for the IARC monograph by the medical and research community which has evolved to be philosophically reactionary and opposes the consumption of any components of SBQ even should these components be physiologically inactive or be used to reduce harm to the chewer.In short the development of culturally appropriate replacement therapies has not been pursued for 20 years because it deviates from a conservative philosophy generated from an influential historical document that is factually in error.