Hold that needle: Acupuncture for holistic addiction treatment?
Acupuncture as addiction treatment sounds good but holds little promise
Posted Aug 07, 2010
Acupuncture treatment is supposed to help heal numerous conditions including cancer, depression, and more. Well, when it comes to addiction treatment, poking with needles seems to provide pretty mixed results.
Holistic addiction treatment - Addiction research fact or fiction?
The use of holistic addiction treatment methods, especially ones that originate in disciplines outside of Western medicine, are all the rage nowadays. We've written about a number of them on here, including yoga, as they can provide some real help for those struggling with early recovery from addictions. My wife is a big believer in many of these methods, but we both like seeing evidence that treatments work before we recommend them. Apparently, when it comes to acupuncture, it doesn't really matter where you stick yourself, your probability of quitting won't go up... or down.
An addiction research study published a little while back used the clinical standards of a double blind, placebo controlled, study to assess the usefulness of acupuncture in treating cocaine addiction. Specialists from Yale, Columbia, UCLA, and other outstanding institutions enrolled over 600 cocaine users who were interested in quitting and gave them one of three treatments: A 4-needle NADA acupuncture condition, a 4 needle-insertion control condition, and a no needle relaxation control condition where patients watched calming videos. The only difference between the experimental and control needle conditions was the location of the insertions - The experimental condition used spots that are supposed to be of clinical utility, the control condition specifically didn't hit those spots. All clients were offered addiction treatment counseling in addition to their experimental conditions mentioned. Apparently, relatively few of them took advantage of these, not a big surprise to those of us who look at these kinds of studies often.
The clients in each of these conditions were pretty heavy crack-cocaine users, averaging about 11 years of use and something like 30 dime bags a week with over 3.5 days of use per week. These are not your recreational, party, cocaine-users. However, severity of use looked about the same across all three conditions, which is what you want in a study like this.
Acupuncture not most relaxing or best addiction treatment method
Surprisingly (?) watching those videotapes proved more relaxing, as far as the patients themselves reported, than either needle conditions. Still, the level of relaxation wasn't really what researchers were interested in most - it's all about quitting cocaine, remember?
The good news? There was a reduction in cocaine use across all of the three conditions throughout the study. The bad news was that there was no difference between the conditions on retention, meaning that patients stayed in treatment as long regardless of whether they received acupuncture, control needle insertions, or watched tapes. Since we know that retention is one of the best predictors of successful outcomes in addiction treatment (CM, or contingency management is a great methods to increase retention), this is already a pretty bad sign for acupuncture. Indeed, when the researchers looked at the percent of cocaine-positive (as in dirty) urine-tests across the 8 weeks of the treatment, or at two follow-up points (3 and 6 months later) they found no differences between acupuncture and the control conditions.
A review of studies assessing the usefulness of acupuncture for the treatment of heroin addicts found that while the treatment offered no reductions in relapse rates, it did help relieve some of the withdrawal symptoms associated with stopping heroin use. There's no doubt that heroin addicts wouldn't mind a little help in that department, so it seems that acupuncture isn't completely useless when it comes to addiction treatment. I'm a little skeptical of a whole string of studies from a single lab, as almost all the studies in this review were, but so it is. In fact, a second review stated exactly my point - that acupuncture treatment for opiate addiction (or cocaine addiction) just doesn't seem to have scientific support when studies using proper controls are taken into account.
Holistic addiction treatment - Learn before you trust
Overall, it looks like acupuncture didn't make things better for these more than 200 cocaine addicts, and while may help withdrawal, it doesn't seem to improve addiction treatment outcomes for heroin addicts either. While this might be disappointing for some, it's part of the risk of getting involved in alternative treatment. The thing about holistic treatment methods like acupuncture, herbs, equine therapy, and massage is that not being medical, they don't have to be evaluated by anyone. As this study shows, a method that can be widely accepted as effective may have no real effect when pitted against other, similar treatments. This is why addiction research is so important.
Overall, it's important to note that this study does not mean that acupuncture does not work for any of the other conditions it is purported to help. However, as far as I'm concerned, it seems that this specific method provided no help for cocaine addiction. But hey, it didn't hurt things either, so if you like having 4 inch needles inserted into different sections of your body I say go right ahead!!!
Margolin, A., Kleber, H. D., Avants, S. K., et al. (2002). Acupuncture for the Treatment of Cocaine Addiction: A Randomized Controlled Trial. JAMA, 287: 55 - 63.
Ting-ting Liu, Jie Shi, David H. Epstein, Yan-ping Bao, Lin Lu (2009). A Meta-Analysis of Acupuncture Combined with Opioid Receptor Agonists for Treatment of Opiate-Withdrawal Symptoms. Cellular Molecular Neurobiology 29:449–454.
Jordan, J. B. (2006). Acupuncture treatment for opiate addiction: A systematic review. Journal of Substance Abuse Treatment, 30(4), Pages 309-314.
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