Ten little needles: treating drug addiction with acupuncture
Acupuncture may provide an effective alternative treatment for drug addiction.
"What do you put in those needles?"
This is a question often asked of John Evans, director of the Methadone Maintenance Program at Crouse Hospital in Syracuse, New York. Evans is a credentialed alcohol and substance abuse counselor (CASAC) as well as an acupuncture detoxification specialist (ADS) who combines the ancient Chinese practice of acupuncture with standard treatments for drug and alcohol addiction.
Patients have trouble believing that the ten needles, inserted so carefully into specific spots in their ears, are providing such relief without releasing any chemicals into their bodies. When patients opt for the acupuncture treatment offered daily at Evans' center, they are often amazed by the immediate feelings of well-being, relaxation, and focus that accompany their 45-minute group sessions.
The answer to their question, however, is simply "nothing." Or, to be more exact, NADA the National Acupuncture Detoxification Association protocol for the treatment of addiction.
"This is a simple, drug-free modality," explains Michael Smith, MD, creator of the NADA protocol. "Patients feel comfort and focus, and are better able to participate in the other phases of their treatment," says Smith, who is also director of the Recovery Center at Lincoln Hospital in South Bronx, New York, and assistant professor of psychiatry at Cornell University. In his center, acupuncture is offered daily along with individual counseling, group therapy, self-help classes, and other anti-addiction programs. Smith recommends acupuncture at least three times per week.
Not a hard sell
Although it may sound difficult to convince people with drug addictions to try acupuncture, the opposite is often true. Smith's patients, many of whom are addicted to crack cocaine, are always in search of the peaceful feelings they associate with being high. Many achieve similar feelings through acupuncture.
For Evans' detoxification patients, most of whom are opiate abusers, acupuncture can ease the withdrawal symptoms body aches, runny nose, joint pain, and other flu-like symptoms that typically drive their cravings for drugs.
Some people report a slight pinch when the needles are inserted, but this discomfort is usually quickly replaced by feelings of euphoria and relaxation. And these positive feelings persist; within a week of starting acupuncture, many of Evans' patients report they are sleeping better and feeling more in control.
At most drug treatment clinics, supervised urine samples are collected regularly and tested for the presence of drugs. "We've seen a 50% drop in positive urine [tests] among patients who receive acupuncture three times per week compared with those who don't have acupuncture," explains Evans.
Acupuncture can be especially useful for cocaine abusers, since there are no medications to treat this addiction. A recent study done at Yale University and published in the Archives of Internal Medicine found that cocaine-addicted patients who were treated with acupuncture five times a week for eight weeks were significantly more likely to provide cocaine-negative urine samples than were patients treated with either of two control procedures.
Patients receiving acupuncture are also more likely to continue with ongoing treatment. "The treatments stabilize them," says Smith, and keep them coming back to the center for other vital services, which help them make progress toward beating their addictions.
The birth of NADA
The notion of using acupuncture to treat addiction began in Hong Kong in the early 1970s. A surgeon named Dr. Wen noticed that when he gave his patients acupuncture after an operation, they needed less pain medication, if any at all. He applied this discovery to the treatment of addiction. His style of acupuncture utilized just one needle, placed in a patient's ear and attached to a battery-powered stimulus device. The electrical stimulation affected the entire ear, and subsequently delivered a feeling of calm and comfort throughout the patient's body.
Smith brought Wen's procedure to his own clinic in 1974, and began treating his patients with acupuncture twice a day. One day, the battery-powered machine broke, and treatment had to be done with needles alone.
"We were concerned that the effect would not be as great without the battery-powered electrical stimulus," he recalls. "When none of the patients returned for the afternoon session, we were sure that the treatment had failed. But the next morning, they were all back. It turned out that the needles alone created a longer-lasting effect, so the patients didn't need their afternoon sessions."
With a little trial and error, Smith went on to devise a technique of inserting five needles into specific points in the ear and leaving them in place for 45 minutes at a time. The points chosen are believed to address major systems in the body: sympathetic points and shenmen points ("shenmen" is a Chinese word that means "spirit gate"), both of which help to ease anxiety; as well as kidney, liver, and lung points. Thus, the NADA protocol was born, and is now used in more than 700 licensed drug treatment centers in the United States and more than 800 centers internationally.
A person need not be a licensed acupuncturist to administer the NADA protocol. Rather, he or she can become certified to deliver this simplified form of ear acupuncture in the context of an addiction setting. To do so, the treatment center must be approved by the appropriate government agency the Department of Health, Office of Mental Health, or Office of Alcohol and Substance Abuse Services. The person delivering the treatment must complete a 70-hour training program (32 hours in the classroom and 38 hours of supervised treatment) that is approved by the State Department of Education. And finally, the certified professional must work under the supervision of a person licensed in all forms of acupuncture or a physician who has received training in acupuncture.
Paying for acupuncture
Acupuncture is considered part of a drug treatment program and is therefore covered by Medicaid and most insurance plans. The cost of this treatment is minimal, since the center staff are trained to insert needles and the needles are very inexpensive.
Regaining balance and control
Despite skepticism that there is something in those needles, acupuncture does not add anything to the body; it simply helps to guide a person's physiology toward a more optimal state.
"We have a lot of potential in our bodies, but at times, it can be misguided," explains Smith. "Acupuncture helps us achieve balance and control. The exact biological mechanisms are not well understood, and maybe not so important, but in some way, acupuncture has a peaceful, calming, and empowering effect."
American Academy of Medical Acupuncture
Acu Detox Information Center
PO Box 1927
Vancouver, WA 98668-1927
Last reviewed November 2000 by HealthGate Medical Review Board
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