A Randomized Controlled Trial of Auricular Acupuncture for Cocaine Dependence

Avants, S. Kelly; Margolin, Arthur; Holford, Theodore R.; Kosten, Thomas R.

doi:10.1001/archinte.160.15.2305

Cited by 155 publications

(99 citation statements)

References 38 publications

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“…Among subjects returning to the clinic three or more times, the self-reported overall use of drugs declined during the study period, as did severity of withdrawal symptoms. Similar to other studies, 2,[8][9][10][11] we experienced a high rate of attrition among study subjects. Previous studies of community-based interventions have reported drop-out rates ranging from 34 2 to 75%.…”

Section: Discussionsupporting

confidence: 83%

“…2 Retention in treatment was significantly associated with reduction in cocainespecific urine metabolites. In a recent trial of acupuncture for cocaine dependence, Avants et al 10 randomized subjects attending a community-based methadone maintenance program in New Haven, Connecticut, to auricular acupuncture, sham acupuncture, or a no-needle relaxation control. Subjects receiving the National Acupuncture Detoxification Association acupuncture protocol were more likely to provide cocaine negative urine samples than either the needle insertion or relaxation controls at 8 weeks.…”

Section: Introductionmentioning

confidence: 99%

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Acupuncture for Substance Abuse Treatment in the Dowtown Eastside of Vancouver

Janssen

Whynot

2005

Journal of Urban Health: Bulletin of the New York Academy of Me

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Acupuncture for Substance Abuse Treatment in the Dowtown Eastside of Vancouver

Janssen

Whynot

2005

Journal of Urban Health: Bulletin of the New York Academy of Me

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“…This includes: the relevance of acupuncture for treatment of opiate based addictions (e.g. Brumbrough, 1993;Riet et al, 1990;Avants et al, 2000) and the use of Transcendental Meditation practices as successful means of treating addictions (see O'Connell and Alexander, 1994;; and cross-cultural reviews of ethnomedical approaches to addiction treatment (Jilek, 1994;Heggenhougen, 1997;Singer and Borrego, 1984).…”

Section: Introduction: Culture Consciousness and Addictionmentioning

confidence: 99%

Alternative and traditional medicine approaches for substance abuse programs: a shamanic perspective

Winkelman

2001

International Journal of Drug Policy

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Analysis of the relationship of altered states of consciousness (ASC) to culture and human psychobiology provides guidance for new approaches for addressing substance abuse and dependence. While Western cultures have a long history of repressing ASC, cross-cultural research illustrates the ubiquitous human drive to alter consciousness and the near universality of institutionalized healing practices based on ASC. These may reflect adaptive mechanisms that do not operate in contemporary societies as they did in the human past. Effectiveness of ASC procedures in treating substance dependence is found in ethnomedical treatments of addiction, the addiction literature, Alcoholics Anonymous, and the physiological effects of shamanistic practices. A review of shamanic therapeutic mechanisms illustrates their applicability to addressing the psychodynamics of drug addiction. The utility of natural ASC practices to reduce substance dependence problems is illustrated by clinical research on the treatment of drug dependence through the use of meditative practice and models of their psychobiological dynamics. Shamanistic practices induce the relaxation response, enhance theta-wave production, and stimulate endogenous opioid and serotonergic mechanisms and their mood elevating effects. Directions of a shamanic based ASC therapy for drug dependence are suggested.

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“…In several cases, large, definitive studies that hoped to replicate promising results of initial small studies in alcohol and cocaine dependence were negative, but used auricular needling in the control group. [25][26][27][28] Researchers have used two approaches to defining a suitable sham procedure: either conjecture or empiricism. In the first, they have simply assumed that any 'incorrect' point is inactive, by what Margolin memorably termed a 'fiat'.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Auricular Acupuncture on Smoking Cessation May Not Depend on the Point Chosen – An Exploratory Meta-Analysis

White

Moody

2006

Acupunct Med

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Introduction Auricular acupuncture is given as a treatment for drug dependence. Points are usually chosen on the assumption that the body is represented somatotopically in the ear, although there is no anatomical basis for this. In clinical trials, sham treatment is often given at points that are supposedly 'incorrect' for the condition, in the belief that they are inactive. The aim of this study was to explore whether there is any difference in the effectiveness of auricular acupuncture at 'correct' and 'incorrect' points. Methods Controlled trials of semi-permanent auricular acupuncture or acupressure for smoking cessation were systematically located, and the results combined in exploratory meta-analyses which took into account the study quality.Results Thirteen studies were included. Combining ten studies showed auricular acupuncture at 'correct' points to be more effective than control interventions, odds ratio 2.24 (95% CI 1.61, 3.10), a result which is confirmed in the four high validity studies. Other analyses showed inconsistent results between all studies and higher quality studies. Comparisons of three higher quality studies suggest that 'correct' and 'incorrect' point acupuncture is no different (odds ratio 1.22, CI 0.72, 2.07); and two studies showed that 'incorrect' point acupuncture may be more effective than other interventions (odds ratio 1.96, CI 1.00, 3.86).Conclusion Auricular acupuncture appears to be effective for smoking cessation, but the effect may not depend on point location. This calls into question the somatotopic model underlying auricular acupuncture and suggests a need to re-evaluate sham controlled studies which have used 'incorrect' points. Further experiments are necessary to confirm or refute these observational conclusions.

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A Randomized Controlled Trial of Auricular Acupuncture for Cocaine Dependence

Abstract: Findings from the current study suggest that acupuncture shows promise for the treatment of cocaine dependence. Further investigation of this treatment modality appears to be warranted.

Cited by 155 publications

References 38 publications

Acupuncture for Substance Abuse Treatment in the Dowtown Eastside of Vancouver

Acupuncture for Substance Abuse Treatment in the Dowtown Eastside of Vancouver

Alternative and traditional medicine approaches for substance abuse programs: a shamanic perspective

The Effects of Auricular Acupuncture on Smoking Cessation May Not Depend on the Point Chosen – An Exploratory Meta-Analysis

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