Efficacy of acupuncture for cocaine dependence: a systematic review & meta-analysis

Abstract

Background: Acupuncture is a commonly used treatment option for the treatment of addictions such as alcohol, nicotine and drug dependence. We systematically reviewed and meta-analyzed the randomized controlled trials of acupuncture for the treatment of cocaine addiction. Methods:Two reviewers independently searched 10 databases. Unpublished studies were sought using Clinicaltrials.gov, the UK National Research Register and contacting content experts. Eligible studies enrolled patients with the diagnosis of cocaine dependence of any duration or severity randomly allocated to either acupuncture or sham or other control. We excluded studies of acupuncture methods and trials enrolling patients with polysubstance use or dependence. We abstracted data on study methodology and outcomes. We pooled the studies providing biochemical confirmation of cocaine abstinence.Results: Nine studies enrolling 1747 participants met inclusion criteria; 7 provided details for biochemical confirmation of cocaine abstinence. On average, trials lost 50% of enrolled participants (range 0-63%). The pooled odds ratio estimating the effect of acupuncture on cocaine abstinence at the last reported time-point was 0.76 (95% CI, 0.45 to 1.27, P = 0.30, I 2 = 30%, Heterogeneity P = 0.19). Conclusion:This systematic review and meta-analysis does not support the use of acupuncture for the treatment of cocaine dependence. However, most trials were hampered by large loss to follow up and the strength of the inference is consequently weakened.

The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews

“…Seven high quality reviews [92-98] involving 48 RCTs and CCTs and 7,433 participants, studied populations with different types of substance abuse problems, including alcohol, cocaine, crack, and nicotine dependencies and other addictions. Overall, acupuncture was reported as not effective in treating these conditions.…”

“…Serious adverse events (that is, injury to brain/spinal cord, pneumothorax, cardiac tamponade, systemic infection, syncope) have been reported but are extremely rare [114]. Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them.…”

“…Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them. A number of reviews also reported more uncommon events including dizziness/fainting [77,79,104,105,113], drowsiness/fatigue [92,99,108], gastrointestinal problems [77,104,105], sleep disturbance [102,109], dry mouth [104,109], and headache [99,104,109].…”

The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews

“…Seven high quality reviews [92-98] involving 48 RCTs and CCTs and 7,433 participants, studied populations with different types of substance abuse problems, including alcohol, cocaine, crack, and nicotine dependencies and other addictions. Overall, acupuncture was reported as not effective in treating these conditions.…”

“…Serious adverse events (that is, injury to brain/spinal cord, pneumothorax, cardiac tamponade, systemic infection, syncope) have been reported but are extremely rare [114]. Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them.…”

“…Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them. A number of reviews also reported more uncommon events including dizziness/fainting [77,79,104,105,113], drowsiness/fatigue [92,99,108], gastrointestinal problems [77,104,105], sleep disturbance [102,109], dry mouth [104,109], and headache [99,104,109].…”

Acupuncture for substance use disorders: a protocol of systematic review and meta-analysis of randomised controlled trials

“…Despite abundant evidence supporting the efficacy and safety of acupuncture for SUDs, it is not included as a recommendation in most clinical practice guidelines 1 38–40. And this is partly attributed to the inconsistent results reported in some RCTs and meta-analyses that did not support the use of acupuncture for SUDs,18 26 28 29 as well as low-quality studies included in these analyses 40. Therefore, we propose to conduct this systematic review and meta-analysis, comprehensively searching both English and Chinese databases, to provide updated evidence on the effectiveness of acupuncture as a treatment for SUDs, which may guide evidence-based clinical practice and improve patient outcomes.…”

Treatment of stimulant use disorder: A systematic review of reviews

“…(OR: 0.76, 95% Confidence Interval [CI]: 0.45, 1.27). However results were weakened by large loss to follow up [22].…”

The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews

“…Seven high quality reviews [92-98] involving 48 RCTs and CCTs and 7,433 participants, studied populations with different types of substance abuse problems, including alcohol, cocaine, crack, and nicotine dependencies and other addictions. Overall, acupuncture was reported as not effective in treating these conditions.…”

“…Serious adverse events (that is, injury to brain/spinal cord, pneumothorax, cardiac tamponade, systemic infection, syncope) have been reported but are extremely rare [114]. Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them.…”

“…Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them. A number of reviews also reported more uncommon events including dizziness/fainting [77,79,104,105,113], drowsiness/fatigue [92,99,108], gastrointestinal problems [77,104,105], sleep disturbance [102,109], dry mouth [104,109], and headache [99,104,109].…”

Acupuncture for substance use disorders: a protocol of systematic review and meta-analysis of randomised controlled trials

“…Despite abundant evidence supporting the efficacy and safety of acupuncture for SUDs, it is not included as a recommendation in most clinical practice guidelines 1 38–40. And this is partly attributed to the inconsistent results reported in some RCTs and meta-analyses that did not support the use of acupuncture for SUDs,18 26 28 29 as well as low-quality studies included in these analyses 40. Therefore, we propose to conduct this systematic review and meta-analysis, comprehensively searching both English and Chinese databases, to provide updated evidence on the effectiveness of acupuncture as a treatment for SUDs, which may guide evidence-based clinical practice and improve patient outcomes.…”

Treatment of stimulant use disorder: A systematic review of reviews

“…(OR: 0.76, 95% Confidence Interval [CI]: 0.45, 1.27). However results were weakened by large loss to follow up [22].…”

The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews

“…Seven high quality reviews [92-98] involving 48 RCTs and CCTs and 7,433 participants, studied populations with different types of substance abuse problems, including alcohol, cocaine, crack, and nicotine dependencies and other addictions. Overall, acupuncture was reported as not effective in treating these conditions.…”

“…Serious adverse events (that is, injury to brain/spinal cord, pneumothorax, cardiac tamponade, systemic infection, syncope) have been reported but are extremely rare [114]. Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them.…”

“…Of the 52 reviews included in our analyses, 29 [63,70,71,73,74,76-79,84,85,90,92,93,95,98-105,107-111,113] reported on adverse events with six [53,62,70,73,84,93,95] reviews reporting no adverse events. Twelve reviews [74,76,85,90,92,98,101-105] reported expected, likely adverse events, and four reviews [63,70,78,111] reported that adverse events occurred but did not describe them. A number of reviews also reported more uncommon events including dizziness/fainting [77,79,104,105,113], drowsiness/fatigue [92,99,108], gastrointestinal problems [77,104,105], sleep disturbance [102,109], dry mouth [104,109], and headache [99,104,109].…”

Acupuncture for substance use disorders: a protocol of systematic review and meta-analysis of randomised controlled trials

“…Despite abundant evidence supporting the efficacy and safety of acupuncture for SUDs, it is not included as a recommendation in most clinical practice guidelines 1 38–40. And this is partly attributed to the inconsistent results reported in some RCTs and meta-analyses that did not support the use of acupuncture for SUDs,18 26 28 29 as well as low-quality studies included in these analyses 40. Therefore, we propose to conduct this systematic review and meta-analysis, comprehensively searching both English and Chinese databases, to provide updated evidence on the effectiveness of acupuncture as a treatment for SUDs, which may guide evidence-based clinical practice and improve patient outcomes.…”

Treatment of stimulant use disorder: A systematic review of reviews

“…(OR: 0.76, 95% Confidence Interval [CI]: 0.45, 1.27). However results were weakened by large loss to follow up [22].…”