Trials of Acupuncture for Drug Dependence: A Recommendation for Hypotheses Based on the Literature

Abstract

Objectives After initial promising research into acupuncture for withdrawal from drugs of dependence, two large negative trials were published in 2002 and the use of acupuncture in US rehabilitation facilities fell. However, subsequently it has been maintained, despite a lack of support from systematic reviews. This suggests a mismatch between research and clinical observation, which could be due to the acupuncture technique used, choice of controls or outcome measures. This study aims to explore the mismatch. Methods An exploratory review of all 48 clinical trials on alcohol, cocaine, nicotine or opioid dependence included in current reviews. Results Studies with sham controls (that could be active) were less likely to be positive (33%) than those with non-acupuncture controls (75%). Positive results were more likely when measuring craving (56%) or withdrawal symptoms (58%) than when measuring abstinence (31%) or attrition (31%). Three treatment variables appeared to be associated with positive results: (1) body acupuncture, used in 13 studies, was associated with positive outcomes for craving and withdrawal symptoms but not for abstinence or attrition; (2) electroacupuncture, used in seven studies, was associated with positive results with all four outcomes; and (3) bilateral needling in 20 studies was associated with effects on abstinence, craving and withdrawal symptoms. Conclusions The current evidence suggests that acupuncture may have some effects on drug dependence that have been missed because of choice of outcome in many previous studies, and future studies should use outcomes suggested by clinical experience. Body points and electroacupuncture, used in the original clinical observation, justify further research.

Laser Acupuncture for Neonatal Abstinence Syndrome: A Randomized Controlled Trial

“…10,11 This combination also alleviated side effects of opioid agonist. 10,11,12 Clinicians have treated NAS with a variety of opioid preparations. 49 In addition to opioid therapy, several other medications are in use as adjunctive therapy, such as clonidine and phenobarbital.…”

“…Acupuncture at LI 4 is well established as effective against pain in children, 47 and shorter periods of crying due to better relaxation are reported in newborns with colic receiving acupuncture at LI 4. 43,48 Wen and Cheung 7 originally discovered the effect of acupuncture using auricular and body acupuncture points 10 in adults, and the best results of acupuncture treatment of opiate addiction are documented in randomized controlled clinical trials when acupuncture is combined with an opioid agonist that significantly decreases the dosage of methadone needed to allay withdrawal symptoms. 10,11 This combination also alleviated side effects of opioid agonist.…”

“…43,48 Wen and Cheung 7 originally discovered the effect of acupuncture using auricular and body acupuncture points 10 in adults, and the best results of acupuncture treatment of opiate addiction are documented in randomized controlled clinical trials when acupuncture is combined with an opioid agonist that significantly decreases the dosage of methadone needed to allay withdrawal symptoms. 10,11 This combination also alleviated side effects of opioid agonist. 10,11,12 Clinicians have treated NAS with a variety of opioid preparations.…”

“…8,9 A recent review of 48 clinical trials on acupuncture treatment of alcohol, cocaine, nicotine, and opioid dependence demonstrated positive results for the reduction of craving and withdrawal symptoms. 10 Several randomized controlled clinical trials reported that acupuncture combined with an opioid agonist significantly decreased the dosage of methadone needed to allay withdrawal symptoms, 11 alleviated side effects of the opioid agonist, 11,12 and has the potential to significantly modulate several measures of mood and anxiety. 10,13 Our current understanding of the mechanisms of acupuncture suggests a relevant role in the neurophysiology of dependence: acupuncture increases the levels of endomorphin 1, b-endorphin, encephalin, and serotonin in plasma and brain tissue and causes analgesia and sedation.…”

“…10 Several randomized controlled clinical trials reported that acupuncture combined with an opioid agonist significantly decreased the dosage of methadone needed to allay withdrawal symptoms, 11 alleviated side effects of the opioid agonist, 11,12 and has the potential to significantly modulate several measures of mood and anxiety. 10,13 Our current understanding of the mechanisms of acupuncture suggests a relevant role in the neurophysiology of dependence: acupuncture increases the levels of endomorphin 1, b-endorphin, encephalin, and serotonin in plasma and brain tissue and causes analgesia and sedation. 14 Illicit drugs stimulate dopamine release, and withdrawal leads to low levels of dopamine, 15 inducing cravings and withdrawal symptoms.…”