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Acupuncture and Addictions   

       By: Sheria Washington

 

 

 

 

 

What is Acupuncture?

 

            Acupuncture is part of traditional Chinese medicine that has been in existence for many centuries. It can be traced back for at least 2, 500 years. It involves the insertion of tiny needles into various points in the body. Each point represents a pattern of energy, which flows throughout the body in order to maintain health. Acupuncture describes a series of procedures that involve the stimulation of these points by various techniques

(http://my.webmd.com/content/article/1680.50247).

 

            History of Acupuncture in Treating Addiction

 

            A Chinese doctor named H.L. Wen, M.D, first discovered acupuncture. He used electro-acupuncture on a patient suffering from the withdrawal symptoms of opium. After the treatment, the patient reported that his symptoms had disappeared. Then Wen searched for other people suffering from withdrawal. He also used electro-acupuncture on these patients. Their symptoms disappeared; thus the birth of acupuncture for addictions (http://www.acupuncture.com/Acup/Addict.htm).

 

                                    The Principles of Acupuncture

 

            The basic principles of acupuncture revolve around the life force called Qi, (“chee”). Qi is considered the energy that allows one to live. It consists of spiritual, physical, mental, and emotional aspects of life that are essential. It flows through the body in invisible channels called meridians, in order to regulate mental and physical processes. The meridians run deeply within the body. This meridian system is like water irrigating land, which feeds and provides nourishment in order to sustain a healthy life. The meridians surface the body at 360 points, called acupoints. These points coincide with different organs within the body. These points are said act on many spheres all at once. They act on the bioelectrical field of energy, nervous system, and circulation of blood and other bodily fluids. By stimulating these points, Qi is balanced and restored to flow.

The concept of Yin-Yang, opposing forces, also plays a major role within acupuncture. In a healthy person, the yin and the yang are balanced, which allows Qi to flow properly. In a person stricken with illness, the yin dominates the yang, thus causing disease. The concept of Yin and Yang are important because they are interrelated. Within Yin, there is Yang, and vice versa. Yin symbolizes female attributes, while Yang represents male. A human is composed of both Yin (mother) and Yang (father), thus combining these opposing forces (http://www.acupuncture.com/Acup/Acupuncture.htm). The principle of acupuncture is that the insertion of various needles, will adjust the energy potentials of that specific point, thus causing a domino effect on the entire system. This effect will eventually balance the yin and yang (http://health.yahoo.com/health/alternative_medicine/alternative_therapies/Acupuncture).

There are eight principles that are essential to acupuncture. The primary base, Yin and Yang, represent negative and positive energy respectively. Li, meaning internal, and Piao, meaning external, classify and indicate the site and the extent of a certain disease. Han, meaning cold, and Je, meaning hot, denote the nature of the disease. Hsu, meaning empty, and Shih, meaning full, differentiate the extent and seriousness of the disease and the body’s resistance (http://www.rosedaleclinic.co.uk/acupuncture.shtml).

 

Claims of Acupuncture for Addictions

 

Many people believe that acupuncture can help those trying to recover from drug and alcohol problems. It is said that acupuncture can reduce the physical symptoms of withdrawal, such as cravings, body aches, sweating, nausea, etc., relieve tension, depression, and insomnia, and help people relax. It is claimed that acupuncture can quickly restore the body to mental and physical stability, as well as, give a new level of comfort. It is also said that acupuncture can be safely used with any other health condition, doesn’t utilize addictive drugs for treatment, can be successfully done on an outpatient basis, and is successful in drug detoxification programs throughout the United States and other countries (http://www.acupuncture.com/Acup/Addict.htm).

            Many substance abuse programs have instituted acupuncture into their treatment programs. The Underground Railroad – Chemical Dependency Program, is an acupuncture-based program, which combines acupuncture with traditional treatment methods. In traditional drug treatment programs, there was a 20-30% completion rate, but when acupuncture was added to this treatment, there was a 60-65% completion rate. They claim that acupuncture restores rational thinking and a general sense of well-being and makes it possible for the patient to accept the benefits of support groups and psychotherapy (http://www.underground-rr.org).

 

                                    How Does Acupuncture Work?

 

            Despite the numerous research endeavors, how acupuncture really works is yet to be known. Scientists believe that the acupoints are capable of transmitting messages down numerous nerve pathways, thus instituting change in the body. Five needles are inserted in each ear for 45 minutes. It is asked that the patient relax and mediate on changes to be made in their life (http://www.acupuncture.com/Acup/Addict.htm). The needles are then stimulated to obtain a “needling sensation”. The needles are slightly moved while in the skin, and a sensation is experienced. This sensation will be a dull, numb feeling in that particular area. The sensation may travel through the channels, thus affecting other areas of the body. Sometimes electrical stimulators are used to excite the points (http://www.healthy.net/asp/templates/article.asp?ID=1818).

            There are many theories as to how acupuncture really works. The first theory is called The Augmentation of Immunity Theory. It suggests that by an unknown process, acupuncture is able to raise the level of triglicerides, hormones, prostagladins, white blood cells, and antibodies throughout the body. When this occurs, the body is then able to “heal” itself. Another theory, called The Endorphin Theory suggests that acupuncture stimulates an increased secretion of endorphins, which promotes “healing”. The Circulatory Theory states that acupuncture is able to constrict or dilate the blood vessels throughout the body, by the release of histamine. The most popular theory is called The Gate Control Theory. It suggests that pain and/or disease is perceived and controlled by a part in the nervous system. This part is called the “Gate”. When the gate has an overwhelming amount of impulses striking it, it closes, which prevents some impulses from going through. This causes the body to be stricken with disease. The smallest gates close first, which are C nerve fibers. These gates are closed and then reopened by acupuncture (http://www.acupuncture.com/Acup/Acupuncture.htm ).

 

How Acupuncture Works On Specific Addictions

Smoking

            Acupuncturists are most commonly called upon to treat smoking. Quitting smoking is a troublesome process because of the unbearable symptoms, such as mental stress and depression, and because of the nicotine withdrawal syndrome. The treatment for smokers is to stimulate the acupoints that are capable of transmitting messages to the brain, and instituting changes in the “chemistry of the appetite”. Because nicotine is addictive, the encephalin or brain messengers make space for it and allow it to become a necessary part of the chemical balance in the brain. Thus by removing it suddenly, the chemistry of the brain is thrown into shock and withdrawal symptoms occur. However, acupuncture does not suddenly strip the brain of addictive substances. It, in fact, rebalances the brain by sending messages to the brain as if the patient were a non-smoker. This rebalances the chemistry and restores normal conditions in order to avoid the harsh withdrawal symptoms (http://www.rosedaleclinic.co.uk/acupuncture.shtml).

 

Alcohol and Other Drugs

            Acupuncture helps the body to detoxify itself and restore proper blood circulation. During the detoxification process, the body filters out the harmful toxins that it has stored in various organs.  Acupoints are associated with specific organs, thus allowing the body to detoxify itself without the typical withdrawal symptoms (http://www.acupuncture.com/Acup/Addict.htm).  Other drugs such as Heroin, Cocaine, etc., alter the chemistry brain on a higher level. With diligence, along with support programs, these addictions can be balanced by a series of electro-acupuncture treatments. The treatment series for these types of addictions are more intense and require more treatments (http://www.rosedaleclinic.co.uk/acupuncture.shtml).

 

                                                Side Effects of Acupuncture

           

            Although acupuncture has no inherent side effects, there are many instances where acupuncture should not be used. People with heart valve disease, bleeding disorders, or who use certain medications should not use acupuncture. People with pacemakers, irregular heartbeat, epilepsy, or pregnant women should not use electro-acupuncture. Acupuncture is generally a safe procedure in the hands of a safe acupuncturist. Sometimes, however, there is minor bruising and temporary symptoms that are not common. Serious side effects with acupuncture are rare. Most of the complications occurred because of the acupuncturist’s negligence. In the United States, there have been 9 complaints in the last 20 years. Some of the serious complications include; hepatitis B, HIV, serious bacterial infections due to non-sterile needles, damage to internal organs, abortion, convulsions, and hemorrhaging (http://my.webmd.com/content/article/1680.50248). Although these complications do not occur vastly, it is very important to find a skilled, reputable acupuncturist.

 

                                                Studies on Acupuncture and Addictions

 

            The studies on acupuncture in treating certain addictions seem to be questionable. The first problem that was encountered was that most of the studies are not published in many mainstream journals. The studies that were done and published, seemed to have many confounding variables, along with biased data. These studies primarily showed the uncertainty of many scientists. They also showed how many of the claims about acupuncture are not necessarily accurate and true.

One of the earliest published studies on acupuncture in treating addiction was in 1974. A study was done in Hong Kong, which assessed the withdrawal symptoms of many addicted patients. These patients were addicted to marijuana, alcohol, opium, and many other drugs. Acupuncture needles were inserted in the ear of each patient and electricity was added to each point. The treatment was repeated and the withdrawal symptoms were evaluated. After two months of treatment and clean urine samples, the patient was declared cured. Many patients were considered “cured”, but specific percentages were not given (Lancet, 1974).

            In a Yale study, acupuncture was used to treat people that were addicted to both heroin and cocaine. These people received methadone for the heroin addiction and counseling, in addition to acupuncture. The results showed that 55% of the people who received acupuncture treatment tested drug-free by the conclusion of the study, in comparison to the 23% who received a “sham acupuncture” and the 9% who watched relaxing videos (http://www.underground-rr.org).

            In another study conducted by Yale University, a randomized controlled study was done in order to evaluate the effectiveness of auricular acupuncture. In this study, 82 cocaine addicted people were randomly assigned to one of three treatments. These treatments were; auricular acupuncture, needle-insertion control conditions, or no-needle relaxation control. The treatment was given 5 times a week for 8 weeks and using urine testing assessed the use of cocaine. The results of this study found that the patients that received acupuncture were significantly more likely to have no trace of cocaine in their urine samples in relation to the other control groups. Although the results sound promising, researchers concluded that acupuncture showed promise in treating cocaine dependence, but further investigation was needed (Archives of Internal Med, 2000).

            A study at the University of California, San Francisco, was done in order to assess “the efficacy of acupuncture as a treatment modality”. In this single-blind, controlled study, 100 heroin addicts were randomly assigned to auricular acupuncture and a “sham” acupuncture. The results showed that attrition was high for both groups and that the attendance of the patients varied inversely with the self-reports of drug use. This study was inconclusive because of the limitations on it. Those who received the real acupuncture attended treatment more, than those who received the “sham” treatment. The scientists suggested that those who had lighter habits found this treatment more helpful (Journal of Substance Abuse Treatment, 1993).

            In order to contradict many of the claims about acupuncture, a study was done at Emory University. This single-blind study of auricular acupuncture was evaluated on 36 cocaine-dependant veterans. The scientist assessed whether the treatment was able to reduce cravings, increase treatment retention, and prevent relapse. Acupuncture was given to both the treatment and control groups. The results failed to show a significant difference between the treatment and control groups. They did conclude that the patients who received acupuncture did stay in treatment longer than a retrospectively analyzed group who received no auricular acupuncture (American Journal of Addictions, 1998).

            Another randomized, single-blind, placebo controlled study was done in order to assess auricular acupuncture in 236 cocaine addicts. These people were randomly assigned to auricular acupuncture, a “sham” treatment, and conventional treatment without acupuncture. The treatment was given at regular times for many weeks. After assessing each patient, the scientists concluded that with rare exceptions, the data was not able to identify significant treatment differences among the real auricular acupuncture, the “sham” treatment, and the treatment without acupuncture (Journal of Substance Abuse Treatment, 1999).

            Other studies have evaluated the effectiveness of acupuncture along with other herbs and medicines. A study was done to assess the effects of acupuncture in combination with herbs and opioid peptides. The study was done on 119 morphine addicted rats.  The study concluded that acupuncture along with herbs, being non-opiated, might be used as a supplementary treatment on morphine addiction (American Journal of Chinese Medicine, 1986). A similar study was done to evaluate acupuncture along with pharmaceuticals and vitamins. In this study only 2 patients were used, a man and a woman, both addicted to cocaine. Both patients had relapses, but remained drug-free for an extended time. The downfall to this study was that one of the patients was lost to follow-up. The scientists concluded that acupuncture, vitamins, and medications are all necessary in order to detoxify an addicted patient (www.medicalacupuncture.org/aama_marf/journal/vol12_1/addiction.html).

Another study treated patients addicted to smoking. They took 52 patients, 24 females and 28 males, with the longest smoking history being 40 years to the shortest being 1 year. They also took into account the amount of cigarettes consumed in a day. They selected various bilateral acupoints and inserted the needles and stimulated each point with electric pulses. The results showed that of the 52 patients studied, “37 smokers quit smoking after 3 to 5 treatments; 10 smokers reduced smoking after 4 to 5 sessions; only 5 smokers kept smoking even after 6 sessions of treatment” (http://www.acuhealing.com/clinicreports/smoking.htm).

            Many courts in the United States are adopting acupuncture as a means of treating addictions. The Shelby County Criminal Court adopted acupuncture and reported that acupuncture helped many addicts, by reducing their urges and cravings for drugs. Studies in Florida and California found that first time drug offenders that were treated with acupuncture “had only a 3% recidivism rate”. They also noticed that the inmates receiving acupuncture were less violent (http://memphis.bcentral.com/memphis/stories/2001/05/28/story4.html).

 

                                                            Conclusion

 

            Acupuncture as a means of therapeutic intervention has become widely used across the United States. The studies show its potential usefulness, but there are many confounding variables. Although this treatment seems to provide an adequate means of treating various addictions, there are many controversial issues surrounding acupuncture. There are also many limitations placed on each study. Research concerning the effectiveness of acupuncture is difficult and at times impossible. Although there have been promising results in a lot of the studies, contradiction was also found. Acupuncture seems to have potential, in most cases, to reduce withdrawal symptoms and promote a chemical balance in the body, but this is not certain. As of today, a definite scientific explanation as to “why acupuncture works” does not exist. This uncertainty warrants further investigation into acupuncture’s physiological and clinical value. I believe that there is a lot of significant evidence of acupuncture’s ability to expand traditional medicine, but I also think that more studies are needed. 

 


                                                            References

 

Avants, S.K., Margolin, A., Holford, T.R., & Kosten, T.R. (2000). A Randomized Controlled Trial of Auricular Acupuncture for Cocaine Dependence. Archives of Internal Medicine. Aug 14-28; 160.

 

Bullock, M.L., Kiresuk, T.J., Pheley, A.M., Culliton, P.D., & Lenz, S.K. (1999). Auricular Acupuncture in the Treatment of Cocaine Abuse. A Study of Efficacy and Dosing. Journal of Substance Abuse Treatment. 16(1):31-38.

 

Otto, K.C., Quinn, C., & Sung, Y.F. (1998). Auricular Acupuncture as an Adjunctive Treatment for Cocaine Addiction. A Pilot Study. American Journal of Addictions. 7(2): 164-170.

 

Tseung, Y.K. (1974). Acupuncture for Drug Addiction. The Lancet. 2(7884):839.

 

Washburn, A.M., Fullilove, R.E., Fullilove, M.T., Keenan, P.A., McGee, B., Morris, K.A., Sorensen, J.L., & Clark, W.W. (1993). Acupuncture Heroin Detoxification: A Single-Blind Clinical Trial. Journal of Substance Abuse Treatment. 10(4):345-351.

 

Yang, M.M., & Kwork, J.S. (1986). Evaluation on the Treatment of Morphine Addiction by Acupuncture, Chinese Herbs and Opioid Peptides. American Journal of Chinese Medicine. 14(1-2):46-50.

 

 

        

 

           

 

 

 

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