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Cocaine Addicts Get Help From the Needle

Cocaine addicts looking to get clean may want to turn to needles for help.

A new study by Yale University researchers says acupuncture is an effective treatment for cocaine abuse. The finding gives the ancient Chinese remedy a much-needed foothold in Western medicine, experts say, because it’s based on a well-controlled clinical study from a major American medical school. A report on the finding appears in the latest issue of the Archives of Internal Medicine.

Although the work might be the first large, controlled trial of acupuncture for cocaine addiction, it’s not the first time anyone has used the treatment for substance abuse. Indeed, some 1,000 clinics worldwide offer the needle therapy for the symptoms of cocaine withdrawal, including nearly 175 in New York state alone, says Dr. Michael Smith, a pioneer in the field.

Smith, a Cornell University psychiatrist who has been practicing acupuncture at Lincoln Hospital in the Bronx for nearly two decades, calls the Yale research “a very well-documented report with high standards that shows that acupuncture helps reduce the craving for cocaine.”

The study, led by Yale psychologist Arthur Margolin, looked at the effectiveness of acupuncture in 82 heroin and cocaine addicts who were getting methadone for the first habit but nothing for the second.

Margolin and his colleagues split the subjects into three groups. The first received eight weeks of standard addiction acupuncture therapy, based on guidelines from the National Acupuncture Detoxification Association, which calls for three to five needles placed at specific points in the outer ear. The second group had sham needles placed in non-therapeutic sites on the ear. The third group watched relaxing videos.

Urine tests for cocaine were taken three times a week over the trial’s two-month period, during which all patients received counseling and group therapy.

By the last week of the trial, nearly 54 percent of the patients in the acupuncture group had cocaine-free urine, compared with 23 percent of those in the sham needle group and only 9 percent of those who watched videos.

“This was a highly active placebo arm and we still found an effect over and above that,” says Margolin, who notes that the effect of acupuncture was as good as that from drug treatment for cocaine addiction.

How it works still a mystery

While the latest work suggests that acupuncture helps control cravings for cocaine, it doesn’t say anything about why it succeeds. “Quite honestly, we don’t know why it works,” Margolin says. “We’re just beginning to look in Western terms” at the biological mechanism behind acupuncture’s effect.

Smith, however, says tests show that the needles, if properly placed, restore balance to the body’s electrical currents. “Acupuncture helps the body help itself.” Still, he admits, no one really understands the full mechanics of this assistance.

Whatever the reason, Margolin and Smith agree that acupuncture alone isn’t a sufficient treatment for addiction, be it to cocaine, alcohol, tobacco or other substances.

“This is a treatment that helps a person participate in all the other treatments we have,” such as counseling and group therapy, Smith says. In fact, by law, ear acupuncture for addicts can only be performed in the context of a licensed drug-treatment program that includes these other methods, he says.

However, acupuncture does have a key advantage over counseling, Smith says. If addicts refuse to acknowledge their drug cravings, therapists have little recourse to treat them. But with acupuncture, he says, addicts can get treated without losing face. “You can treat a problem that the patient doesn’t admit to.”

Barbara Mitchell, a licensed acupuncturist and executive director of the Acupuncture and Oriental Medicine Alliance in Olalla, Wash., says the Yale research lends an extra measure of credibility to the practice. On the other hand, Mitchell says, with an estimated 15,000 licensed acupuncturists in the United States already, the field is well on its way to becoming mainstream.

Many insurance companies now reimburse for the treatment, which got a major shot in the arm in 1997 when the National Institutes of Health held a consensus conference to discuss the scientific validity of needle therapy. That report found that acupuncture helped control pain from dental procedures, menstruation and other conditions, with fewer side effects than conventional remedies, Mitchell says.

What To Do

To learn more about the use of acupuncture for addiction, try the National Acupuncture Detoxification Association.

For more on the practice in general, visit the Medical Acupuncture Web Page.

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